Why do most young women not take up contraceptives after post-abortion care? An ethnographic study on the effectiveness and quality of contraceptive counselling after PAC in Kilifi County, Kenya
AbstractPost-abortion care (PAC) counselling and the provision of contraceptive methods are core components of PAC services. Nevertheless, this service is not uniformly provided to PAC patients. This paper explores the factors contributing to young women leaving health facilities without counselling...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Sexual and Reproductive Health Matters |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/26410397.2023.2264688 |
| _version_ | 1797633649482399744 |
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| author | Mercy Kadzo Mwadhi Martin Bangha Shelmith Wanjiru Michelle Mbuthia Grace Kimemia Kenneth Juma Jane Shirima Shilla Unda Anne Achieng Jonna Both Ramatou Ouedraogo |
| author_facet | Mercy Kadzo Mwadhi Martin Bangha Shelmith Wanjiru Michelle Mbuthia Grace Kimemia Kenneth Juma Jane Shirima Shilla Unda Anne Achieng Jonna Both Ramatou Ouedraogo |
| author_sort | Mercy Kadzo Mwadhi |
| collection | DOAJ |
| description | AbstractPost-abortion care (PAC) counselling and the provision of contraceptive methods are core components of PAC services. Nevertheless, this service is not uniformly provided to PAC patients. This paper explores the factors contributing to young women leaving health facilities without counselling and contraceptive methods. The paper draws from an ethnographic study conducted in Kilifi County, Kenya, in 2021. We conducted participant observation in health facilities and neighbouring communities, and held in-depth interviews with 21 young women aged 15–24 who received PAC. In addition, we interviewed 11 healthcare providers recruited from the public and private health facilities observed. Findings revealed that post-abortion contraceptive counselling and methods were not always offered to patients as part of PAC as prescribed in the PAC guidelines. When PAC contraceptive counselling was offered, certain barriers affected uptake of the methods, including inadequate information, coercion by providers and partners, and fears of side effects. Together, these factors contributed to repeat unintended pregnancies and repeat abortions. The absence of quality contraceptive counselling therefore infringes on the right to health of girls and young women. Findings underscore the need to strengthen the capacities of health providers on PAC contraceptive counselling and address their attitudes towards young female PAC patients. |
| first_indexed | 2024-03-11T11:56:52Z |
| format | Article |
| id | doaj.art-7bf0cad5e4154aaba2a4fbc676153241 |
| institution | Directory Open Access Journal |
| issn | 2641-0397 |
| language | English |
| last_indexed | 2024-03-11T11:56:52Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Sexual and Reproductive Health Matters |
| spelling | doaj.art-7bf0cad5e4154aaba2a4fbc6761532412023-11-08T12:50:00ZengTaylor & Francis GroupSexual and Reproductive Health Matters2641-03972023-12-0131110.1080/26410397.2023.2264688Why do most young women not take up contraceptives after post-abortion care? An ethnographic study on the effectiveness and quality of contraceptive counselling after PAC in Kilifi County, KenyaMercy Kadzo Mwadhi0Martin Bangha1Shelmith Wanjiru2Michelle Mbuthia3Grace Kimemia4Kenneth Juma5Jane Shirima6Shilla Unda7Anne Achieng8Jonna Both9Ramatou Ouedraogo10Research Assistant, African Population and Health Research Center, Nairobi, KenyaAssociate Research Scientist, African Population and Health Research Center, Nairobi, KenyaResearch Officer, African Population and Health Research Center, Nairobi, KenyaCommunications Officer, African Population and Health Research Center, Nairobi, KenyaResearch Officer, African Population and Health Research Center, Nairobi, KenyaResearch Officer, African Population and Health Research Center, Nairobi, KenyaResearch Assistant, African Population and Health Research Center, Nairobi, KenyaResearch Assistant, African Population and Health Research Center, Nairobi, KenyaResearch Assistant, African Population and Health Research Center, Nairobi, KenyaSenior Researcher, Rutgers, Utrecht, NetherlandsResearch Scientist, African Population and Health Research Center, Nairobi, KenyaAbstractPost-abortion care (PAC) counselling and the provision of contraceptive methods are core components of PAC services. Nevertheless, this service is not uniformly provided to PAC patients. This paper explores the factors contributing to young women leaving health facilities without counselling and contraceptive methods. The paper draws from an ethnographic study conducted in Kilifi County, Kenya, in 2021. We conducted participant observation in health facilities and neighbouring communities, and held in-depth interviews with 21 young women aged 15–24 who received PAC. In addition, we interviewed 11 healthcare providers recruited from the public and private health facilities observed. Findings revealed that post-abortion contraceptive counselling and methods were not always offered to patients as part of PAC as prescribed in the PAC guidelines. When PAC contraceptive counselling was offered, certain barriers affected uptake of the methods, including inadequate information, coercion by providers and partners, and fears of side effects. Together, these factors contributed to repeat unintended pregnancies and repeat abortions. The absence of quality contraceptive counselling therefore infringes on the right to health of girls and young women. Findings underscore the need to strengthen the capacities of health providers on PAC contraceptive counselling and address their attitudes towards young female PAC patients.https://www.tandfonline.com/doi/10.1080/26410397.2023.2264688post-abortion carecontraceptive counsellingreproductive coercionreproductive health rightsadolescent girlsfamily planning |
| spellingShingle | Mercy Kadzo Mwadhi Martin Bangha Shelmith Wanjiru Michelle Mbuthia Grace Kimemia Kenneth Juma Jane Shirima Shilla Unda Anne Achieng Jonna Both Ramatou Ouedraogo Why do most young women not take up contraceptives after post-abortion care? An ethnographic study on the effectiveness and quality of contraceptive counselling after PAC in Kilifi County, Kenya Sexual and Reproductive Health Matters post-abortion care contraceptive counselling reproductive coercion reproductive health rights adolescent girls family planning |
| title | Why do most young women not take up contraceptives after post-abortion care? An ethnographic study on the effectiveness and quality of contraceptive counselling after PAC in Kilifi County, Kenya |
| title_full | Why do most young women not take up contraceptives after post-abortion care? An ethnographic study on the effectiveness and quality of contraceptive counselling after PAC in Kilifi County, Kenya |
| title_fullStr | Why do most young women not take up contraceptives after post-abortion care? An ethnographic study on the effectiveness and quality of contraceptive counselling after PAC in Kilifi County, Kenya |
| title_full_unstemmed | Why do most young women not take up contraceptives after post-abortion care? An ethnographic study on the effectiveness and quality of contraceptive counselling after PAC in Kilifi County, Kenya |
| title_short | Why do most young women not take up contraceptives after post-abortion care? An ethnographic study on the effectiveness and quality of contraceptive counselling after PAC in Kilifi County, Kenya |
| title_sort | why do most young women not take up contraceptives after post abortion care an ethnographic study on the effectiveness and quality of contraceptive counselling after pac in kilifi county kenya |
| topic | post-abortion care contraceptive counselling reproductive coercion reproductive health rights adolescent girls family planning |
| url | https://www.tandfonline.com/doi/10.1080/26410397.2023.2264688 |
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