Despite the fact that modern contraceptive methods are very safe and effective, many barriers still affect women's access to family planning. Medical barriers refer to unnecessary or unjustifiable policies, procedures or practices, based at least in part on medical rationale, that result in an impediment to, or denial of, contraception. This paper examines the prevalent medical barriers occurring during family planning consultation sessions in Indonesia, Kenya and Ghana. Four types of barriers were examined: inappropriate contraindications, process hurdles, eligibility criteria and provider bias. The data consist of transcribed audio/ video recordings made during family planning consultation sessions with new and continuing clients. The data were collected for previous studies in Kenya (173 clients in 25 clinics), Ghana (44 clients in 18 clinics) and Indonesia (38 clients in 10 clinics). To develop a coding guide in determining barriers, we used the WHO and USAID new technical guidance for family planning methods. Both quantitative and qualitative analysis were applied to describe in detail the contents and situation of barriers specific to each contraceptive method. The results showed that particular medical barriers occur repeatedly in a specific country. For example in Indonesia, medical barriers that occur most frequently are related to inappropriate contraindications, process barriers involving unnecessary questioning and extensive follow-up procedures, and provider biases that tend to minimize client options. Implications of variations among providers, clinics, and countries were discussed. Practical mechanisms to help providers identify barriers in their own practices were also discussed.
Learning Objectives: To identify the content of medical barriers which commonly occur during family planning consultation sessions and to analyze the influences of such barriers to client's access to contraceptive methods
Keywords: Barriers to Care, Family Planning
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.