“Hear from those that you cannot reach” …..Dyads tell stories
“Hear from those that you cannot reach” …..Dyads tell stories
There was no consensus amongst women as to who should broach family planning discussions; is it the man or woman? – There were those who felt that since contraceptive use has a direct bearing on the woman’s health, they should initiate discussion. The majority felt that the financial burden and their responsibilities as the household made it the man’s mandate.
My husband …. we don’t discuss anything I even fear him… He is the head of the house, he must start everything ( 19yrs, newborn and currently pregnant )
Some couples talk about their children and planning for the future (educational needs), but rarely do they talk about contraceptives, although both parties might have preferences in terms of child spacing.
“always remind him of the need to plan ahead and save for our children. He seems to be very ignorant of the future well-being of our children….no we do not sit down and talk about family planning or the options; I don’t even know what my husband knows about it. (26yrs mother of 3)
Many women assumed that their husbands were either pro-natalist or anti-family planning. Several women had not broached the subject of FP with their husbands, assuming that their spouses would disapprove and fearing that it could cause tension in the family.
“Although we have never had such a discussion (FP) I would welcome such an opportunity, I am tired of giving birth every year, I need a break… I don’t think people talk about it..” (26yrs mother of 3)
The educated and urban dwellers were singled out as sub-groups that freely discussed modern contraceptives.
“The issue of child upbringing we talk about it and discuss on what to do but that of when you want to have the next child, it’s God that plans…but if you hear they say these educated people sit down and talk these things can you imagine (laughter)” (30yrs mother of 5)
FP before the first child is unacceptable – Fear of infertility and pressure to bear children within the first 12 months of marriage means that aggressive FP promotion to this segment will not bear fruit until they get a child.
“Let me start with the day you get married, after day one of marriage are you pregnant yet’ and then again after one week. Girls must have children early or else they will get into menopause.” (32yrs mother of 2)
Women are most receptive to FP messaging at postpartum. Women prioritize their baby’s health upon delivery and are most receptive to messages that promote the same. This presents an opportunity to consider using modern contraceptives, which can be presented as an option for extending breastfeeding for the child’s health. Yet they felt that health workers prioritised women with high parity. Some women found it inappropriate to consider modern family planning too soon after birth, as they feared that it would interfere with the quantity of milk. For a number of these women, modern contraceptives must somehow link to the child’s health to help them rationalise.
“The mother also thinks of her child’s health and says this is the right time to say, I want to relax and space my children. It could not be earlier as a mother, and I think I still have to eat that to get the milk. Now when I settle in that breastfeeding and all I can start agreeing for this one to be healthy, I should breastfeed him for 2 years, so let me avoid getting pregnant” (19yrs mother of 1)
These findings were incorporated into an intervention by a local NGO….still waiting to see the results.
