‘Foreign body’: a social history of Implanon in South Africa’s Eastern Cape

Abstract

This article explores the reception of the contraceptive implant, Implanon, by healthcare workers and patients in family planning units in South Africa’s public health sector. Based on observations conducted at public health facilities in the Eastern Cape Province, and on interviews with nurses and patients in the same province, the study explored real-world experiences of the implant. This article examines the strategies used by nurses to promote use of the device, and explores how patients themselves responded to a widescale, national rollout of the implant within government family planning services. The study examines the reception of Implanon in the context of the post-Apartheid era in South Africa, in which the vestiges of Apartheid-era healthcare provision, and lack thereof, continue to animate personal experiences of contraception.

Keywords:

• Contraception
• Implanon
• IUD
• side-effects
• Apartheid
• Post-Apartheid South Africa

Acknowledgements

I am grateful to peer reviewers for their valuable feedback on this work. Principal thanks go to the research participants and to the anonymised healthcare facilities in which this work was carried out. Thanks are also due to the co-principal Investigators of the Mzantsi Wakho study, Lucie Cluver and Elona Toska, and to Mildred Thabeng and Kanya Makabane for research assistance.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Clinics and healthcare workers in this study have been given pseudonyms to ensure confidentiality.

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Additional information

Funding

This research was conducted under the auspices of the The Mzantsi Wakho study, jointly funded by the Nuffield Foundation [CPF/41513] (but the views expressed are those of the authors and not necessarily those of the Foundation); the Evidence for HIV Prevention in Southern Africa (EHPSA) programme, a UK aid initiative managed by Mott MacDonald; Janssen Pharmaceutica N.V., part of the Janssen Pharmaceutical Companies of Johnson & Johnson; the Regional Inter-Agency Task Team for Children Affected by AIDS - Eastern and Southern Africa (RIATT-ESA); UNICEF Eastern and Southern Africa Office (UNICEF-ESARO); and the International AIDS Society through CIPHER grant [155-Hod; 2018/625-TOS].