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A study of contraceptive drop-outs in Lesotho: using focus groups to determine causes of discontinuation.
[Unpublished] . , 36,  p.Focus groups of married women aged 25-40 from Lesotho who has used contraception for at least 3 months, but discontinued within the last 12 months, were conducted in 1989 to learn reasons for discontinuation. Groups had 3, 5, 6, and 9 participants, and other groups of staff were also held. In warm-up discussion topics it was learned that Basotho families desired families of 2-6 children; that men wanted the maximum number of children and believed that family planning promoted promiscuity in wives; that most people believed in spacing births and practiced traditional methods to do so, primarily breastfeeding and abstinence. Women liked injection because they can be used without husband's knowledge, and do not require daily medication or constant resupply. Misinformation was common on all methods, and lists of examples are included for each method. Some of the many reasons for discontinuing were real or impugned side effects. Many women complained of vaginal wetness (which was also a reason for accepting contraception). Many also accepted and others stopped to keep husbands at home. High cost of pills and exams was a reason cited. Program-related reasons were long lines at clinics and unavailability and brand-switching by the clinics. Staff focus groups identified several characteristics among drop-outs: husbands disapproved of contraception; negative rumors used to pressure women; inadequate counseling on side effects; pressures from in-laws and husbands to have more children. Screening out of potential drop-outs was not considered a viable policy. Staff groups suggested that the government emphasize IEC campaigns for men, the public and private doctors, and maintain supplies of the same brands of contraceptives at its clinics.