Abstract

Unmet need for family planning (FP) remains prevalent worldwide. In Tanzania, 21.7% of women desire to delay pregnancy, but do not use modern contraception despite its free availability at local clinics. Our prior data suggest that this is related to complex gender and religious dynamics in rural communities. To understand how education about FP could be improved, we developed a discrete choice experiment (DCE) to rank preferences of six attributes of FP education. Results were stratified by gender. Sixty-eight women and 76 men completed interview-assisted DCEs. Participants significantly preferred education by a clinician (men = 0.62, p < .001; women = 0.38, p < .001) and education in mixed-gender groups (men = 0.55, p < .001; women = 0.26, p < .001). Women also significantly preferred education by a religious leader (0.26, p = .012), in a clinic versus church, mosque, or community centre (0.31, p = .002), and by a female educator (0.12, p = .019). Men significantly preferred a male educator (0.17, p = .015), whom they had never met (0.25, p < .001), and educating married and unmarried people separately (0.22, p = .002). Qualitative data indicate women who had not previously used contraception preferred education led by a religious leader in a church or mosque. FP education tailored to these preferences may reach a broader audience, dispel misconceptions about FP and ultimately decrease unmet need.

摘要

未满足的计划生育需求 (FP) 在世界范围内仍然普遍存在。在坦桑尼亚，21.7% 的妇女希望推迟怀孕，但尽管当地诊所免费提供现代避孕方法，但并不使用现代避孕方法。我们之前的数据表明，这与农村社区复杂的性别和宗教动态有关。为了了解如何改进 FP 教育，我们开发了一个离散选择实验 (DCE)，对 FP 教育的六个属性的偏好进行排序。结果按性别分层。68 名女性和 76 名男性完成了面试辅助的 DCE。参与者明显更喜欢临床医生的教育（男性 = 0.62，p  < .001；女性 = 0.38，p  < .001）和混合性别群体的教育（男性 = 0.55，p  < .001；女性 = 0.26，p < .001）。女性也明显更喜欢宗教领袖 (0.26, p  = .012)、诊所与教堂、清真寺或社区中心 (0.31, p  = .002) 以及女性教育者 (0.12, p  = .019) 的教育）。男性明显更喜欢 他们从未见过的男性教育者 (0.17, p = .015) (0.25, p  < .001)，并分别教育已婚和未婚人士 (0.22, p  = .002)。定性数据表明，以前未采取避孕措施的女性更喜欢在教堂或清真寺接受宗教领袖领导的教育。针对这些偏好量身定制的 FP 教育可能会覆盖更广泛的受众，消除对 FP 的误解，并最终减少未满足的需求。