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- Title
Family planning for women with severe mental illness in rural Ethiopia: a qualitative study.
- Authors
Zerihun, Tigist; Sorsdahl, Katherine; Hanlon, Charlotte
- Abstract
Background: Family planning is a crucial issue for all women of reproductive age, but in women with severe mental illness (SMI), there may be particular challenges and concerns. As primary care-based mental health services are expanding in low- and middle-income countries (LMICs), there is an opportunity to improve family planning services for women with SMI. However, research exploring unmet family planning needs of women with SMI in such settings is scarce. Therefore, the present study explored the family planning experiences and preferences of women with SMI who reside in a predominantly rural area of Ethiopia. Methods: A qualitative study was conducted. Women with SMI who were participating in the ongoing population-based cohort study in Butajira were selected purposively based on their responses to a quantitative survey of current family planning utilisation. In-depth interviews were conducted with 16 women with SMI who were of reproductive age. Audio files were transcribed in Amharic, translated into English and analysed thematically. Results: Participants reported pervasive effects of SMI upon the intimate relationships and sexual lives of women. Although women with SMI felt that family planning was important, they had limited knowledge of family planning generally, and a lack of understanding of the specific family planning needs relevant to having SMI. None of the women with SMI in the present study had received any recommendations to use family planning services while accessing mental health care services. The participants identified ways in which primary care-based mental health services could better meet their family planning needs. Conclusions: This study provided in-depth perspectives from women with SMI about the broader context of their family planning experience, needs, barriers and how integrated primary care services could better meet their needs. Empowerment of women with SMI to access information and services needs to be an important focus of future efforts to improve the reproductive experiences of this vulnerable group. Plain language summary: Family planning is a crucial issue for all women of reproductive age, but in women with severe mental illnesses (SMI), including conditions like schizophrenia, bipolar disorder and severe depression, there may be particular challenges and concerns. Very little is known about the unmet family planning needs of women with SMI who live in low- and middle-income countries. In this study, we explored the family planning experiences, unmet needs and preferences of women with SMI who live in a rural area of Ethiopia. We identified women with SMI who were taking part in a community study asking about their use of family planning. We selected 16 women with low and high use of family planning to interview in depth. The study women spoke of how having a mental illness drastically affected their intimate relationships and sexual life. Although the women felt that family planning was important, they had limited knowledge of family planning generally and a lack of understanding of the specific issues that mental illness might have on family planning choices. None of the women had received any recommendations to use family planning services while accessing mental health care services. The participants identified ways in which primary care-based mental health services could better meet their family planning needs. We concluded that it is important to focus on empowerment of women with SMI in this rural Ethiopian community, making sure that they have access to the kind of information and services that they need for family planning.
- Subjects
ETHIOPIA; FAMILY planning; RURAL conditions; RESEARCH methodology; INTERVIEWING; PATIENTS' attitudes; PRIMARY health care; QUALITATIVE research; HEALTH literacy; JUDGMENT sampling; NEEDS assessment; THEMATIC analysis; MENTAL illness; MEDICAL needs assessment; WOMEN'S health; MENTAL health services
- Publication
Reproductive Health, 2021, Vol 18, Issue 1, p1
- ISSN
1742-4755
- Publication type
Article
- DOI
10.1186/s12978-021-01245-1