Youth accessing reproductive health services in Malawi: Drivers, barriers, and suggestions from the perspectives of youth and parents

Andrew Self, Samuel Chipokosa, Amos Misomali, Tricia Aung, Steven A Harvey, Mercy Chimchere, James Chilembwe, Lois Park, Chrissie Chalimba, Edson Monjeza, Fannie Kachale, Jameson Ndawala, Melissa Hewett-Marx

Research output: Contribution to journalArticle

Abstract

Background: Malawi has made progress in increasing its overall modern contraceptive prevalence rate since 2000, resulting in a dramatic reduction in its total fertility rate. However, youth, 15-24 years, have not had the same successes. Teenage pregnancies are on the rise and little progress has been made in reducing unmet need for family planning among youth. With two-thirds of the population under the age of 25 and with Malawi's rapid population growth, reducing unmet need for family planning among youth remains a priority for the government's reproductive health agenda. To further explore this situation, we conducted a qualitative study to explore the perspectives of youth and adults about the drivers and barriers to youth accessing family planning in Malawi and their ideas to improve services. Methods: We conducted 34 focus group discussions with youth aged 15-24 and parents or legal guardians of female youth in 3 districts in Malawi. Focus groups were translated and transcribed. Data was input into Dedoose and analyzed using a thematic framework to identify broader patterns and themes. Results: Youth participants felt motivated to use family planning to protect themselves from sexually transmitted diseases and to prevent unwanted pregnancies. Females focused on the consequences of unplanned pregnancies and believed family planning services were targeted primarily at them, while males thought family planning services targeted males and females equally. Barriers to youth accessing family planning included contraception misconceptions, the costs of family planning services, and negative attitudes. Parents had mixed views on family planning. While many parents acknowledged they could play a role in supporting youth, most said they are reluctant to support youth using family planning. Participants said improving counseling services, integrating family planning services and education within school curricula, and utilizing youth clubs could improve family planning services for youth. Conclusions: Policy makers and program implementers should consider the diverse preferences among youth and parents and continue seeking their input when designing policies and programs. Youth clubs and school-based services were among the most common suggestions. However, the effectiveness of youth clubs and school-based initiatives to increase contraceptive use among youth in Malawi is not clear.

Original languageEnglish (US)
Article number108
JournalReproductive Health
Volume15
Issue number1
DOIs
StatePublished - Jun 19 2018

Keywords

  • Adolescent
  • Contraception
  • Family planning
  • Malawi
  • Qualitative research
  • Sexual and reproductive health
  • Youth

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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