Online Program

“Siempre me critican”: Barriers to reproductive health in Ocotal, Nicaragua

Monday, November 2, 2015 : 2:30 p.m. - 2:50 p.m.

Samantha Luffy, MPH, Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA

Objective. To identify perceived barriers to accessing reproductive health care according
to the women of Ocotal, Nicaragua; describe their understanding of their reproductive rights;
and document their opinions about Nicaragua’s total ban on abortion.
Methods. From May to June 2014, three focus group discussions were held in Spanish
with 17 women from two different neighborhoods (barrios) in the city of Ocotal, Nicaragua. A
semi-structured discussion guide with open-ended questions was employed to elucidate local
perspectives regarding the focus group discussions themes.
Results. Serious obstacles including 1) violence against women, 2) machismo, 3) criticism
from others, and 4) lack of communication and education limit women’s ability to make
their own reproductive health decisions. Women had a pervasive lack of knowledge about
reproductive rights and the international human rights documents that define them. In
addition, due to religious and cultural ideologies, most women supported the country’s total
ban on abortion in most circumstances, with the possible exception of rape.
Conclusions. Both men and women in Ocotal should be encouraged to participate in
community-level programs designed to reduce the impact of the following obstacles to
receiving reproductive health care: 1) violence against women and machismo; 2) insufficient,
non-standardized sexual education and information about reproductive rights; and 3) poor
communication within families and the community at large. Any future public health
campaigns to address women’s reproductive health needs in Ocotal should implement these
types of programs, at the neighborhood level, to reduce stigma surrounding sexual health and

Learning Areas:

Advocacy for health and health education
Other professions or practice related to public health
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
identify perceived barriers to accessing reproductive health care among women in Ocotal Nicaragua; and describe their understanding of reproductive rights

Keyword(s): Abortion, Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Lead author on twp published manuscripts on sexual and reproductive health
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.