Understanding perceived access barriers to contraception through an African feminist lens: a qualitative study in Uganda

Abstract

Background: There are many barriers that impact a woman's access to contraception in rural sub-Saharan Africa, such as financial constraints, supply shortages, stigma, and misconceptions. Through and African Feminist lens, this study examines how these perceived barriers intersect with each other, and how they negatively impact women's access to family planning and their perceived value of contraceptives in Luweero, Uganda.

Methods: This qualitative study analyzed data collected from healthcare workers at one private clinic and one public clinic that offer family planning services in four focus group discussions in Luweero, Central Region, Uganda. Two focus group discussions were held in each clinic. Eligible participants spoke English, were at least 18 years of age, and had at least 3 years of experience as a healthcare worker in Luweero. Among the participants were nurses, midwives, family planning counsellors, and village health workers, both male and female. Coded transcripts were analyzed using a reflexive methodology through an African Feminist lens.

Results: Most of the responses indicated that financial constraints experienced either by the clinic or the women significantly impact access to family planning. Certain social barriers were discussed, and the participants explained that barriers such as stigma, misconceptions, lack of knowledge, religiosity and cultural values impact women's motivation or ability to access contraceptive methods. Side effects also have a significant role to play in women's ability or motivation to navigate through these perceived social barriers.

Conclusions: Participants determined that increased funding for transportation for village health teams, consistent funding for free contraception, and expanded sensitization efforts that particularly target men would be some of the most impactful methods they can adapt to address some of these barriers.

Keywords: Contraception; Family planning services; Focus groups; Health services accessibility; Healthcare personnel; Uganda.