Post 6: Learnings from the field visits

 

After returning from the fieldwork, we started the analysis of the different interviews organizing them by topic. We identified four main findings based on the interviews, interactions, and observations during the field visits:

1. The public supply of contraceptives seems conditional on being already a mother or married, limiting access to women without children.
2. In some cases, Antenatal Care (ANC) is delayed because there is shame around pregnancy among women, especially if it is unplanned or out of marriage, despite pregnancy being considered "God's gift" and "God's will".
3. The objectives of some health schemes, especially the new ones, might overlap each other, making it harder for the population to understand and benefit from them. The scheme's guidelines might not be clearly communicated to the health workers who must implement the policies.
4. Counseling (about the use of contraceptives, nutrition, etc.) is among the leading roles of health actors; however, the effectiveness of those sessions is unclear, as well as the counseling's content, methodology, and frequency.

Due to our prior findings of the trends using data and the women's focus group, we devote time to understanding contraceptive use. Zooming in on the interviews regarding the use of contraceptives, we found that there is no clear information about the pros and cons of contraceptives and the various types of contraceptives available. Moreover, despite the efforts of counseling that ASHAs, ANMs, and other actors do, people do not consider it necessary to plan their pregnancies, given that, for them, it is "God's will" to have as many children as possible. Furthermore, there is no clear information about how effective counseling is in changing perceptions toward contraceptive use. 

As a result, birth spacing patterns are not well understood. The mainstream answer received from villagers was that birth spacing should be 3-4 years and that they follow this practice, even if they do not use contraceptives. However, when talking to frontline workers and health personnel, they explained that birth spacing is common for one year or so. 

Finally, regarding counseling, we notice that it is still hard to discuss family planning topics because of shyness and fear of judgment among villagers. People laughed when they were asked about this topic and avoided it. For example, a TBA told us that people usually do not talk about contraceptives because the community will say that they are killing the baby.

In this scene, we decided that our next step should be to focus on increasing contraceptive use among the population.