title: Barriers to Modern Contraceptive Use in Kinshasa, DRC.
abstract: 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.
authors.affiliation: Programme National de Sante de l'Adolescent (National Program for Adolescent Health), Ministry of Health, Kinshasa, Democratic Republic of Congo.
authors.forename: Mbadu
authors.initials: M
authors.lastname: Muanda
authors.affiliation: L'Institut Supérieur de Développement Rural, Kongo Central, Democratic Republic of Congo.
authors.forename: Parfait
authors.initials: P
authors.lastname: Gahungu Ndongo
authors.affiliation: Department of Global Community Health and Behavioral Sciences, Tulane University School Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America.
authors.forename: Leah D
authors.initials: LD
authors.lastname: Taub
authors.affiliation: Department of Global Health Management and Policy, Tulane University School Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America.
authors.forename: Jane T
authors.initials: JT
authors.lastname: Bertrand
mesh_terms: D000328:Adult; D003267:Contraception / Q000191:economics / Q000523:psychology / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D003270:Contraceptive Agents / Q000191:economics / Q000600:supply & distribution; D015023:Democratic Republic of the Congo; D005193:Family Planning Services / Q000193:education* / Q000941:ethics; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D018454:Spouses / Q000193:education / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D003270:Contraceptive Agents