Despite availability of modern contraceptive methods and documented unmet need for family planning in Ghana, many women still report forgoing modern contraceptive use due to anticipated side effects. The goal of this study was to examine the use of modern family planning, in particular hormonal methods, in one district in rural Ghana, and to understand the role that side effects play in women’s decisions to start or continue use. This exploratory mixed-methods study included 281 surveys and 33 in-depth interviews of women 18–49 years old in the Amansie West District of Ghana between May and July 2018. The survey assessed contraceptive use and potential predictors of use. In-depth interviews examined the context around uptake and continuation of contraceptive use, with a particular focus on the role of perceived and experienced side effects. The prevalence of unmet need for modern family planning among sexually active women who wanted to avoid pregnancy (n = 135) was 68.9%. No factors were found to be significantly different in comparing those with a met need and unmet for modern family planning. Qualitative interviews revealed significant concerns about side effects stemming from previous method experiences and/or rumors regarding short-term impacts and perceived long-term consequences of family planning use. Side effects mentioned include menstrual changes (heavier bleeding, amenorrhea or oligomenorrhea), infertility and childbirth complications. As programs have improved women’s ability to access modern family planning, it is paramount to address patient-level barriers to uptake, in particular information about side effects and misconceptions about long-term use. Unintended pregnancies can be reduced through comprehensive counseling about contraceptive options including accurate information about side effects, and the development of new contraceptive technologies that meet women’s needs in low-income countries.

中文翻译：

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副作用问题及其对加纳农村妇女采用现代计划生育方法的影响：一项混合方法研究。


尽管加纳拥有现代避孕方法，并且有记录表明计划生育需求未得到满足，但许多妇女仍然报告称，由于预期的副作用而放弃使用现代避孕方法。这项研究的目的是检查加纳农村一个地区现代计划生育（特别是激素方法）的使用情况，并了解副作用在妇女决定开始或继续使用时所起的作用。这项探索性混合方法研究包括 2018 年 5 月至 7 月期间对加纳阿曼西西区 18-49 岁女性进行的 281 项调查和 33 次深度访谈。该调查评估了避孕药具的使用情况和潜在的使用预测因素。深入访谈调查了避孕药具的采用和继续使用的背景，特别关注感知和经历的副作用的作用。在性活跃且想要避免怀孕的女性 (n = 135) 中，现代计划生育需求未得到满足的比例为 68.9%。在比较满足现代计划生育需求和未满足需求的人群时，没有发现任何因素存在显着差异。定性访谈揭示了人们对副作用的严重担忧，这些副作用源于先前的方法经验和/或有关计划生育使用的短期影响和感知的长期后果的谣言。提到的副作用包括月经变化（出血增多、闭经或月经稀发）、不孕和分娩并发症。由于各项计划提高了妇女获得现代计划生育的能力，因此解决患者层面的接受障碍至关重要，特别是有关长期使用的副作用和误解的信息。 通过有关避孕选择的全面咨询（包括有关副作用的准确信息）以及开发满足低收入国家妇女需求的新避孕技术，可以减少意外怀孕。