Access to primary health care family planning services and contraceptive use in disadvantaged women: a qualitative study

Abstract

Objectives

The study aimed to provide a deeper understanding of the gender-related determinants and organisational structure of primary health care that shape contraceptive use among disadvantaged women living in a developing Islamic country where family planning services are affected by health care reforms.

Methods

A qualitative study was conducted in three disadvantaged neighbourhoods in the metropolitan district of Bornova, Izmir. A purposive sampling method with maximum diversity was used to obtain a study sample of 43 women. Data were collected through in-depth interviews and analysed using a coding paradigm of grounded theory.

Results

Three themes emerged from the analysis, namely, factors affecting participants’ number of children, experiences with using contraceptive methods, and use of family planning services at family health centres. Despite a desire to limit their number of children and a positive view of contraception, women in the study faced gender-related barriers to accessing family planning services. Their statements indicate significant deficiencies in terms of provision of contraception and family planning consultations at family health centres.

Conclusion

For disadvantaged women living in conservative areas, family planning is a fragile exercise. Gender-sensitive primary care services are essential to ensure access to everyone in the community.

摘要

目的：这项研究旨在更深入地了解初级卫生保健的性别相关决定因素和组织结构, 这些决定因素和组织结构影响生活在发展中国家的弱势妇女应用避孕药, 这些国家的计划生育服务受到卫生保健改革的影响。

方法：在伊兹密尔州博尔诺瓦大都市区的三个弱势社区进行了定性研究。本研究采用具有最大多样性的目的抽样方法, 以43名妇女为研究样本。数据通过深度访谈收集, 并应用基本理论的编码规范进行分析。

结果：分析结果产生了三个主题, 即影响参与者儿童人数的因素、应用避孕方法的经验以及在家庭保健中心应用计划生育服务。尽管希望限制生育数量并对避孕持积极态度, 但参与研究的妇女在获得计划生育服务方面面临着与性别有关的障碍。他们的声明表明, 在提供避孕和计划生育咨询方面, 家庭保健中心存在重大缺陷。

结论：对于生活在保守地区的弱势妇女来说, 计划生育是一项脆弱的工作。对性别问题敏感的初级保健服务对于确保社区的每个人都能获得服务至关重要。

Keywords:

• Disadvantaged women
• family planning
• gender
• qualitative study

Acknowledgements

We extend our thanks to the women who participated in the study. We are also indebted to Bornova municipality for providing organisational support.

Disclosure statement

The authors declare no conflicts of interest associated with this article.

Additional information

Funding

Financial assistance was provided by the Scientific Research Projects Coordination Unit of Ege University [project no. 17-BF-005].