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Contraceptive use and decision-making in Guéra, Chad: a mixed-methods study.

Vincent de Paul Allambademel1, Mahamat Abdelaziz1, Natalie Andrasko2

  • 1Laboratoire de Sociologie, d'Anthropologie et des Etudes Africaines (LASA), Department of Sociology, College of Humanities and Social Sciences, University of N'Djamena, N'Djamena, Chad.

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Summary

Understanding contraceptive use barriers in Chad is crucial for reducing maternal mortality. Interventions should address religious beliefs, stigma, misconceptions, and involve men and community leaders to improve modern contraceptive uptake.

Keywords:
Chadcontraceptiondecision-makingmixed methodssexual and reproductive health

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Area of Science:

  • Reproductive Health
  • Maternal Health
  • Public Health

Background:

  • Chad faces a high maternal mortality ratio and low modern contraceptive prevalence.
  • Understanding barriers to contraceptive use is critical for reducing unmet need and maternal mortality.

Purpose of the Study:

  • To investigate barriers and influences on women's decision-making regarding modern contraceptive use in Chad.
  • To inform strategies for reducing unmet contraceptive need and improving maternal health outcomes.

Main Methods:

  • A mixed-methods study was conducted in Guéra province, Chad.
  • Included a longitudinal survey of women, focus group discussions, and in-depth interviews with healthcare providers and community leaders.

Main Results:

  • Participant knowledge of modern contraceptive methods increased, with endline use at 20.5%.
  • Key barriers included religious beliefs, community stigma, misconceptions (especially about long-acting reversible contraceptives), and spousal influence.
  • Husbands significantly influenced contraceptive decision-making, acting as facilitators or barriers.

Conclusions:

  • Increased awareness and contraceptive use were observed, exceeding the provincial rate.
  • Community-based distribution of self-injectable contraceptives (DMPA-SC) should be explored.
  • Tailored stigma reduction interventions and provider training are needed to promote equitable contraceptive service provision.