Among youth participants (Table 1), 56.7% of male respondents reported to have completed their secondary education compared to 28.6% of females. When disaggregated by age and sex groupings, the proportion of females in dating relationships was relatively high compared to their male counterparts (46.4% and 26.7% respectively). There were more Muslim female participants (82.1%) than Christians (17.9); by contrast, all male participants were Muslims.
Results are presented under three key themes: (i) Awareness of contraception (ii) Myths and misconceptions around contraception and (iii) Males’ contraceptive narratives.
Awareness of contraception
When asked to explain what they understood by contraceptives, both males and females reported awareness of contraceptives, with some providing a combination of descriptions and/or listing of the methods. Injections and the intrauterine device (IUD or the ‘coil’, as it was called by respondents in the study) were the most frequently identified contraceptives. Other methods mentioned included condoms, withdrawal and rhythm method of birth control. It was clear that young people knew or had heard about contraceptive methods, but had minimal knowledge on how they actually worked.
There are injections that you can use, I don’t know how to explain it to you. There are injections when one uses, it will just help you to family plan (Respondent 4, young women FGD 001)
There is something I have heard but I’m not familiar … with a coil, when you get to a hospital, you get the coil … they put coilto women (Respondent 9, young men, FGD 003)
Participants also explained their perceived duration of effectiveness of methods like the injection and implant.
To add more on the injection, there is an injection that someone can have for three months and there is the implant … which is put here (shows her arm) for five years (Respondent 6, young women, FGD 001)
Myths and misconceptions around contraception
Male and female participants shared several myths and misconceptions around contraception. Some respondents mentioned that the use of contraceptives jeopardized future fertility and could lead to serious health complications such as prolonged menstrual bleeding, problems conceiving, and birth defects.
People say that when you get the injection and if it does not work well for you, you bleed. You will bleed until you cannot get pregnant again and give birth. You will just be bleeding and bleeding, there are people who bleed for two months because of those injections. And immediately when the medicine effect disappears from their body, she stops bleeding. (Respondent 1, young women, FGD 001)
If for example you want to use the-after-three-months injection they say that if you use it often, then time comes and you want to stop using it and you want to get pregnant, you may wait for ten good years and you will not get a baby. Because … I don’t know it makes the egg to get lost and it becomes weak that is what it means by destroying the womb. (Respondent 6, young women, FGD 001)
When they have used contraceptive to prevent them from getting pregnant, if a man and a woman, maybe in some years to come they will have stopped using them and they now want to have children, some of them (children) will be born with abnormalities, not as usual children but deformed and underweight. (Respondent 9, young men, FGD 001)
Participants also reported fears that IUDs could be pushed inward during sexual intercourse and damage the women’s reproductive organs.
I heard about the coil, that coil is inserted here in the womb, the time you are having sex with that person and he pushes it inside already he would have messed up everything, it will force you to remove it. (Respondent 4, young women, FGD 001)
Men’s contraceptives narratives
Men in the study had their own strong concerns about adverse socio-cultural effects of contraceptives. Several of these related to sexual relations between couples and sexual desire. Some reported that contraceptives contribute to decreased sexual desires among women, ‘forcing’ men into infidelity.
Other negative effect is that, it breaks marriages because those drugs lower women’s sexual feelings, so if you (as a man) were used to like four sex rounds a week, this will reduce to two times, it will be a must for you to go outside you will not agree. (Respondent 4, young men, FGD 002)
Somewhat counterintuitively, contraceptives were also perceived to contribute to infidelity on the part of women. As a result, male respondents worried about the effect of contraception on the trust in a relationship.
We have trusted one another, and the wife takes those contraceptives and prevented herself from pregnancy, there will be no trust between us because one (wife) knows that she can have sex with anyone from outside and not getting pregnant, so I will not trust her (Respondent 2, young men, FGD 001)
In short it means untrustworthiness because you cannot get pregnant, … so maybe you will be having sex with someone or feel free to have sex anyhow and thereby infecting your partner with sexual diseases (Respondent 2, young men, FGD 002)
Interestingly, male participants also perceived that contraceptive methods deny couples their sexual freedom and regarded them as an unnecessary burden. Respondents were concerned about the implied prerequisite of always attaching contraception to sex, perceiving their sexual lives to be ‘enslaved’ to contraception thereby taking away the pleasure of having sex.
I see it as slavery using them, because it will be you and your wife at home and the time you do the marriage act (sex) you will be wearing trust (condom) and then using drugs every time you cannot skip, if you skip it will be a problem, when you say that you are leaving them (family planning pills) also it is a problem. Again, every time you will be going to the hospital or going to the chemist and take drugs, as in a burden, something like that. (Respondent 4, young men, FGD 001)
Among additional socio-cultural concerns, young men in the study also expressed beliefs that it was against ‘African’ traditions to NOT want children.
First of all, in Africa, Many Africans perceive contraceptives as un-African … In the African communities, children are important …if someone avoids getting a child …, the first year no child, second year no child … husband will now start to worry … And due to that the woman will be divorced (Respondent 6, young men FGD 003)
Finally, young men confused abortion and pregnancy prevention methods, with some participants mentioning that contraceptives could also be used to terminate pregnancies.
Contraceptives are things which prevent one from getting pregnant or if one wants to abort when she has been impregnated by a man (Respondent 2, young men FGD 001)
This confusion resulted in some participants feeling contraceptives were a ‘curse’.
You can say it is a curse because it is like doing murder, you will have killed, you can get a curse from God because you are not allowed to kill another for any mistake (Respondent 3, young men, FGD 003)