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Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers

BACKGROUND: An estimated one-third of women in Ghana use contraceptives without the knowledge of their partners, a phenomenon known as Covert Contraceptive Use (CCU). Most research on CCU to date has focused on individual women to the neglect of the role of health system. This study explores CCU in...

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Autores principales: Kushitor, Mawuli, Henry, Elizabeth G., Obeng-Dwamena, Akua Danquah, Agyekum, Martin Wiredu, Agula, Caesar, Toprah, Theophilus, Shah, Iqbal, Bawah, Ayaga A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9636747/
https://www.ncbi.nlm.nih.gov/pubmed/36333714
http://dx.doi.org/10.1186/s12978-022-01516-5
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author Kushitor, Mawuli
Henry, Elizabeth G.
Obeng-Dwamena, Akua Danquah
Agyekum, Martin Wiredu
Agula, Caesar
Toprah, Theophilus
Shah, Iqbal
Bawah, Ayaga A.
author_facet Kushitor, Mawuli
Henry, Elizabeth G.
Obeng-Dwamena, Akua Danquah
Agyekum, Martin Wiredu
Agula, Caesar
Toprah, Theophilus
Shah, Iqbal
Bawah, Ayaga A.
author_sort Kushitor, Mawuli
collection PubMed
description BACKGROUND: An estimated one-third of women in Ghana use contraceptives without the knowledge of their partners, a phenomenon known as Covert Contraceptive Use (CCU). Most research on CCU to date has focused on individual women to the neglect of the role of health system. This study explores CCU in urban poor communities of Accra, Ghana, from the experiences and perspectives of health providers. METHODS: Qualitative in-depth interviews were conducted with health care providers in both the public and private sectors at multiple levels, from the community clinic to the tertiary hospital, to gain insights into the strategies women use and the ways in which the health system supports the practice of CCU. RESULTS: Five major thematic areas emerged: use of easily concealed-methods, discrete-access-and-information-keeping, time-of-day, non-verbal-communication and use of relationships. The study further revealed that fear, mistrust, shyness, myths, and misperceptions regarding contraceptives explain CCU among women in the communities that the providers serve. CONCLUSION: Importantly, disclosure of methods used by providers without women’s consent could potentially lead to violent outcomes for both women and the providers. Our results highlight the pivotal role that providers play in confidentially supporting women’s choices regarding the use of contraceptives.
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spelling pubmed-96367472022-11-06 Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers Kushitor, Mawuli Henry, Elizabeth G. Obeng-Dwamena, Akua Danquah Agyekum, Martin Wiredu Agula, Caesar Toprah, Theophilus Shah, Iqbal Bawah, Ayaga A. Reprod Health Research BACKGROUND: An estimated one-third of women in Ghana use contraceptives without the knowledge of their partners, a phenomenon known as Covert Contraceptive Use (CCU). Most research on CCU to date has focused on individual women to the neglect of the role of health system. This study explores CCU in urban poor communities of Accra, Ghana, from the experiences and perspectives of health providers. METHODS: Qualitative in-depth interviews were conducted with health care providers in both the public and private sectors at multiple levels, from the community clinic to the tertiary hospital, to gain insights into the strategies women use and the ways in which the health system supports the practice of CCU. RESULTS: Five major thematic areas emerged: use of easily concealed-methods, discrete-access-and-information-keeping, time-of-day, non-verbal-communication and use of relationships. The study further revealed that fear, mistrust, shyness, myths, and misperceptions regarding contraceptives explain CCU among women in the communities that the providers serve. CONCLUSION: Importantly, disclosure of methods used by providers without women’s consent could potentially lead to violent outcomes for both women and the providers. Our results highlight the pivotal role that providers play in confidentially supporting women’s choices regarding the use of contraceptives. BioMed Central 2022-11-04 /pmc/articles/PMC9636747/ /pubmed/36333714 http://dx.doi.org/10.1186/s12978-022-01516-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kushitor, Mawuli
Henry, Elizabeth G.
Obeng-Dwamena, Akua Danquah
Agyekum, Martin Wiredu
Agula, Caesar
Toprah, Theophilus
Shah, Iqbal
Bawah, Ayaga A.
Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers
title Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers
title_full Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers
title_fullStr Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers
title_full_unstemmed Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers
title_short Covert Contraceptive Use amongst the urban poor in Accra, Ghana: experiences of health providers
title_sort covert contraceptive use amongst the urban poor in accra, ghana: experiences of health providers
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9636747/
https://www.ncbi.nlm.nih.gov/pubmed/36333714
http://dx.doi.org/10.1186/s12978-022-01516-5
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