Exploring the disclosure of risks and benefits of depo-provera by health care workers at public health facilities in Kyotera and Rakai districts

Abstract

Background: Contraception is a basic human right for all women as articulated in the Universal Declaration of Human Rights. Every girl and woman should have the right to choose what contraception method, when they want, and how they would like to plan their families and control their fertility. Injectable Depo-Provera is the most popular contraceptive used by women in Uganda despite the controversies surrounding its approval by FDA and possible higher risk from its use as compared to other methods of contraception. Objectives: The objectives of the study were to explore the disclosure of risks and benefits of the Depo-Provera injectable by the health care workers to the clients at public health care facilities in Kyotera and Rakai districts, and to explore the reflections and experiences of the women on the risks and benefits of the Depo-Provera injectable. Methods: We conducted 24 in-depth interviews with the family planning providers and held 4 focus group discussions with women using the injectable at the selected facilities. We employed only qualitative methods of data collection and data analysis. Results: The results showed mixed outcomes. The health workers painted a picture of an ideal disclosure process they employ to administer the Depo-Provera injectable, while testimonies from the women who use the injectable to a greater extent revealed the opposite picture. The results indicated a deficiency in disclosure of the risks and benefits of the Depo-Provera injectable by the health workers at the sampled public health facilities. Conclusion: Given the vulnerable position in which most women in the developing countries find themselves, and a high demand for the Depo-Provera contraceptive owing to its advantages, the family planning providers do not give the disclosure of the risks and benefits of the injectable appropriate seriousness to prevent potential any causation of harm to some women who are adversely affected by the injectable and enable an environment of informed choice, and this is an ethical concern.