“I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania

Drawing on 29 in-depth interviews with health care providers in Dar es Salaam, Tanzania, this paper describes providers’ attitudes and beliefs about contraceptive methods and the extent to which providers consider client choice and autonomy when providing contraceptive care. Interviews were analyzed...

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Main Authors: Alexandra Wollum, Jessica D. Gipson, Amon Sabasaba, Mohamad I. Brooks, Corrina Moucheraud
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:SSM: Qualitative Research in Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667321524001148
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author Alexandra Wollum
Jessica D. Gipson
Amon Sabasaba
Mohamad I. Brooks
Corrina Moucheraud
author_facet Alexandra Wollum
Jessica D. Gipson
Amon Sabasaba
Mohamad I. Brooks
Corrina Moucheraud
author_sort Alexandra Wollum
collection DOAJ
description Drawing on 29 in-depth interviews with health care providers in Dar es Salaam, Tanzania, this paper describes providers’ attitudes and beliefs about contraceptive methods and the extent to which providers consider client choice and autonomy when providing contraceptive care. Interviews were analyzed thematically using the constant comparative approach. Providers described a preference for long-acting reversible methods (i.e., implants and IUDs) primarily due to concerns regarding injectables’ slow return to fertility, exposure to hormones, and concerns about client adherence to pills or injectables. Providers understood the importance of centering a client’s preference to use a specific method and to have a method removed when the client desired. However, providers also described counseling clients toward their own preferences, highlighting a tension between what providers wanted for their clients and client preferences. While most providers described prioritizing client choice even when it contradicted their recommendation, some providers insisted on a certain outcome (e.g., a client taking up an implant), contradicting tenets of informed, full, and autonomous choice. Attention is needed to ensure providers center client autonomy and preferences and guarantee freedom from coercion in contraceptive care.
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spelling doaj-art-179be393cac049e294bf4f4995db79de2025-08-20T02:50:16ZengElsevierSSM: Qualitative Research in Health2667-32152024-12-01610050510.1016/j.ssmqr.2024.100505“I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in TanzaniaAlexandra Wollum0Jessica D. Gipson1Amon Sabasaba2Mohamad I. Brooks3Corrina Moucheraud4Department of Community Health Sciences, University of California, Los Angeles, USA; Corresponding author. 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA.Department of Community Health Sciences, University of California, Los Angeles, USAHealth For a Prosperous Nation, TanzaniaPathfinder International, Washington D.C, USADepartment of Public Health Policy & Management, New York University, USADrawing on 29 in-depth interviews with health care providers in Dar es Salaam, Tanzania, this paper describes providers’ attitudes and beliefs about contraceptive methods and the extent to which providers consider client choice and autonomy when providing contraceptive care. Interviews were analyzed thematically using the constant comparative approach. Providers described a preference for long-acting reversible methods (i.e., implants and IUDs) primarily due to concerns regarding injectables’ slow return to fertility, exposure to hormones, and concerns about client adherence to pills or injectables. Providers understood the importance of centering a client’s preference to use a specific method and to have a method removed when the client desired. However, providers also described counseling clients toward their own preferences, highlighting a tension between what providers wanted for their clients and client preferences. While most providers described prioritizing client choice even when it contradicted their recommendation, some providers insisted on a certain outcome (e.g., a client taking up an implant), contradicting tenets of informed, full, and autonomous choice. Attention is needed to ensure providers center client autonomy and preferences and guarantee freedom from coercion in contraceptive care.http://www.sciencedirect.com/science/article/pii/S2667321524001148ContraceptionQuality of careProvidersLong-acting reversible contraception
spellingShingle Alexandra Wollum
Jessica D. Gipson
Amon Sabasaba
Mohamad I. Brooks
Corrina Moucheraud
“I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania
SSM: Qualitative Research in Health
Contraception
Quality of care
Providers
Long-acting reversible contraception
title “I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania
title_full “I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania
title_fullStr “I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania
title_full_unstemmed “I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania
title_short “I am forced to just give it to her because she is the one who wants it”: A qualitative study of providers’ perspectives on contraceptive counseling in Tanzania
title_sort i am forced to just give it to her because she is the one who wants it a qualitative study of providers perspectives on contraceptive counseling in tanzania
topic Contraception
Quality of care
Providers
Long-acting reversible contraception
url http://www.sciencedirect.com/science/article/pii/S2667321524001148
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