BACKGROUND Reliable contraception enables women and men to plan their family sizes and avoid unintended pregnancies, which can cause distress and anxiety, but also increase maternal mortality. This study explored potential barriers to contraceptive use for women in the Gaza Strip, Palestine from user and provider perspectives. METHODS A convenient sample was used to recruit women, who were current contraception users, from three healthcare clinics that provide family planning care, two governmental and one non-governmental. A 16-item questionnaire was completed by 204 women, including socio-demographic data, contraceptive use and eight questions exploring user experience. Additionally, 51 women attended focus groups for a deeper insight into their contraceptive use experience and potential barriers. Furthermore, 14 healthcare providers were interviewed about their experience with service provision. Quantitative data are presented as means and frequencies and qualitative data were analysed item by item and are presented in themes jointly with the quantitative data. RESULTS Women reported usage of only three main modern methods of contraception with 35.2% using intrauterine devices, 25.8% combined oral contraception and 16.4% condoms, while only 3.1% used the hormonal implant. Expectations from family planning services were low with most women attending the clinic having already decided their contraceptive method with decisions being made by husbands (41.2%) or women jointly with their partner (33.3%), only 13.7% took advice from service providers. Healthcare providers experienced high prevalence of beliefs that modern contraceptives cause infertility and cancer. Main barriers to effective family planning services were misconceptions of potential harm, poor availability and limited choice of contraceptive methods. CONCLUSION Women's contraceptive choices in Gaza are limited by prevalent misconceptions and fears as well as recurring shortages, negatively impacting fertility control. Men are a major factor in choosing a contraceptive method, however, they have limited access to information and therefore, potentially more misconceptions. Therefore, male community members need to be included in the delivery of information on contraceptives to increase women's choice. Furthermore, greater access to long-acting reversible contraceptives, such as the hormonal implant, and improved availability might be key factors in improving contraceptive uptake in Gaza and, thus, reducing unintended pregnancies.

中文翻译：

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巴勒斯坦加沙地带与避孕相关的选择和服务：服务使用者和提供者的看法。


背景技术可靠的避孕措施使女性和男性能够计划家庭规模并避免意外怀孕，意外怀孕可能会导致痛苦和焦虑，但也会增加孕产妇死亡率。本研究从使用者和提供者的角度探讨了巴勒斯坦加沙地带妇女使用避孕药具的潜在障碍。方法 使用方便的样本从三个提供计划生育护理的医疗诊所（两个政府的和一个非政府的）招募当前使用避孕药具的妇女。 204 名女性完成了一份包含 16 项的调查问卷，包括社会人口统计数据、避孕药具的使用以及探索用户体验的 8 个问题。此外，51 名女性参加了焦点小组，以更深入地了解她们的避孕药具使用经验和潜在障碍。此外，还采访了 14 名医疗保健提供者，了解他们提供服务的经验。定量数据以手段和频率的形式呈现，定性数据则逐项分析并与定量数据一起按主题呈现。结果 女性报告仅使用三种主要现代避孕方法，其中 35.2% 使用宫内节育器，25.8% 使用联合口服避孕药，16.4% 使用避孕套，而只有 3.1% 使用激素植入物。对计划生育服务的期望较低，大多数到诊所就诊的妇女已经决定了避孕方法，由丈夫（41.2%）或妇女与伴侣共同决定（33.3%），只有13.7%听取服务提供者的建议。医疗保健提供者普遍认为现代避孕药具会导致不孕和癌症。 有效计划生育服务的主要障碍是对潜在危害的误解、避孕方法的可用性较差和选择有限。结论 由于普遍存在的误解和恐惧以及反复出现的短缺，加沙妇女的避孕选择受到限制，对生育控制产生了负面影响。男性是选择避孕方法的主要因素，但他们获取信息的机会有限，因此可能存在更多误解。因此，男性社区成员需要参与避孕药具信息的传播，以增加女性的选择。此外，更多地获得长效可逆避孕药具（例如激素埋植剂）以及提高其可用性可能是提高加沙避孕药具采用率的关键因素，从而减少意外怀孕。