Study Of The Informed Choice Of Modern Contraceptives Among Reproductive Aged Women In The Khomas Region: Provider And Client Perspectives

Abstract

Although advances in support of informed choice were made a wide gap still exists between what is documented in policy and guidelines and the reality at the service delivery sites in Khomas region. However the extent to which nurses are implementing the family planning policy and guidelines regarding the elements of informed choice is not known as no study was conducted so far in Namibia. The aim of the study was therefore to explore the extent to which nurses applied the elements of informed choice; client’s acknowledgement of the receipt of family planning information from the nurses during family planning counselling and their demonstration of knowledge about contraceptives method they have chosen; and views of both clients and nurses about quality of application of informed choice.

An explorative, descriptive quantitative design was used. Populations consist of 7381 women of reproductive age (15-49 years) and 65 nurses worked at selected facilities. A sample size of 184 was calculated from the 7381 population using the computer probability of 95% and the confidence interval of 7.22. All 65 nurses participated in the study. Systematic random sampling and purposive sampling methods were used to select urban and rural facilities respectively; convenience sampling was used for 184 clients at facilities. Self-administrative questionnaires were used to collect data from the sample of nurses and exit interviews were conducted for clients. Data was analysed, using EPI Info. The study found that nurses applied the elements of informed choice to such extend that the majority, 73%, of the clients made own choice of contraceptives; 90% of them were treated with respect; 65% who could not find their method at specific facility were referred where it was available and 85% of the clients

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indicated that autonomuos decision making of women to use family planning was acceptable in communities.

However; only two contraceptive, injectables and pills were commonly available and was used by 79% and 18% respectively; crucial information was not given to majority, (77%) of the clients. Knowledge of clients about their methods of choice: sixty seven percent (67%) of the clients did not know what to do if they forget to take the contraceptive pill. Nurses and clients expressed their views that application of elements of informed choice as good. Based on the findings the study recommended that more family planning methods should be added; Information Education and Communication materials for the clients should be developed and effective training of nurses in family planning and communication provided. Ethical considerations were accordingly adhered to.