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Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives

BACKGROUND: Unintended pregnancies lead to unsafe abortions, which are a leading cause of preventable maternal mortality among young women in Uganda. There is a discrepancy between the desire to prevent pregnancy and actual contraceptive use. Health care providers' perspectives on factors influ...

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Autores principales: Nalwadda, Gorrette, Mirembe, Florence, Tumwesigye, Nazarius M, Byamugisha, Josaphat, Faxelid, Elisabeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181204/
https://www.ncbi.nlm.nih.gov/pubmed/21923927
http://dx.doi.org/10.1186/1472-6963-11-220
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author Nalwadda, Gorrette
Mirembe, Florence
Tumwesigye, Nazarius M
Byamugisha, Josaphat
Faxelid, Elisabeth
author_facet Nalwadda, Gorrette
Mirembe, Florence
Tumwesigye, Nazarius M
Byamugisha, Josaphat
Faxelid, Elisabeth
author_sort Nalwadda, Gorrette
collection PubMed
description BACKGROUND: Unintended pregnancies lead to unsafe abortions, which are a leading cause of preventable maternal mortality among young women in Uganda. There is a discrepancy between the desire to prevent pregnancy and actual contraceptive use. Health care providers' perspectives on factors influencing contraceptive use and service provision to young people aged 15-24 in two rural districts in Uganda were explored. METHODS: Semi-structured questionnaires were used for face- to-face interviews with 102 providers of contraceptive service at public, private not-for-profit, and private for-profit health facilities in two rural districts in Uganda. Descriptive and inferential statistics were used in the analysis of data. RESULTS: Providers identified service delivery, provider-focused, structural, and client-specific factors that influence contraceptive use among young people. Contraceptive use and provision to young people were constrained by sporadic contraceptive stocks, poor service organization, and the limited number of trained personnel, high costs, and unfriendly service. Most providers were not competent enough to provide long-acting methods. There were significant differences in providers' self-rated competence by facility type; private for-profit providers' competence was limited for most contraceptives. Providers had misconceptions about contraceptives, they had negative attitudes towards the provision of contraceptives to young people, and they imposed non-evidence-based age restrictions and consent requirements. Thus, most providers were not prepared or were hesitant to give young people contraceptives. Short-acting methods were, however, considered acceptable for young married women and those with children. CONCLUSION: Provider, client, and health system factors restricted contraceptive provision and use for young people. Their contraceptive use prospects are dependent on provider behavior and health system improvements.
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spelling pubmed-31812042011-09-28 Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives Nalwadda, Gorrette Mirembe, Florence Tumwesigye, Nazarius M Byamugisha, Josaphat Faxelid, Elisabeth BMC Health Serv Res Research Article BACKGROUND: Unintended pregnancies lead to unsafe abortions, which are a leading cause of preventable maternal mortality among young women in Uganda. There is a discrepancy between the desire to prevent pregnancy and actual contraceptive use. Health care providers' perspectives on factors influencing contraceptive use and service provision to young people aged 15-24 in two rural districts in Uganda were explored. METHODS: Semi-structured questionnaires were used for face- to-face interviews with 102 providers of contraceptive service at public, private not-for-profit, and private for-profit health facilities in two rural districts in Uganda. Descriptive and inferential statistics were used in the analysis of data. RESULTS: Providers identified service delivery, provider-focused, structural, and client-specific factors that influence contraceptive use among young people. Contraceptive use and provision to young people were constrained by sporadic contraceptive stocks, poor service organization, and the limited number of trained personnel, high costs, and unfriendly service. Most providers were not competent enough to provide long-acting methods. There were significant differences in providers' self-rated competence by facility type; private for-profit providers' competence was limited for most contraceptives. Providers had misconceptions about contraceptives, they had negative attitudes towards the provision of contraceptives to young people, and they imposed non-evidence-based age restrictions and consent requirements. Thus, most providers were not prepared or were hesitant to give young people contraceptives. Short-acting methods were, however, considered acceptable for young married women and those with children. CONCLUSION: Provider, client, and health system factors restricted contraceptive provision and use for young people. Their contraceptive use prospects are dependent on provider behavior and health system improvements. BioMed Central 2011-09-17 /pmc/articles/PMC3181204/ /pubmed/21923927 http://dx.doi.org/10.1186/1472-6963-11-220 Text en Copyright ©2011 Nalwadda et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Nalwadda, Gorrette
Mirembe, Florence
Tumwesigye, Nazarius M
Byamugisha, Josaphat
Faxelid, Elisabeth
Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives
title Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives
title_full Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives
title_fullStr Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives
title_full_unstemmed Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives
title_short Constraints and prospects for contraceptive service provision to young people in Uganda: providers' perspectives
title_sort constraints and prospects for contraceptive service provision to young people in uganda: providers' perspectives
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181204/
https://www.ncbi.nlm.nih.gov/pubmed/21923927
http://dx.doi.org/10.1186/1472-6963-11-220
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