Barriers to modern contraceptive use in rural Peru.

ABSTRACT

PIP: This paper, based on fieldwork done in 1984 in a Peruvian highland community with a population of about 3,500, examines Quechua-speaking Indians' choice of contraceptive methods and discusses barriers to the use of modern contraceptives. The village is poor, with many of the villagers involved in migrant labor, but there have been modernization influences: most villagers are bilingual, men average 8 years of schooling and wives 6. Government family planning programs (FP) were initiated at the local health post in 1982. This study, sampling 54 couples, 2/3 in consensual unions shows 1st pregnancy is usually at 18, and about 5 live births take place by age 31. Only 12 couples reported not using any form of contraception, 27 unreliable natural or traditional methods, and 15 modern methods. Non-contracepting women tended to breastfeed longer and have less schooling, and tended not to be working full-time. Contraceptive choice is strongly related to a couple's life experiences, their contact with urban centers, their economic status, and their emphasis on cultural values. Among contraceptive users, some husbands are concerned with family size (for economic, child welfare, and health reasons) and encourage their wives to seek information about the use of modern contraceptives. A discrepancy in attitudes exists between spouses: men's positive attitude toward modern contraception contrasts with women's traditional desire for a large family. Villagers do not use modern contraceptives because of barriers created by FP services that do not take into account the lifestyle of these people (e.g. language, work hours, respect for privacy), disturbing and poorly explained side-effects, especially of pills and injected depo-provera, insufficient knowledge of human physiology, contraception failures due to inappropriate use (often because of poor explanations by health post staff), comments from dissatisfied users, and women's reliance on their reproductive role for self-esteem.