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The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study

Family planning (FP) has been a global health priority for decades, yet barriers persist, including women being turned away from facilities without receiving services. This study assessed the provider role and perspective in client turnaway in three districts of Malawi. In 2019, data collectors surv...

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Autores principales: Peterson, Jill M., Bendabenda, Jaden, Mboma, Alexander, Chen, Mario, Stanback, John, Gunnlaugsson, Geir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910402/
https://www.ncbi.nlm.nih.gov/pubmed/35270771
http://dx.doi.org/10.3390/ijerph19053076
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author Peterson, Jill M.
Bendabenda, Jaden
Mboma, Alexander
Chen, Mario
Stanback, John
Gunnlaugsson, Geir
author_facet Peterson, Jill M.
Bendabenda, Jaden
Mboma, Alexander
Chen, Mario
Stanback, John
Gunnlaugsson, Geir
author_sort Peterson, Jill M.
collection PubMed
description Family planning (FP) has been a global health priority for decades, yet barriers persist, including women being turned away from facilities without receiving services. This study assessed the provider role and perspective in client turnaway in three districts of Malawi. In 2019, data collectors surveyed 57 FP providers from 30 health facilities. All reported being comfortable providing FP to married women with children and married adolescents under 18 years old with children, whereas 12% of the providers expressed discomfort providing such services to married adolescents under 18 without children. Sixty percent of the providers required clients desiring FP and wishing to initiate oral contraceptives or injectables to be currently menstruating. Data collectors later conducted in-depth interviews (IDIs) with 8 of the 57 providers about client turnaway. During IDIs, providers’ most frequently mentioned reasons for turnaway was client pregnancy or suspicion of pregnancy. Providers expressed fears that initiating FP with a pregnant woman could cause community mistrust in the efficacy of modern contraception. Provider support for FP waned for nulliparous clients, regardless of age or marital status. To improve FP services in Malawi, providers need continuous education on all available methods of FP, a reduction in stockouts and programs to further sensitize the community to how contraception works. Understanding how Malawi has helped providers overcome social and cultural norms regarding provision of FP to adolescents might help other countries to make improvements.
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spelling pubmed-89104022022-03-11 The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study Peterson, Jill M. Bendabenda, Jaden Mboma, Alexander Chen, Mario Stanback, John Gunnlaugsson, Geir Int J Environ Res Public Health Article Family planning (FP) has been a global health priority for decades, yet barriers persist, including women being turned away from facilities without receiving services. This study assessed the provider role and perspective in client turnaway in three districts of Malawi. In 2019, data collectors surveyed 57 FP providers from 30 health facilities. All reported being comfortable providing FP to married women with children and married adolescents under 18 years old with children, whereas 12% of the providers expressed discomfort providing such services to married adolescents under 18 without children. Sixty percent of the providers required clients desiring FP and wishing to initiate oral contraceptives or injectables to be currently menstruating. Data collectors later conducted in-depth interviews (IDIs) with 8 of the 57 providers about client turnaway. During IDIs, providers’ most frequently mentioned reasons for turnaway was client pregnancy or suspicion of pregnancy. Providers expressed fears that initiating FP with a pregnant woman could cause community mistrust in the efficacy of modern contraception. Provider support for FP waned for nulliparous clients, regardless of age or marital status. To improve FP services in Malawi, providers need continuous education on all available methods of FP, a reduction in stockouts and programs to further sensitize the community to how contraception works. Understanding how Malawi has helped providers overcome social and cultural norms regarding provision of FP to adolescents might help other countries to make improvements. MDPI 2022-03-05 /pmc/articles/PMC8910402/ /pubmed/35270771 http://dx.doi.org/10.3390/ijerph19053076 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Peterson, Jill M.
Bendabenda, Jaden
Mboma, Alexander
Chen, Mario
Stanback, John
Gunnlaugsson, Geir
The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study
title The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study
title_full The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study
title_fullStr The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study
title_full_unstemmed The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study
title_short The Provider Role and Perspective in the Denial of Family Planning Services to Women in Malawi: A Mixed-Methods Study
title_sort provider role and perspective in the denial of family planning services to women in malawi: a mixed-methods study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8910402/
https://www.ncbi.nlm.nih.gov/pubmed/35270771
http://dx.doi.org/10.3390/ijerph19053076
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