Results of a field study in seven countries exploring the reasons for low contraceptive use

• Published in: The European journal of contraception & reproductive health care Vol. 17; p. S150
• Main Author: Vandewiele, M
• Format: Journal Article
• Language: English
• Published: Carnforth Taylor & Francis Ltd 01.06.2012
• Subjects: Birth control; Condoms; Family planning; Field study; Focus groups; Young adults; Eastern Europe; Central Asia
• ISSN: 1362-5187; 1473-0782

Modern contraceptive use is alarmingly low in many countries of Eastern Europe and Central Asia. A study in seven countries (Armenia, Azerbaijan, Bosnia-Herzegovina, Bulgaria, Kazakhstan, FYR Macedonia and Serbia) was carried out to explore the reasons of these low rates. The study focused on perspective of the client and his/her reasons for (not) using modern contraception. In each country, ten focus group discussions were organised with: Married and unmarried boys and girls, married and unmarried women and men both from rural and urban areas; and with two selected vulnerable groups. Semi-structured interviews with key community and health informants and with donors, pharmaceutical companies, key institutions and policymakers (up to 25 per country) were also held. Six key issues were identified as being the main cross-country factors influencing contraceptive behaviour, demand and access: An overarching factor is the (lack of) commitment of policy-makers and government actors to contraceptive security; a top factor is the provider, who is viewed by (potential) clients as a trustworthy source of information and service for family planning - but at the same time is not always passing on correct and up-to-date information on FP, thus being a major source of misinformation - often confirming myths; in general, there is huge misinformation and distrust towards modern (hormonal) methods of contraception, fuelled by misinformation and myths; gender and socio-cultural issues were a fourth important factor that influences contraceptive choice in these countries; cost/affordability was a factor particularly present in Kazakhstan, where modern methods of contraceptives are relatively expensive. In other countries, it was not the top-factor, except for pockets of populations, such as Roma and young people. Condoms are expensive though. There are also factors adding on to cost, such as unnecessary tests and services; a limited range of modern methods is available on the market in these countries. It is mainly limited to condoms, pills and IUDs. Young people face particular barriers limiting their access to FP. Efforts to increase modern contraceptive use in Eastern Europe and Central Asia should primarily focus on tackling the misinformation and distrust among the population. A key channel is the service provider, who does not always pass on correct and up-to-date information on FP.