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Understanding the Barriers to Contraceptive Use in Hiv-Positive Women of Child Bearing Age in Dar-Es-Salaam, Tanzania

Thesis Info

Author

Nyanja, Tabitha-Alexandria Njeri

Department

Family Medicine (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2014

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728073884

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Title: Understanding the barriers to contraceptive use among HIV-positive women of child bearing age in Dar-es-Salaam, Tanzania- a multi-site study Purpose: The purpose of this study was to explore the perceived barriers to contraceptive use and identify the factors that influence contraceptive choice, as well as the relationship of these among HIV-positive women living in an urban population in Dar-es-Salaam Tanzania. Goals and Objectives: To determine the perceived barriers to contraceptive use among HIV-positive women of child-bearing age attending the Care Treatment Centres (CTCs) Tanzania and in the President’s Emergency Plan for AIDS Relief (PEPFAR) supported CTCs within Dar-es-salaam. Methodology: In a phenomenological approach the study adopted a cross-sectional study design that utilized qualitative methodology to assess HIV-positive women’s perceptions towards modern methods of contraception (including barrier, hormonal, permanent, and dual protection methods). It was a multi-sited study involving a selection of Management and Development for Health (MDH) supported CTCs whose focus is HIV/AIDS in women and children. The study population included all sexually active women of child bearing age (15-49) confirmed HIV-positive and attending the MDH supported CTC facilities within Dar-es-salaam. The study assumed pragmatic purposive strategic sampling in selecting participants. All participants who meet the inclusion criteria on signage of informed consent were subjected to either In-depth Interviews or Focused Group Discussions. Data collected was transcribed based on emergent themes and analysed using Nvivo 9 qualitative analysis software. During data analysis, stigma was identified as an issue cutting across all other themes. As a result a further analysis of the data was undertaken using Erving Goffman’s Conceptualization of stigma as the analytical framework. Ethical considerations: The study commenced once ethical approval and considerations were met by governing bodies of the Aga Khan University East Africa as well as the National Institute of Medical Research Tanzania. Timeline: The study was carried out from January 2012-April 2014. Results: The study identified eight barriers to contraceptive use: social and healthcare relationships, a woman’s current priorities in particular concerning motherhood, her beliefs about HIV/contraception/menstruation, her stage of acceptance of her HIV diagnosis, her own and other women’s previous experiences with various contraceptive methods, the knowledge she has on them and her access to these methods. Stigma was an underlying issue seen to cut across all these barriers and the subsequent theoretical analysis showed stigma to be a core issue reinforcing all barriers for the HIV-positive woman’s appropriate use of contraception. Conclusion: The
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اظہارِ تشکر

اظہارِ تشکر
اقرار مصطفیٰ
اللہ تبارک و تعالیٰ کے نہایت فضل و کرم اور نبیِ مکرمﷺ کے وسیلہ ٔ جمیلہ کے سبب نعتیہ مجموعہ’’ حسنِ کُن‘‘(مسدسِ مصطفیٰؐ)مسدس کی صورت میںمکمل ہوا۔ عہدِ رواں انتشار و خلفشار اور طرح طرح کے زوالی فتنوں کا عہد ہے۔ مسائل کی فراوانی اور وسائل کی کم یابی کے باعث ضروریات ِ حیات کو پورا کرنا وبالِ جان بن چکا ہے۔ ایسے میں خواہشات کی تکمیل کے لیے پر تولنا ، کم فہمی اور دیوانے کے خواب کے مترادف ہے۔مگر کچھ خواہشات ،ضروریات ِ حیات سے بھی بڑھ کے ہوتی ہیں کیوں کہ ان کا تعلق ایمان ومحبت سے جڑا ہوتا ہے اور اہلِ ایمان و محبت کا اعتقاد و یقین سے بھرپور او رمسلم نظریہ یہ ہے کہ تعلقِ خاطر خالصتاً نبی ِ آخرالزماں ﷺ سے ہو تو خواہشوں کی تکمیل کے خواب کو تعبیر میں ڈھلنے کے اسباب خود بہ خود پیدا ہوجاتے ہیں یا اسباب پیدا کر دیے جاتے ہیں۔ موجودہ نامساعد حالات کے پیشِ نظر ، مجھ ایسے کم مایا کا مجموعہ منصہ شہود پر آنا درحقیقت احمد رضاؒ خاں بریلوی کے اس شعر کے مصداق ہے:
کون دیتا ہے دینے کو منہ چاہیے
دینے والا ہے سچا ہمارا نبیؐ
عزیزانِ من! حُسنِ کُن‘‘مسدس کی ہئیت میں لکھا گیا ہے۔ اسمِ محمدﷺ اور اسمِ احمدﷺ کے اعداد کا مجموعہ 145بنتا ہے، اسی نسبت سے مسدس کے بندوں کی تعداد 145رکھی گئی ہے اور اسی وجہ کے پیشِ نظر اس میں خصوصی طور پہ یہ التزام ملحوظ رکھا گیا ہے کہ یہ موضوع ، موضوعِ نعت ہے اور یہ سراپا نعت ہی رہے۔
الحمد للہ!’’ حُسنِ کُن‘‘ (مسدسِ مصطفیٰؐ) حسنِ نعت سے مزین ہے۔ پھر بھی یہ بات اپنی جگہ صد فی صد درست ہے کہ:
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