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Women using family planning secretly to avoid partner violence

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Four out of 10 women in Kenya who have ever been married reported intimate partner violence because they were using a family planning method, a report has shown.

The report indicated that the violence, which was either physical, sexual or emotional, was the reason behind unintended pregnancy, with many women resorting to the secret use of family planning methods.

The study, which sought to assess the impact of intimate partner violence on women’s contraceptive use outcomes, revealed that 20 per cent of women went through emotional violence while 13 per cent experienced physical or sexual violence.

Conducted by the Performance Monitoring for Action and presented at the just-conclude sixth International Family Planning Conference, the study covered Burkina Faso, Côte d’Ivoire and Kenya.

Reproductive coercion

Reproductive coercion ranged from 6.4 per cent in Côte d’Ivoire to 7.8 per cent in Kenya while intimate violence ranged from 23 per cent in Kenya to 32 per cent in Côte d’Ivoire.

“Reproductive coercion is a critical barrier to modern contraceptive use in Kenya. The intimate partners tried to force their women to become pregnant, others threatened to have a baby with someone else if the women did not get pregnant while some took away family planning methods,” states the study.

Emotional violence was most prevalent in Côte d’Ivoire at 29 per cent, followed by Burkina Faso at 24 per cent and Kenya at 20 per cent. Physical and sexual violence was most prevalent in Côte d’Ivoire (15 per cent), followed by Kenya (13 per cent) and Burkina Faso (10 per cent)

The study involved 6,358 women between the ages of 15 and 49: 1,863 in Burkina Faso, 1,105 in Côte d’Ivoire and 3,390 in Kenya. 

Sampling was restricted to married women in need of contraception. These were defined as those who reported being sexually active in the last 12 months, wanting to wait more than 12 months to have another child or not wanting any more children and not currently pregnant.

“Partner control over contraceptive use and reproductive health outcomes is a unique form of abuse. This is concerning to women’s health given their links to decreased use of contraception and increased risk of unintended pregnancy,” said Mary Thiong’o, Senior Technical Advisor, Performance Monitoring for Action Kenya.

In the study, physical violence perpetrated by male partners was commonly reported in the context of discovering that their partners were using contraception without their knowledge.

“After realising that their partners were using contraceptives they either slapped, hit, or physically hurt them, some were threatened with a weapon, strangled or killed, while others insisted or forced them to have sex when the women did not want to,” reveals the study.

Contraception

Results from this study highlight opportunity for family planning providers to play a critical role in supporting women and girls in their use of contraception when reproductive coercion is present.

“Universal, affordable and judgement-free provision of covert contraceptive methods and emergency contraception is needed to counteract coercion reproductive health impact. Policies must include practical, rights-based solutions that ensure freedom from partner interference in women’s contraceptive decision-making and use,” states the study.

Dr Issak Bashir, from the Department of Family Health in the Health Ministry, said men should support their women in the family planning journey.

“One is using family planning because she means well for the family; there is no woman who will not want to give birth and because of several reasons, she might decide to use a method. Sit her down and discuss this together and come to a conclusion rather than becoming violent,” he said.

The study mirrors another done in Ghana that assessed the prevalence and determinants of the secret use of contraceptives among women attending a public reproductive health clinic.

“Secret contraceptive use in sub-Saharan Africa is an indication of women’s inability to exercise autonomy in their reproductive choices,” states the Ghana study.

About 300 women were interviewed, 48 per cent of whom were aged between 26 and 33 years. The prevalence of secret use of contraceptives was 34 per cent. Single and sexually active women were more likely to practise secret family planning use than married or cohabiting women.

Kenya is characterised by a high unmet need for family planning and a high number of unplanned pregnancies. In the country, 52 per cent of women of reproductive age are eligible for family planning methods, according to a report launched by the Ministry of Health last week. 

However, Kenya has made notable strides to improve the uptake of modern contraceptives. In 2020, the country attained a contraceptive prevalence of 61 per cent, surpassing the target of 58 per cent. This year, it stands at 61 per cent, while the other targets have been revised to 66 per cent by 2030 and 70 per cent by 2050. 

For unmet needs, the number has come down from 28 per cent to 14 per cent. The country’s target is 10 per cent by 2030.

However, the country has witnessed a worsening shortage of commodities including implants, injectables, pills and male condoms in the past two years.



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