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Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study
OBJECTIVES: Understanding quality of contraceptive care from clients’ perspectives is critical to ensuring acceptable and non-harmful services, yet little qualitative research has been dedicated to this topic. India’s history of using incentives to promote contraceptive use, combined with reports of...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491289/ https://www.ncbi.nlm.nih.gov/pubmed/34607862 http://dx.doi.org/10.1136/bmjopen-2021-049260 |
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author | Holt, Kelsey Uttekar, Bella Vasant Reed, Reiley Adams, Madeline Kanchan, Lakhwani Langer, Ana Barge, Sandhya |
author_facet | Holt, Kelsey Uttekar, Bella Vasant Reed, Reiley Adams, Madeline Kanchan, Lakhwani Langer, Ana Barge, Sandhya |
author_sort | Holt, Kelsey |
collection | PubMed |
description | OBJECTIVES: Understanding quality of contraceptive care from clients’ perspectives is critical to ensuring acceptable and non-harmful services, yet little qualitative research has been dedicated to this topic. India’s history of using incentives to promote contraceptive use, combined with reports of unsafe conditions in sterilisation camps, make a focus on quality important. The study objective was to understand women’s experiences with and preferences for contraceptive counselling and care in the public sector in India. DESIGN: Qualitative study using eight focus group discussions (FGDs). FGDs were thematically analysed using a framework approach. SETTING: Rural and urban areas in one district in Gujarat. PARTICIPANTS: 31 sterilisation and 42 reversible contraceptive users who were married and represented different backgrounds. Inclusion criteria were: (1) female, (2) at least 18 years and (3) receipt of contraception services in the last 6 months from public health services. RESULTS: Providers motivate married women to use contraception and guide women to specific methods based on how many children they have. Participants found this common practice acceptable. Participants also discussed the lack of counselling about reversible and permanent options and expressed a need for more information on side effects of reversible methods. There were mixed opinions about whether compensation received for accepting long-term methods affects contraceptive decision making. While many women were satisfied with their experiences, we identified minor themes related to provider coercion towards provider-controlled methods and disrespectful and abusive treatment during sterilisation care, both of which require concerted efforts to address systemic factors enabling such experiences. CONCLUSIONS: Findings illuminate opportunities for quality improvement as we identified several gaps between how women experience contraceptive care and their preferences, and with ideals of quality and rights frameworks. Findings informed adaptation of the Quality of Contraceptive Counselling Scale for India, and have implications for centring quality and rights in global efforts. |
format | Online Article Text |
id | pubmed-8491289 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-84912892021-10-14 Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study Holt, Kelsey Uttekar, Bella Vasant Reed, Reiley Adams, Madeline Kanchan, Lakhwani Langer, Ana Barge, Sandhya BMJ Open Global Health OBJECTIVES: Understanding quality of contraceptive care from clients’ perspectives is critical to ensuring acceptable and non-harmful services, yet little qualitative research has been dedicated to this topic. India’s history of using incentives to promote contraceptive use, combined with reports of unsafe conditions in sterilisation camps, make a focus on quality important. The study objective was to understand women’s experiences with and preferences for contraceptive counselling and care in the public sector in India. DESIGN: Qualitative study using eight focus group discussions (FGDs). FGDs were thematically analysed using a framework approach. SETTING: Rural and urban areas in one district in Gujarat. PARTICIPANTS: 31 sterilisation and 42 reversible contraceptive users who were married and represented different backgrounds. Inclusion criteria were: (1) female, (2) at least 18 years and (3) receipt of contraception services in the last 6 months from public health services. RESULTS: Providers motivate married women to use contraception and guide women to specific methods based on how many children they have. Participants found this common practice acceptable. Participants also discussed the lack of counselling about reversible and permanent options and expressed a need for more information on side effects of reversible methods. There were mixed opinions about whether compensation received for accepting long-term methods affects contraceptive decision making. While many women were satisfied with their experiences, we identified minor themes related to provider coercion towards provider-controlled methods and disrespectful and abusive treatment during sterilisation care, both of which require concerted efforts to address systemic factors enabling such experiences. CONCLUSIONS: Findings illuminate opportunities for quality improvement as we identified several gaps between how women experience contraceptive care and their preferences, and with ideals of quality and rights frameworks. Findings informed adaptation of the Quality of Contraceptive Counselling Scale for India, and have implications for centring quality and rights in global efforts. BMJ Publishing Group 2021-10-04 /pmc/articles/PMC8491289/ /pubmed/34607862 http://dx.doi.org/10.1136/bmjopen-2021-049260 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Global Health Holt, Kelsey Uttekar, Bella Vasant Reed, Reiley Adams, Madeline Kanchan, Lakhwani Langer, Ana Barge, Sandhya Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study |
title | Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study |
title_full | Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study |
title_fullStr | Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study |
title_full_unstemmed | Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study |
title_short | Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study |
title_sort | understanding quality of contraceptive services from women’s perspectives in gujarat, india: a focus group study |
topic | Global Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491289/ https://www.ncbi.nlm.nih.gov/pubmed/34607862 http://dx.doi.org/10.1136/bmjopen-2021-049260 |
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