30 years on, myths and misconceptions still a barrier to contraceptive use

Mistimed and unwanted pregnancies remain common among young women in Kenya several decades after the introduction of modern contraceptive methods. Contraceptive use among young women remains low compared to older women. Some known barriers to the low uptake include side effects, access to commodities and partner approval.

Using evidence from a qualitative study on barriers to modern contraceptive methods uptake among young women in Kenya conducted by Rhoune Ochako and other researchers, it was reported that use of modern contraceptives is surrounded by confusion on appropriate usage and beliefs and myths most of which were hearsay from social networks.

The study developed to better understand barriers to modern contraceptive use among young women was carried out in Nyanza, Coast, and Central regions. Within these regions, urban or peri-urban districts were purposively selected based on having contraceptive prevalence rate close to the regional average. In depth interviews were conducted with a sample of sexually active women aged 15–24 years, both users and non-users from randomly selected households.

Rhoune and colleagues found that most young women were familiar with modern methods of contraception and most could describe their general mechanisms of action. Astonishingly, condoms were not considered as contraception by many users. Many associated contraception and specifically condom use with promiscuity and straying therefore unsuitable for couples in relationships. Fear of side effects and adverse reactions were a major barrier to use. Many mentioned real side effects associated with the use of such methods like weight changes, bleeding and lack of sexual desire. A few mentioned headaches and blood pressure. The biggest fear was that a particular method would cause infertility. In general, there was over-exaggeration of the side effects based on myths and misconceptions. Many fears were based on myths and misconceptions. The largest concern cited by participants was fear that a particular method would render them infertile; in many cases, this prevented them from using contraception. While infertility was cited as a possible consequence of most methods, it was most strongly expressed around injectables. As a result, many young women believed that injectables were only recommended for women who already had children. Others associated contraceptives with birth defects or abnormalities and cancer.

Young women learn about both true side effects and myths from their social networks. The role of others in influencing contraceptive use was demonstrated by the repeated use of the third person pronouns (‘he’, ‘she’, ‘they’, ‘others’) in almost all the narrations from the young women. These included both true side effects and myths from others in their community - peers, family or partners. Often these women received inaccurate information and were directly counselled by others not to engage with or use family planning methods.

Women also shared concerns raised by their spouses or partners on use of contraceptives, which echoed their own concerns about outcomes and side effects. Male partners raised concerns about family planning diminishing sexual urges, resulting in birth defects, or discomfort during sex.

Findings from this research confirm that awareness and knowledge of contraception do not necessarily translate to use. The main barriers to modern contraceptive uptake among young women are myths and misconceptions. These findings also stress the influence of social network approval on the use of family planning, beyond the individual’s beliefs. In such settings, family planning programming should engage with the wider community through mass and peer campaign strategies. As an outcome from this study, Population Services Kenya (formerly PSI) developed a mass media campaign to address key myths and misconceptions among youth.