Data sheet_Rumours, myths, and misperceptions as barriers to contraceptive use among adolescent girls and young women in South Africa.pdf

BackgroundRumours, myths, and misperceptions about contraceptives are a barrier to contraceptive use in general, but more so among adolescent girls and young women (AGYW). As rumours and misinformation disseminate easily, it is important to explore how they affect the uptake of contraceptives among AGYW at risk of unintended pregnancies. This study used qualitative methods to explore whether rumours, myths, and misperceptions about contraceptives remain barriers to modern contraceptive use among AGYW who were beneficiaries of a combination HIV prevention intervention in South Africa.MethodsFour (4) once-off in-depth interviews, 53 serial in-depth interviews, and 19 focus group discussions (FGDs) with 185 AGYW aged 15–24 years living in 5 of the 10 intervention districts were conducted as part of the HERStory 1 Study. Interviews and FGDs were audio recorded and data were analysed thematically, aided by Nvivo 12 software.ResultsRumours, myths, and misperceptions about contraceptives, as well as sociocultural norms regarding contraception seriously hinder AGYWs’ use of modern contraceptives. Peer/friends’ disapproval and parents’ and boyfriend’s lack of support for AGYWs’ use of contraceptives, based on rumours and perceived side effects, also impede AGYWs’ access and use of contraceptives.ConclusionSexual and reproductive health programmes could address social norms that disapprove of contraception and target rumours, myths, and misperceptions regarding modern contraceptive methods through educational campaigns and community engagements. Promoting the use of contraception in the community and men’s acceptance of contraceptive use, in particular, may increase their understanding of modern contraceptives and, subsequently, their approval for their partners to use them.</p

Datasheet_Rumours, myths, and misperceptions as barriers to contraceptive use among adolescent girls and young women in South Africa.pdf

BackgroundRumours, myths, and misperceptions about contraceptives are a barrier to contraceptive use in general, but more so among adolescent girls and young women (AGYW). As rumours and misinformation disseminate easily, it is important to explore how they affect the uptake of contraceptives among AGYW at risk of unintended pregnancies. This study used qualitative methods to explore whether rumours, myths, and misperceptions about contraceptives remain barriers to modern contraceptive use among AGYW who were beneficiaries of a combination HIV prevention intervention in South Africa.MethodsFour (4) once-off in-depth interviews, 53 serial in-depth interviews, and 19 focus group discussions (FGDs) with 185 AGYW aged 15–24 years living in 5 of the 10 intervention districts were conducted as part of the HERStory 1 Study. Interviews and FGDs were audio recorded and data were analysed thematically, aided by Nvivo 12 software.ResultsRumours, myths, and misperceptions about contraceptives, as well as sociocultural norms regarding contraception seriously hinder AGYWs’ use of modern contraceptives. Peer/friends’ disapproval and parents’ and boyfriend’s lack of support for AGYWs’ use of contraceptives, based on rumours and perceived side effects, also impede AGYWs’ access and use of contraceptives.ConclusionSexual and reproductive health programmes could address social norms that disapprove of contraception and target rumours, myths, and misperceptions regarding modern contraceptive methods through educational campaigns and community engagements. Promoting the use of contraception in the community and men’s acceptance of contraceptive use, in particular, may increase their understanding of modern contraceptives and, subsequently, their approval for their partners to use them.</p

Is self-assessment of medical abortion using a low-sensitivity pregnancy test combined with a checklist and phone text messages feasible in South African primary healthcare settings? A randomized trial

<div><p>Objective</p><p>To evaluate feasibility of self-assessment of medical abortion outcome using a low-sensitivity urine pregnancy test, checklist and text messages. The study assessed whether accurate self-assessment required a demonstration of the low-sensitivity urine pregnancy test or if verbal instructions suffice.</p><p>Methods</p><p>This non-inferiority trial enrolled 525 adult women from six public sector abortion clinics. Eligible women were undergoing medical abortion at gestations within 63 days. Consenting women completed a baseline interview, received standard care with mifepristone and home-administration of misoprostol. All were given a low-sensitivity urine pregnancy test and checklist for use 14 days later, sent text reminders, and asked to attend in-clinic follow-up after two weeks. Women were randomly assigned 1:1 to an <i>instruction-only group</i> (n = 262; issued with pre-scripted instructions on the low-sensitivity pregnancy test), or a <i>demonstration group</i> (n = 263; performed practice tests guided by lay health workers). The primary outcome was accurate self-assessment of incomplete abortion, defined as needing additional misoprostol or vacuum aspiration. Analysis was by intention to treat and a non-inferiority margin was set to six percentage points. Women’s acceptability of their abortion procedure and preferences for follow-up were also assessed.</p><p>Results</p><p>Follow-up was 81% for abortion outcome, confirmed in-clinic at two weeks or self-reported within six months. Non-inferiority of instruction-only to a demonstration was inconclusive for accurate self-assessment (risk difference for <i>instruction-only –demonstration</i>: -2.5%; 95%CI: -9% to 4%). Comparing instruction-only to demonstration groups, 99% and 100% found the pregnancy test easy to do; and 91% and 93% respectively chose the pregnancy test, checklist and text messages for abortion outcome assessment in the future.</p><p>Conclusion</p><p>Routine self-assessment using a low-sensitivity pregnancy test, checklist and text messages is feasible and preferred by women attending South African primary care abortion clinics. Counselling with additional emphasis on prompt recognition of ongoing pregnancies is recommended.</p><p>Trial registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT02231619" target="_blank">NCT02231619</a></p></div

Participant characteristics at enrollment by randomization group.

<p>Participant characteristics at enrollment by randomization group.</p

Observed difference (95% CI) between study groups for accurate self-assessment.

<p>Observed difference (95% CI) between study groups for accurate self-assessment.</p

Trial profile.

<p>(A)Women returned to the clinic, but the provider was not present. In final FU phone contact abortion outcome was self-reported. (B)Women returned to the clinic, but the provider was not present. Final FU phone contact was unsuccessful and abortion outcome could not be confirmed. (C)Women did not return to the clinic, FU at 14 days was by phone. Final FU phone contact was unsuccessful and abortion outcome could not be confirmed.</p

Additional file 2: of Women’s experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study

Survey Instrument. This is the survey instrument used to survey participants. (PDF 450 kb

Misoprostol dosage regimen.

<p>Misoprostol dosage regimen.</p

Procedure details and clinical outcomes.

<p>Procedure details and clinical outcomes.</p

Participant characteristics by medication regimen.

<p>Participant characteristics by medication regimen.</p