ArticleBMJ open2020
'Our culture prohibits some things': qualitative inquiry into how sociocultural context influences the scale-up of community-based injectable contraceptives in Nigeria.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 27 citations in OpenAlex.
- The world of contraception: A global mapping project across FIGO member societies.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Knowledge, attitudes, and practices regarding contraception amongst community pharmacy staff: a cross-sectional study in Nigeria.Frontiers in reproductive health · 2025Article
- Perception of couples' on multipurpose prevention technology attribute choice: the case of MTN 045.BMC public health · 2024Article
- "It doesn't exist, only other people have it, or it's bad luck": perceptions of HIV as barriers to its prevention in Bata.BMC public health · 2023Article
- Scale-up of the DMPA-SC in Nigeria: Why policy matters.BMC women's health · 2022Article
- Achieving universal reproductive health coverage for deaf women in Ghana: an explanatory study of knowledge of contraceptive methods, pregnancy and safe abortion practices.BMC health services research · 2022Article
- Article
- Developing a socio-ecological model for community engagement in a health programme in an underserved urban area.PloS one · 2022Article
- Conducting clinical research in a resource-constrained setting: lessons from a longitudinal cohort study in The Gambia.BMJ global health · 2021Article
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Authors and funding
3 authors at 2 institutions in 3 countries.
Funding
Abstract
objectivesTo explore how sociocultural factors may support or impede the adoption of community-based distribution of injectable contraceptives in Nigeria.
designA qualitative study based on inductive thematic analysis was conducted through in-depth interviews and focus group discussions.
settingMost participants lived in Gombe State, North-East Nigeria. Other participants were from Ibadan (South-West) and Abuja (Federal Capital Territory).
participantsThrough seven key informant interviews, 15 in-depth interviews and 10 focus group discussions, 102 participants were involved in the study.
methodsThis study conducted in 2016 was part of a larger study on scale-up of community-based distribution of injectable contraceptives. Qualitative data were collected from traditional and religious leaders, health workers and community members. The data were audio recorded, transcribed and analysed using a thematic framework method.
resultsSociocultural challenges to scale-up included patriarchy and men's fear of losing control over their spouses, traditional and religious beliefs about fertility, and myths about contraceptives and family planning. As a result of deep-rooted beliefs that children are 'divine blessings' and that procreation should not be regulated, participants described a subtle resistance to uptake of injectable contraceptives. Since Gombe is largely a patriarchal society, male involvement emerged as important to the success of meaningful innovation uptake. Community leaders largely described their participation in the scale-up process as active, although they also identified the scope for further involvement and recognition.
conclusionScale-up is more than setting up health sector implementing structures, training health workers and getting innovation supplies, but also requires preparedness which includes paying attention to complex contextual issues. Policy implementers should also see scale-up as a learning process and be willing to move at the speed of the community.
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