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Published in: BMC Women's Health 1/2015

Open Access 01-12-2015 | Research article

Every method seems to have its problems”- Perspectives on side effects of hormonal contraceptives in Morogoro Region, Tanzania

Authors: Joy J. Chebet, Shannon A. McMahon, Jesse A. Greenspan, Idda H. Mosha, Jennifer A. Callaghan-Koru, Japhet Killewo, Abdullah H. Baqui, Peter J. Winch

Published in: BMC Women's Health | Issue 1/2015

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Abstract

Background

Family planning has been shown to be an effective intervention for promoting maternal, newborn and child health. Despite family planning's multiple benefits, women's experiences of - or concerns related to - side effects present a formidable barrier to the sustained use of contraceptives, particularly in the postpartum period. This paper presents perspectives of postpartum, rural, Tanzanian women, their partners, public opinion leaders and community and health facility providers related to side effects associated with contraceptive use.

Methods

Qualitative interviews were conducted with postpartum women (n = 34), their partners (n = 23), community leaders (n = 12) and health providers based in both facilities (n = 12) and communities (n = 19) across Morogoro Region, Tanzania. Following data collection, digitally recorded data were transcribed, translated and coded using thematic analysis.

Results

Respondents described family planning positively due to the health and economic benefits associated with limiting and spacing births. However, side effects were consistently cited as a reason that women and their partners choose to forgo family planning altogether, discontinue methods, switch methods or use methods in an intermittent (and ineffective) manner. Respondents detailed side effects including excessive menstrual bleeding, missed menses, weight gain and fatigue. Women, their partners and community leaders also described concerns that contraceptives could induce sterility in women, or harm breastfeeding children via contamination of breast milk. Use of family planning during the postpartum period was viewed as particularly detrimental to a newborn’s health in the first months of life.

Conclusions

To meet Tanzania’s national target of increasing contraceptive use from 34 to 60 % by 2015, appropriate counseling and dialogue on contraceptive side effects that speaks to pressing concerns outlined by women, their partners, communities and service providers are needed.
Footnotes
1
At the time of data collection, Kilosa District Council (DC) was one district. Kilosa DC was later divided into two districts: Gairo and Kilosa DC.
 
