title: Barriers to modern contraceptive use in rural areas in DRC.
abstract: Recent research in the Democratic Republic of Congo (DRC) has shown that over a quarter of women have an unmet need for family planning and that modern contraceptive use is three times higher among urban than rural women. This study focuses on the reasons behind the choices of married men and women to use contraception or not. What are the barriers that have led to low levels of modern contraceptive use among women and men in DRC rural areas? The research team conducted 24 focus groups among women (non-users of any method, users of traditional methods and users of modern methods) and husbands (of non-users or users of traditional methods) in six health zones of three geographically dispersed provinces. The key barriers that emerged were poor spousal communication, sociocultural norms (especially the husband's role as primary decision-maker and the desire for a large family), fear of side-effects and a lack of knowledge. Despite these barriers, many women in the study indicated that they were open to adopting a modern family planning method in the future. These findings imply that programming must address mutual comprehension and decision-making among rural men and women alike in order to trigger positive changes in behaviour and perceptions relating to contraceptive use.
authors.affiliation: a National Program for Adolescent Health , Ministry of Health , Kinshasa , Democratic Republic of Congo.
authors.forename: Mbadu Fidèle
authors.initials: MF
authors.lastname: Muanda
authors.affiliation: b L'Institut Supérieur de Développement Rural , Ministry of Health , Kongo Central , Democratic Republic of Congo.
authors.forename: Gahungu Parfait
authors.initials: GP
authors.lastname: Ndongo
authors.affiliation: c Paysn Center for International Development , Tulane University Law School , New Orleans , LA , USA.
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Messina
authors.affiliation: d Department of Global Health Management and Policy , Tulane University School Public Health and Tropical Medicine , New Orleans , LA , USA.
authors.forename: Jane T
authors.initials: JT
authors.lastname: Bertrand
mesh_terms: D000328:Adult; D003142:Communication; D003268:Contraception Behavior / Q000208:ethnology / Q000523:psychology; D003469:Culture; D015023:Democratic Republic of the Congo; D005191:Family Characteristics / Q000208:ethnology; D005193:Family Planning Services; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology; D012424:Rural Population; D055815:Young Adult
keywords: Democratic Republic of Congo; barriers; cultural norms; family planning; family size