Exploring maternal health experiences of contraceptive use and anti-natal care for young women who marry early in Namaacha, Mozambique.
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Date
2017
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Abstract
This study explores the Sexual Reproductive Health and Rights (SRHR) experiences of women
who marry early in Namaacha District of Mozambique. Young women who marry early are
often forced into marriages and experience a life void of choices, about their SRHR. This study
is anchored through a review of literature that examined the impact of early marriage practice,
its trends, and determinants to influence SRHR decision-making both globally and locally; and
is informed by a critical theoretical framework of Gender and Power proposed by Connell
(1987). The research specifically explored how women talk about their experiences of
maternal health (i.e., use of modern contraceptives and attendance of antenatal (ANC) care
services during pregnancies); decision making processes regarding the use of contraceptive
methods; and barriers/facilitators for effective use of modern contraceptives and antenatal care
services. A life grid methodology from the qualitative interpretivist tradition was used to
collect narrative data of ten adult women residing in Namaacha District in Mozambique. The
women were selected using a purposive/judgmental and snowball sampling methods and
selection was based on self reported criteria that they married early and had their first
pregnancy before the age of eighteen. Two open ended interview guides were utilised to collect
data and the interpretative phenomenological analytical method guided the data analysis
process. The findings in this study revealed a positive prognosis regarding women’s use of
modern contraceptives (MC) as well as attendance of ANC during pregnancy in Namaacha
district. Despite reports of low and inconsistent use of MC as well as later attendance of ANC
during pregnancy, participants reported having support from their community and respective
husbands to utilise maternal health services. The majority of participants described how the
information about the benefits of family planning methods that they have accessed, whether at
the health centers, media or in community gatherings, motivate them to seek and use modern
contraceptives. Participants mentioned using at least one or more modern contraceptive method
during marriage and they could name some of the modern contraceptive methods currently
available. Participants did not report attending four or more times ANC appointments during
normal pregnancies as recommended by the literature on ANC model, however, they did report
attending at least once during some of their pregnancies. The current struggle includes
motivating women to start attending these services earlier in their pregnancies. From the
participants’ stories, awareness of the personal and external barriers and facilitators to
accessing information to empower themselves is critical. For them, early marriage is still
deeply rooted in the community and culture, which in many ways affects their decision to seek
and use contraceptives and ANC during pregnancy. The participants described living in
privation of basic necessities and in an environment where their decision-making power around
general issues and private ones were very low, particularly at early stages of their marriage.
Thus, this study found that early marriage had negatively impacted women’s well-being and
further possibilities of growth. Overall, participants described being satisfied with the marriage
despite the challenges of it. They understand the negative impacts of early marriage on their
lives but work within such patriarchal systems to change them.
Description
Master’s degree. University of KwaZulu-Natal, Durban.