[Factors Affecting a Womans Decision to Have a Tubal Ligation or to Use Norplant: final report. Hopital Aristide le Dantec Clinique Gyneco-Obstetrique Association for Voluntary Surgical Contraception (AVSC) Senegal. Contract No. CI92.78A May-August 1993]

In 1993 in Senegal health workers interviewed 88 and 132 women who had accepted tubal ligation or the contraceptive implant Norplant respectively and the husbands of 33 tubal ligation clients and of 35 Norplant clients. Researchers wanted to know what factors influence the womans decision to accept long-term or permanent methods in a culture holding large family size in high esteem. Norplant users were younger and more educated than women accepting tubal ligation (32 vs. 39 years; secondary education vs. no formal schooling). The factors having the most influence on the womens choice and acceptance of a long-term/permanent method were economic factors and family size. The level of influence that another person had on the womans choice of method was determined by the economic role and the status of the person in the household who had an influence on contraceptive choice; the similarity of his/her judgment with that of the womans; the community in which the woman lived; and the womans knowledge of health problems economic constraints and family size. Thus the husband had more influence in the contraceptive decision-making process than did other family members in-laws and friends. Acceptors of both Norplant and tubal ligation were very satisfied with the contraceptive method and related services. Yet they disapproved of the long waiting time and the many visits required before receiving contraception. Laboratory tests and preconditions to receiving services necessitated these visits. Even though Norplant users having side effects (e.g. menstrual problems) were annoyed with them the side effects did not have a big influence on satisfaction. These findings will be used to improve the skills of health workers in using the counseling guide for Norplant to help program managers to put together a counseling guide for tubal ligation to create strategies to minimize visits needed to receive either method and to develop communication strategies for Norplant and tubal ligation.