Private providers' knowledge, attitudes and misconceptions related to long-acting and permanent contraceptive methods: a case study in Bangladesh.
In Bangladesh, use of long-acting and permanent methods of contraception (LAPMs) remains stagnant. Providers' limited knowledge and biases may be a factor. We assessed private providers' knowledge, misconceptions and general attitudes towards LAPM in two urban areas. The ultimate goal is to shape programs and interventions to overcome these obstacles and improve full method choice in Bangladesh.



Trained data collectors interviewed a convenience sample of 235 female doctors (obstetricians-gynecologists and general practitioners) and 150 female nurses from 194 commercial (for-profit) health care facilities in Chittagong City Corporation and Dhaka district. Data were collected on the nature of the practice, training received, knowledge about modern contraceptives and attitudes towards LAPM [including intrauterine device (IUDs), implants, female and male sterilization].



All providers, and especially doctors, lacked adequate knowledge regarding side effects for all LAPMs, particularly female and male sterilization. Providers had misconceptions about the effectiveness and convenience of LAPMs compared to short-acting contraceptive methods. Implants and IUDs were generally perceived more negatively than other methods. The majority of providers believed that husbands favor short-acting methods rather than LAPMs and that women should not use a method that their husbands do not approve of.



Our findings document knowledge and attitudinal barriers among private for-profit providers in urban areas affecting their provision of accurate information about LAPM choices. Practitioners should be offered the necessary tools to provide women full access to all modern methods, especially LAPMs, in order to contribute to decreasing unmet need and improving full method choice in Bangladesh.
Abt Associates Inc., 4550 Montgomery Avenue, Suite 800N, Bethesda, MD 20814, USA. Electronic address: jugazf@yahoo.com.
Jorge
J
Ugaz
Abt Associates Inc., 4550 Montgomery Avenue, Suite 800N, Bethesda, MD 20814, USA. Electronic address: Kathryn_Banke@abtassoc.com.
Kathryn
K
Banke
Abt Associates Inc., 4550 Montgomery Avenue, Suite 800N, Bethesda, MD 20814, USA. Electronic address: rahaim.stephen@gmail.com.
Stephen
S
Rahaim
SHOPS Project, Dhaka, Bangladesh. Electronic address: wahid.swapon@gmail.com.
Wahiduzzaman
W
Chowdhury
Abt Associates Inc., 4550 Montgomery Avenue, Suite 800N, Bethesda, MD 20814, USA. Electronic address: Julie_Williams@abtassoc.com.
Julie
J
Williams
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001459:Bangladesh; D002755:Choice Behavior; D003267:Contraception / Q000379:methods*; D003430:Cross-Sectional Studies; D005193:Family Planning Services / Q000592:standards; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data; D008875:Middle Aged; D011331:Private Practice; D017149:Private Sector; D013245:Sterilization, Reproductive; D019037:Urban Health Services; D055815:Young Adult
Bangladesh; Contraception use; Family planning; Long-acting methods; Private sector