Challenges Faced by Older Women in Botswana in Accessing Services that Address Sexual and Reproductive Health; and Family Planning Needs; in Botswana

ABSTRACT

Objective: This study explored the challenges that older women from selected sites in Botswana face in accessing services that address sexual and reproductive health (SRH) and family planning (FP) needs. Design; setting and subjects: Two rural and two urban health districts were randomly selected for the study. A statistically determined sample of 454 older women was allocated to the different districts (strata); using probability proportional to size. Outcome measures: The study estimated the percentage use of sexual and reproductive health services (including family planning services); unmet need for family planning and factors inhibiting use of these services. Results: The study revealed that 25 of the older women used some type of FP method. Of this number; 67.9 were aged 50-59 years; 17.4 60-69 years; 10.1 70-79 years; and 72 had unmet needs for FP. The older women used natural FP methods mainly. The main SRH services used by them were screening for human immunodeficiency virus/acquired immune deficiency syndrome; sexually transmitted infections and cervical cancer. Obstacles to accessing SRH and FP services were found to include illiteracy; lack of education; financial constraints; a perception that healthcare planners limited SRH needs to antenatal and obstetrical services; a cultural reluctance to discuss SRH in public and domestic issues.Conclusion: The study recommends comprehensive public health education for older women on human sexuality and fertility; contraceptive use; access to services; effective training programmes for healthcare providers on how to deal with older women's issues and better access to STI and cervical cancer screening services