Reproductive Health and Wellness
My husband will love me more if I give birth to more children: Rural women’s perceptions and beliefs on family planning services utilization in a low resource setting
Responsibility for family planning in low resource settings is almost solely delegated to women,
with very low male involvement. This study investigated rural Tanzanian women’s perceptions and cultural
beliefs of the barriers to family planning services utilization.
Methods: This study used a qualitative descriptive approach drawing on four group discussions with 20 pur-
posively selected married women with two or more children. The study followed COREQ guidelines for reporting
qualitative studies. Data were collected from participants at four health facilities in Bagamoyo and Kisarawe
districts in Pwani, Tanzania.
Results: Participants’ occupations included housewives, small-scale farmers, and entrepreneurs. Most women
were Muslim and had a primary school education.
Five main themes were identified: use of modern and traditional family planning methods; my husband will
love me more if I give birth to more children; men’s expected roles in family planning; provide education to
dispel myths; and religious barriers. Associated sub-themes covered use of strings, snares and pigis; calendars;
breastfeeding linked to family planning; men as heroes for having many children; men not having time to attend
clinic; and conflicting sources of health information.
Conclusion: Lack of adequate family planning information; beliefs on and use of traditional/unconventional
methods; gender roles expectations that influence decision making and limit women’s choices of family planning
methods and; socio-cultural and religious beliefs were main perceived barriers for family planning utilization in
this study. Mitigation of these barriers depends on the sustained engagement of key stakeholders including
religious and community leaders. Health education must be designed to adapt socio-cultural and religious
doctrines with benefits of family planning and health outcomes. Health delivery services must also address
women’s’ prevailing perceptions and beliefs with emphasize on the partner communication and their en-
couragement of men’s’ involvement in reproductive health services utilization.
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