Contraceptive Conversations among Adolescent Girls and Young Women and Their Partners, Peers, and Older Female Family Members in Lilongwe, Malawi: A Qualitative Analysis

Abstract In sub‐Saharan Africa, adolescent girls and young women (AGYW) have high levels of unmet need for contraception, particularly those who are unmarried or nulliparous. Conversations with partners, peers, and family members influence AGYW contraceptive decision‐making yet little is known about...

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Bibliographic Details
Published in:Studies in family planning 2021-12, Vol.52 (4), p.397-413
Main Authors: Bhushan, Nivedita L., Phanga, Twambilile, Maseko, Bertha, Vansia, Dhrutika, Kamtsendero, Linda, Gichane, Margaret W., Maman, Suzanne, Pettifor, Audrey E., Rosenberg, Nora E.
Format: Article
Language:English
Subjects:
Adolescent girls
Adolescents
Birth control
Condoms
Contraception
Contraceptives
Decision making
Families & family life
Girls
Influence
Intimacy
Marriage
Misinformation
Norms
Older people
Older women
Parity
Peer influence
Permission
Qualitative analysis
Relatives
Reproductive health
Sexual behavior
Social networks
Young women
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Summary:Abstract In sub‐Saharan Africa, adolescent girls and young women (AGYW) have high levels of unmet need for contraception, particularly those who are unmarried or nulliparous. Conversations with partners, peers, and family members influence AGYW contraceptive decision‐making yet little is known about conversation content and impact or how they vary by relationship status and parity. This paper draws on qualitative data from 60 AGYW (aged 15–24) participating in a sexual and reproductive health study in Malawi to examine contraceptive conversation patterns among participants and their social ties. AGYW's relationship status and parity influenced whether they talked about contraceptives, who they talked to about contraceptives, and the type of contraceptives that were endorsed during conversations. Unmarried and nulliparous AGYW were less likely to discuss contraceptives with all social ties and when conversations occurred, norms and misinformation regarding nonbarrier methods were reinforced, and condoms were largely prescribed. Conversations with intimate partners often provided permission for contraceptive use while conversations with peers and older women in the family provided information on contraceptive methods. Our results highlight the unique roles that social ties play in AGYW contraceptive decision‐making and suggest that existing contraceptive conversation patterns might exclude unmarried, nulliparous AGYW from accurate and comprehensive contraceptive information and options.
ISSN:0039-3665
1728-4465
DOI:10.1111/sifp.12174