BARRIERS TO USE CONTRACEPTIVE METHODS AMONG POST ABORTION CLIENTS IN SARGODHA, PAKISTAN: A QUALITATIVE STUDY

Abstract

World Health Organization (WHO) recommends at least 6 months inter pregnancy interval after an abortion. Pakistan has low contraceptive prevalence rate and high unmet need of contraception. Post abortion women are the potential clients for contraception but national data reveal low uptake of contraceptive method by these clients. This study aimed to explore the barriers to adopt contraception among post abortion clients in district Sargodha, Pakistan. A qualitative research design was used. Study participants were recruited from three private and three public sector hospitals in district Sargodha, Pakistan. Study was conducted from July 2018 to November 2018. Ninety-nine in-depth interviews (IDIs) of post abortion women were conducted using an un-structured interview guide within the period of one month after abortion. Detailed field notes were made. Interviews continued until thematic saturation had reached. Content was organized into a matrix based on themes and sub-themes. A descriptive thematic analysis using both inductive and deductive coding was conducted. Reasons of not adopting contraceptive methods were explored Although many clients expressed desire to limit fertility, some barriers were found to be hindering uptake of contraception. Major barriers expressed by clients were un willingness of husband, resistance of other family members and real or perceived fear of side effect of contraceptive methods. Lack of adequate knowledge about fertility and contraception was another factor which contributed in decision of not adopting contraception. Socio-cultural norms to have large family size were also reported by some clients. Other barriers include religious beliefs, focus on other health issues, financial unaffordability, infrequent intercourse and plan for tubal ligation. The study concluded that without addressing the barriers post abortion contraceptive uptake unlikely to improve. Identification of barriers is the first step to address the existing unmet need contraception.