Myths and misconceptions still surround contraception

Over 98 percent of Zimbabwean women know about family planning, with 60 percent of married women using modern methods of contraception, according to figures from the Zimbabwe National Family Planning Council (ZNFPC).

The most widely used method is the pill, with the least used methods being vasectomy and tubal litigation.

Edmore Munongo, the acting executive director, said while 70 percent of women in Zimbabwe preferred using the pill compared to other family planning methods, women shunned using permanent methods of contraception such as vasectomy and tubal litigation due to cultural reasons.

“Cultural and religious beliefs and myths and misconceptions about the side-effects of contraception is prevalent in our country,” said Munongo.

“All medicines have some sort of side effects – which vary enormously. Scientific evidence shows that the benefits of using contraceptives far outweigh their side effects. The Ministry of Health and Child Care through the ZNFPC is dispensing both hormonal and non-hormonal contraceptives for its clients like any other country in the world.”

Vasectomy is a surgical procedure for male sterilisation and/or permanent birth control while tubal litigation is the permanent female sterilisation where a woman’s tubes are tied for permanent birth control.

Side effects

Women in Zimbabwe have various choices regarding the methods of contraception at their disposal. These include condoms, contraceptive injections, implants, traditional and intra-uterine contraceptive devices.

Munongo said women should anticipate moderate side effects such as bleeding between their menstrual periods, weight gain, nausea and vomiting. Most of these occur at the beginning of use but usually go away after two to three months of use, depending on the individual.

“The ZNFPC works with the government and other partners towards the provision of safe and adequate family planning services to the public. Some of our objectives as we head towards 2020 are to reduce the unmet need from the present figure of 13% of married women to 6.5% and from the current 16.9% of adolescents to 8.5%,” said Munongo.

Insufficient

New information from a study by the Guttmacher Institute, an organisation that operates globally to advance sexual and reproductive health through research, policy analysis and public education, established that more than 1 in 10 married women in the developing world want to avoid pregnancy but are not using contraceptives.

According to the report entitled, “New infographics: Increasing access to modern contraceptive methods is key but not enough to satisfy women’s need for effective family planning”, 28% of married women in Africa are worried about the side effects and health risks that are associated with the use of contraception.

Obstacles

“Increasing access to modern contraceptive methods, while crucial, will not be sufficient to address all women’s obstacles to using family planning services,” read the report. The research, an analysis of data from more than 50 countries in Africa, Asia and Latin America and found that in 2012, an estimated 645 million women aged 15- 49 years in the developing world are using latest methods of contraception.

The use of modern contraceptives in the developing world will prevent 218 million unintended pregnancies, which, in turn, will avert 55 million unplanned births, 138 million abortions- 40 million of them unsafe, 25 million miscarriages and 118,000 maternal deaths.

Infant mortality

It will also prevent an estimated 1.1 million neonatal deaths, the majority of whom die within 28 days of birth and 700,000 post neonatal infant deaths, says the report.

The study established that an estimated 168,000 women in Sub-Saharan Africa will die from pregnancy- and birth-related causes every year; 62,000 of these women did not want to become pregnant in the first place.

“Fully meeting all needs for modern contraceptive methods would prevent 48,000 of these deaths—a 29% decline in maternal mortality. If all unmet need were fulfilled, the number of unintended pregnancies in the region would drop by 78%—from 19 million to four million—resulting in eight million fewer unplanned births, five million fewer abortions and two million fewer miscarriages,” reads the report. The institute stated that fulfilling the unmet need for contraceptives in Sub-Saharan Africa had the potential substantially to reduce infant mortality in the region.

“If the unmet need for contraceptives is met, this would prevent 555,000 infant deaths—255,000 newborn deaths and 300,000 deaths among older infants—which would result in a 22% decline in infant mortality,” it says.

No choice

Wadzanai Vere, the vice Chairperson of the Women’s Coalition said marginalised women in rural communities lacked information on the various choices of available contraceptive methods at their disposal.

“They are not fully equipped with the right information on contraceptives and this limits their choices,” said Vere, who is also director of Self Help Development Foundation, an organisation that works with rural women.

“There is need for investment in the provision of adequate information of the different contraceptive methods, their use and possible side effects, so that women can select or change methods to best fit their needs,” she said.

Vere lamented the financial, cultural and social challenges facing women in Zimbabwe, saying they impacted negatively on contraceptive use.

“Culturally, a woman is supposed to consult her husband – considering that he is the head of the house – and be told to use the pill. Some may forget to take the pill on time resulting in unwanted pregnancies,” she said.

Economic benefits

The Guttmacher report recommended that enabling women to plan their pregnancies leads to healthier outcomes for children and reduces the overall health care costs, while also providing substantial public health and economic benefits to families and governments.

“Significant investments are needed in Sub-Saharan Africa in order to meet the need for modern family planning.

“Key interventions are needed to fully meet family planning needs and include integrating family planning services into the provision of other health care services; ensuring continuous supplies of a broad range of contraceptive methods; building service provision capacity, including strong community-driven service delivery; improving provider competency in counselling, education and method provision; and educating women and their partners to overcome unfounded fears about side effects,” says the report.

The research institute recommended coming up with appropriate interventions that addressed social factors inhibiting the use of modern contraceptives – some of which include women’s low level of decision-making power within families, differences in fertility preferences between partners, and the stigma attached to sexual activity and the use of contraceptive services among unmarried women.

“Addressing these types of barriers requires commitment to providing comprehensive sex education, improving school attendance for girls, launching large-scale public education efforts about the benefits of using contraceptives to avoid unintended pregnancies and eliminating child marriage,” reads the report.