Literature
3.
go back to reference Fortney JA. The of family importance planning in reducing maternal mortality. Stud Fam Plann. 1987;18(2):109–14.CrossRefPubMed Fortney JA. The of family importance planning in reducing maternal mortality. Stud Fam Plann. 1987;18(2):109–14.CrossRefPubMed
4.
go back to reference World Health Organization. Programming strategies for postpartum family planning. Geneva: World Health Organization; 2013. World Health Organization. Programming strategies for postpartum family planning. Geneva: World Health Organization; 2013.
8.
go back to reference Ross JA, Winfrey WL. Contraceptive use, intention to use and unmet need during the extended postpartum period. Int Fam Plan Perspect. 2001;27(1):20–7.CrossRef Ross JA, Winfrey WL. Contraceptive use, intention to use and unmet need during the extended postpartum period. Int Fam Plan Perspect. 2001;27(1):20–7.CrossRef
9.
go back to reference Rossier C, Hellen J. Traditional birthspacing practices and uptake of family planning during the postpartum period in Ouagadougou: qualitative results. Int Perspect Sex Reprod Health. 2014;40(2):87–94.CrossRefPubMed Rossier C, Hellen J. Traditional birthspacing practices and uptake of family planning during the postpartum period in Ouagadougou: qualitative results. Int Perspect Sex Reprod Health. 2014;40(2):87–94.CrossRefPubMed
11.
go back to reference Ndugwa RP, Cleland J, Madise NJ, Fotso J, Zulu EM. Menstrual pattern, sexual behaviors, and contraceptive use among postpartum women in Nairobi Urban Slums. J Urban Health. 2011;88:341–55.CrossRef Ndugwa RP, Cleland J, Madise NJ, Fotso J, Zulu EM. Menstrual pattern, sexual behaviors, and contraceptive use among postpartum women in Nairobi Urban Slums. J Urban Health. 2011;88:341–55.CrossRef
13.
go back to reference National Bureau of Statistics, ICF Macro. Tanzania demographic and health survey 2010. Dar es Salaam: National Bureau of Statistics, ICF Macro; 2011. National Bureau of Statistics, ICF Macro. Tanzania demographic and health survey 2010. Dar es Salaam: National Bureau of Statistics, ICF Macro; 2011.
14.
go back to reference The United Republic of Tanzania Ministry of Health and Social Welfare. Health sector strategic plan III July 2009 – June 2015 “Partnership for Delivering the MDGs ”. 2009. The United Republic of Tanzania Ministry of Health and Social Welfare. Health sector strategic plan III July 2009 – June 2015 “Partnership for Delivering the MDGs ”. 2009.
15.
go back to reference National Bureau of Statistics (NBS), Macro International Incoporated. Service Provision Assessment Survey 2006 (TSPA). Dar es Salaam: National Bureau of Statistics (NBS), Macro International Incoporated; 2007. National Bureau of Statistics (NBS), Macro International Incoporated. Service Provision Assessment Survey 2006 (TSPA). Dar es Salaam: National Bureau of Statistics (NBS), Macro International Incoporated; 2007.
17.
go back to reference National Bureau of Statistics, Office of Chief Government Statistician. 2012 population and housing census; Population Distribution by Adminstrative Areas. 2013. National Bureau of Statistics, Office of Chief Government Statistician. 2012 population and housing census; Population Distribution by Adminstrative Areas. 2013.
18.
go back to reference Nichter M. Use of social science research to improve epidemiologic studies of and interventions for diarrhea and dysentery. Rev Infect Dis. 1991;13 Suppl 4:S265–71.CrossRefPubMed Nichter M. Use of social science research to improve epidemiologic studies of and interventions for diarrhea and dysentery. Rev Infect Dis. 1991;13 Suppl 4:S265–71.CrossRefPubMed
19.
go back to reference Pelto P, Pelto G. Studying knowledge, culture, and behavior in applied medical anthropology. Med Anthropol. 1997;11(2):147–63.CrossRef Pelto P, Pelto G. Studying knowledge, culture, and behavior in applied medical anthropology. Med Anthropol. 1997;11(2):147–63.CrossRef
20.
go back to reference Bentley ME, Pelto GH, Straus WL, Schumann DA, Adegbola C, de la Pena E, et al. Rapid ethnographic assessment: applications in a diarrhea management program. Soc Sci Med. 1988;27(1):107–16.CrossRefPubMed Bentley ME, Pelto GH, Straus WL, Schumann DA, Adegbola C, de la Pena E, et al. Rapid ethnographic assessment: applications in a diarrhea management program. Soc Sci Med. 1988;27(1):107–16.CrossRefPubMed
21.
go back to reference Handwerker WP. Quick enthnography. Walnut Creek, CA: AltaMira Press; 2001. Handwerker WP. Quick enthnography. Walnut Creek, CA: AltaMira Press; 2001.
22.
go back to reference Crotty M. The foundations of social research: meaning and perspective in the research process. London: Sage Publications; 1998. Crotty M. The foundations of social research: meaning and perspective in the research process. London: Sage Publications; 1998.
23.
go back to reference Charles T, Tashakkori A. Foundations of mixed methods research: integrating quantitative and qualitative approaches in the social and behavioral sciences. Thousands Oaks, California: Sage Publications Inc; 2009. Charles T, Tashakkori A. Foundations of mixed methods research: integrating quantitative and qualitative approaches in the social and behavioral sciences. Thousands Oaks, California: Sage Publications Inc; 2009.
24.
26.
go back to reference The United Republic of Tanzania Ministry of Health and Social Welfare. The National Road map strategic plan to accelerate reduction of maternal, newborn and child deaths in Tanzania 2008–2012. One Plan. Dar es Salaam: The United Republic of Tanzania Ministry of Health and Social Welfare; 2008. The United Republic of Tanzania Ministry of Health and Social Welfare. The National Road map strategic plan to accelerate reduction of maternal, newborn and child deaths in Tanzania 2008–2012. One Plan. Dar es Salaam: The United Republic of Tanzania Ministry of Health and Social Welfare; 2008.
34.
go back to reference Cotten N, Stanback J, Maidouka H, Taylor-thomas JT, Cotten BN. Early discontinuation of contraceptive use in Niger and The Gambia. Int Fam Plan Perspect. 2012;18(4):145–9.CrossRef Cotten N, Stanback J, Maidouka H, Taylor-thomas JT, Cotten BN. Early discontinuation of contraceptive use in Niger and The Gambia. Int Fam Plan Perspect. 2012;18(4):145–9.CrossRef
35.
go back to reference Kamau R, Karanja J, Sekadde-Kigondu C, Ruminjo J, Nichols D, Liku J. Barriers to contraceptive use in Kenya. East Afr Med J. 1996;73(10):651–9.PubMed Kamau R, Karanja J, Sekadde-Kigondu C, Ruminjo J, Nichols D, Liku J. Barriers to contraceptive use in Kenya. East Afr Med J. 1996;73(10):651–9.PubMed
36.
go back to reference Agadjanian V. Women’s choice between indigenous and Western contraception in urban Mozambique. Women Heal. 1998;28(2):1–17.CrossRef Agadjanian V. Women’s choice between indigenous and Western contraception in urban Mozambique. Women Heal. 1998;28(2):1–17.CrossRef
39.
go back to reference Lopez LM, Grey TW, Chen M, Hiller JE. Strategies for improving postpartum contraceptive use: evidence from non-randomized studies. Cochrane Database Syst Rev. 2014;11:CD011298.PubMed Lopez LM, Grey TW, Chen M, Hiller JE. Strategies for improving postpartum contraceptive use: evidence from non-randomized studies. Cochrane Database Syst Rev. 2014;11:CD011298.PubMed
Metadata
Title
“Every method seems to have its problems”- Perspectives on side effects of hormonal contraceptives in Morogoro Region, Tanzania
Authors
Joy J. Chebet
Shannon A. McMahon
Jesse A. Greenspan
Idda H. Mosha
Jennifer A. Callaghan-Koru
Japhet Killewo
Abdullah H. Baqui
Peter J. Winch
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2015
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-015-0255-5

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