The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61383

Rasha Dabash, MPH¹, Nisreen Bitar¹, Salah Mawajdeh, MD, DPh², Manal Shahrouri², and Ramez Habash³. (1) Research and Evaluation, EngenderHealth, 440 Ninth Ave, New York, NY 10001, 212-561-8060, rdabash@engenderhealth.org, (2) Family Health Group, Jordan University, Amman, Jordan, (3) Family Health Group, Family Health Group, Jordan University, Amman, Jordan

Female sterilization is one of the oldest methods of family planning available in Jordan. This permanent contraceptive method is offered by all Jordanian hospitals providing obstetric and gynecological services. DHS data suggest that despite a large unmet need for birth limiting, contraceptive users are decreasingly selecting tubal ligation. The total percent of tubal ligation users among users of other modern methods declining from 5.6 in 1990 to 4.2 to 3.0 in 2002. To explore the perspectives of both users and non-users and identify reasons for the use and non-use of tubal ligation, EngenderHealth conducted qualitative research with tubal ligation users, users of reversible contraceptive methods (potential tubal ligation users), and husbands of both users and potential users. A total of 18 focus groups were conducted with participants recruited from both public and private sector sites across Jordan. Findings revealed many motivations for and obstacles to use of tubal ligation. Users reported high satisfaction with the method, chosen primarily for medical reasons. Negative experiences with reversible contraceptive methods also provided impetus for choosing tubal ligation. Religious and cultural beliefs, provider bias, and the availability of temporary and reversible methods were the main reasons for non-use as cited by potential users. Husbands participated in the decision to use tubal ligation and similarly reported high method satisfaction. Vasectomy was unfavorably viewed as an alternative to tubal ligation by both women and husbands. Study findings will be used to strengthen access to and quality of tubal ligation services by addressing potential barriers to choice.

Learning Objectives:

• At the conclusion of the session, the participant will be able to:
• 1.Describe the perspectives of users, potential users, and husbands on voluntary surgical contraception.
• 2.Identify potential barriers to choice of tubal ligation among clients seeking to limit births.
• 3.Discuss recommendations for improving access to voluntary surgical contraceptive services.

Keywords: Family Planning, Reproductive Health Research

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: EngenderHealth
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.