"I am forced to just give it to her because she is the one who wants it": A qualitative study of providers' perspectives on contraceptive counseling in Tanzania

被引:1
作者
Wollum, Alexandra [1 ]
Gipson, Jessica D. [1 ]
Sabasaba, Amon [2 ]
Brooks, Mohamad I. [3 ]
Moucheraud, Corrina [4 ]
机构
[1] Univ Calif Los Angeles, Dept Community Hlth Sci, Los Angeles, CA USA
[2] Hlth Prosperous Nation, Shinyanga, Tanzania
[3] Pathfinder Int, Washington, DC USA
[4] NYU, Dept Publ Hlth Policy & Management, New York, NY USA
来源
SSM-QUALITATIVE RESEARCH IN HEALTH | 2024年 / 6卷
基金
美国国家卫生研究院;
关键词
Contraception; Quality of care; Providers; Long-acting reversible contraception; DECISION-MAKING; YOUNG; CARE; PERCEPTIONS; EXPERIENCES; POPULATION; IMPLICIT; CHOICE; CLIENT; WOMEN;
D O I
10.1016/j.ssmqr.2024.100505
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Drawing on 29 in-depth interviews with health care providers in Dar es Salaam, Tanzania, this paper describes providers' attitudes and beliefs about contraceptive methods and the extent to which providers consider client choice and autonomy when providing contraceptive care. Interviews were analyzed thematically using the constant comparative approach. Providers described a preference for long-acting reversible methods (i.e., implants and IUDs) primarily due to concerns regarding injectables' slow return to fertility, exposure to hormones, and concerns about client adherence to pills or injectables. Providers understood the importance of centering a client's preference to use a specific method and to have a method removed when the client desired. However, providers also described counseling clients toward their own preferences, highlighting a tension between what providers wanted for their clients and client preferences. While most providers described prioritizing client choice even when it contradicted their recommendation, some providers insisted on a certain outcome (e.g., a client taking up an implant), contradicting tenets of informed, full, and autonomous choice. Attention is needed to ensure providers center client autonomy and preferences and guarantee freedom from coercion in contraceptive care.
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页数:9
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