32% of married Yemeni women use birth control, study says [Archives:2007/1107/Local News]

November 29 2007

By: Almigdad Dahesh Mojalli
SANA'A, Nov. 28 ) A recent study revealed that only 32% of Yemeni married women use some method of birth control, though 96% of both men and women are aware of at least one type of birth control.

The report, which covered 1,400 men and women ranging from 15-49, aimed to know the background, education and usage of both women and men regarding birth control methods and sexual trnasmitted diseases, particularly HIV and AIDS. The report revealed that 34% of women in urban areas use birth control, in contrast to 14% of rural women. Contraceptive pills are the most commonly used method with 13%, followed by the IUD with 6% and injections with 4%. 7% of married women use traditional methods of contraception such as periodic abstinence, withdrawal and breastfeeding.

The main reasons given by women for discontinuing contraceptive use was: it is bad for their health (37%), they wanted to get pregnant (28%) and they were told to stop by their spouse (11%). The reasons for non-use were: not wanting to use family planning (FP) (36%), their spouse not agreeing with family planning (24%), not knowing family planning exists (10%) and perceived bad side effects (6%).

The study that included urban and urban districts and districts of refugees in Sana'a, Taiz, Aden, Al-Mukala, Ibb and Hajjah, stated that 13% of women mentioned their abilities to move outside their zones alone while only 1% of women in the rural areas stated that even for healthy care.

A study conducted by Mari Stops International Organization stated that the mean age at marriage was 22 and 17 years for men and women, respectively. Half of the women reported having had up to 4 pregnancies while just under a third reported more than seven pregnancies. There was a disparity in the number of pregnancies and number of living children, with married women reporting a range of 1-17 pregnancies, but only 1-13 living children. There was a preference for male children.

Women reported that the major reasons why women stop using FP is either because of the adverse health effects of FP (37%), or because they want more children (28%), and 11% were told to stop by their spouse. Others noted that the cost of methods was also an issue. One woman put it succinctly that the woman stops: “When her husband asks her to because he is the decision-maker”. Women also stop FP to protect their marriage “when her husband wants to marry another woman because his financial status becomes better”.

The reasons stated for currently not using a method was 36% not wanting to use family planning, 24% because of spouse not agreeing with family planning, 10% not knowing about family planning and 6% not using because of negative side effects of FP in the past.

The study recommended that women especially those in the rural areas should be subject to educational campaigns and services to be enstrengthened and to have an access to the community. It also, recommended that Outreach workers need to be well informed and able to disseminate BCC materials with correct information about how contraception works, its correct side effects and its effectiveness, if used correctly, to contribute towards dispelling negative myths in the community.

The study recommended also that knowledge of HIV/AIDS is higher than of STIs in all the target populations. However, accurate knowledge about the ways HIV is transmitted is not consistent with knowledge of how to avoid transmission. Education campaigns need to have clear messages that are consistently and repeated through various forms of media, such as limiting the number of sexual partners or staying faithful to one partner, using a condom at every non-monogamous sexual encounter etc.

More efforts could be focused on sensitizing men about the risks of having more than one sexual partner/wife in terms of STIs and HIV/AIDS. The use of condoms as both an STI barrier and family planning method needs to emphasized.

Knowledge of HIV testing facilities was low and should be included in education campaigns about HIV/AIDS while simultaneously ensuring that these services do actually exist (especially in rural areas), or alternative referral services made available.

Dr. Arwa Al-Rabe'e, the deputy of the Health Ministry for the population sector stated that the ministry has put a five-year national strategy of birth control in three stages and now the strategy is in its third and final stage. She said that no one can deny that the birth control methods are available everywhere in rural and urban areas equally.

She added that the ministry announced in the beginning of last year free birth control services, available to 85% of the country.

Mrs. Fran Rotes, the representative of Mari Stops Organization, affirmed the necessity that all fathers and mothers have to know the importance of reproduction health as a result of an increasing mortality rate in Yemen because of early marriage and deliveries that negatively affect social and economical development in Yemen.

Rotes added that Mari Stops, within nine years, could broaden its activities in Yemen in terms of reproduction health to reach five clinics for reproduction health, in addition to the social marketing project for the reproduction services.

Dr. Ashraf Badr, the manager of the social marketing project said that the project is part of the Yemeni-Germany program for reproduction health and aims to change society behavior in regards to birth control and the protection of sexual transmitted diseases. “We conducted a survey on the knowledge, performance and behavior of people towards the birth control methods and sexual transmitted diseases. The study covered five governorates of the republic in 2006 and today we publish the results of the survey and all the people concerned with health affairs can get advantages from the survey. During the survey, we found that the rate of the people who use birth control methods increased from 13% to 25% in the year 2006 and this rate will reach 33% in the year 2013.” Dr. Ashraf said.