Barriers to Modern Contraceptive Use in Kinshasa, DRC

• Published in: PloS one Vol. 11; no. 12; p. e0167560
• Main Authors: Muanda, Mbadu, Gahungu Ndongo, Parfait, Taub, Leah D, Bertrand, Jane T
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.12.2016; Public Library of Science (PLoS)
• Subjects: Adult; Analysis; Biology and Life Sciences; Birth control; Cities; Contraception; Contraception - economics; Contraception - psychology; Contraception - statistics & numerical data; Contraception Behavior - psychology; Contraception Behavior - statistics & numerical data; Contraceptive Agents - economics; Contraceptive Agents - supply & distribution; Contraceptives; Decision making; Democratic Republic of the Congo; Family planning; Family Planning Services - education; Family Planning Services - ethics; Female; Focus Groups; Health care facilities; Health facilities; Health Knowledge, Attitudes, Practice; Health Services Accessibility - statistics & numerical data; Humans; Husbands; Male; Medicine and Health Sciences; Mens health; Methods; Norms; Occupational health; Perceptions; Population; Pregnancy; Public health; Qualitative research; Reproductive health; Research methodology; Side effects; Social aspects; Social Sciences; Spouses - education; Spouses - psychology; Sterility; Studies; Surveys; Surveys and Questionnaires; Unions; Vasectomy; Womens health; Workers; Sub-Saharan Africa; Louisiana; Uganda; Nigeria; Malawi; United States > US; Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0167560

Recent research from Kinshasa, DRC, has shown that only one in five married women uses modern contraception; over one quarter have an unmet need for family planning; and almost 400 health facilities across Kinshasa report that they provide modern contraception. This study addresses the question: with reasonable physical access and relatively high unmet need, why is modern contraceptive prevalence so low? To this end, the research team conducted 6 focus groups of women (non-users of any method, users of traditional methods, and users of modern methods) and 4 of husbands (of users of traditional methods and in non-user unions) in health zones with relatively strong physical access to FP services. Five key barriers emerged from the focus group discussions: fear of side effects (especially sterility), costs of the method, sociocultural norms (especially the dominant position of the male in family decision-making), pressure from family members to avoid modern contraception, and lack of information/misinformation. These findings are very similar to those from 12 other studies of sociocultural barriers to family planning in sub-Saharan Africa. Moreover, they have strong programmatic implications for the training of FP workers to counsel future clients and for the content of behavior change communication interventions.