The Medical Mystery of Contraceptive Method Choice in Urban Nigeria

Background: High levels of fertility in Nigeria are a function of both low demand for and low use of contraceptive methods. Method choice is an important determinant of sustained contraceptive use and a number of barriers have been identified. However, our understanding of how clients themselves perceive their choice of method is very limited.
Methods: This study uses qualitative data to examine attitudes and norms surrounding decision-making for method choice.
Results: Choosing a contraceptive method was presented as a medical decision. Participants often mentioned the issue of whether a method is compatible with a woman’s “body system”. This compatibility is determined by tests conducted by a doctor and dictates the method chosen, with the assumption that there will be no side effects.
Discussion: This level of medical mystery placed on family planning is problematic. A belief that a test exists to predict side effects would likely result in disappointment by the user, and possibly a reluctance to switch methods, when side effects do occur. Messages need to be crafted to increase understanding among current and potential family planning users about the process of choosing a contraceptive method, the potential for side effects, and the choice of switching methods.