Abstract:

This study details the results of the in-depth interviews and focus groups conducted with health care providers, supervisors, and senior health officials, in addition to focus groups conducted with a sample of male and female community members in Mafraq. The fieldwork was conducted in March and April of 2014 by an outsourced independent consultant Also this Qualitative study is a very useful tool to determine the general environment and opinions related to sensitive issues such as use of FP methods, so the MOH and HSS II agreed that such a study was needed to better understand how to meet the reproductive health needs of users of traditional FP methods. The objectives of the study is: 1. Assess the current situation of demand and provision of FP methods in specific areas in Jordan (Maan, Mafraq and East Amman). 2. Identify the currently held perceptions of health care providers,decision makers and Mafraq local community members towards the use of modern and traditional family planning methods. 3. Assess perceptions of health care providers and decision makers concerning potential utility of introducing an additional natural method, the Standard Days Method (SDM), as a way to broaden the options of users of traditional FP methods. 4. Concept test the feasibility of piloting introduction of SDM in specific areas of Jordan (this objective was only explored with health care providers and decision makers. The main findings were: - According to many community members in Mafraq, particularly from rural and Bedouin areas, they rarely get proactive advice from service providers, and when asking, sometimes they are faced with no response or with a brief response about the method they asked about and not a comprehensive answer. - A major problem that doctors in Mafraq found to be an issue is the inconsistency in awareness campaigns. Campaigns are usually concentrated in a condensed period of time, which causes a hike in demand which would decrease soon after the campaign ended. - The individuals who very vocal against the use of traditional methods believe that: - Traditional methods have very high failure rates. - In order to be able to use traditional methods, a woman and her husband should be in agreement and very knowledgeable about the method and the mechanism of use. - Modern methods are very convenient and safe substitutes and the variety offered at health care centers leaves only a very small minority uncovered - There is major problem that prevents effective provision of IUDs and Implanon, which is the dire need for trained and qualified female staff. This was a major problem according to decision makers in Mafraq and Maan - There were also several women and men in both rural and urban groups who have used or still using traditional methods (primarily withdrawal). Many acknowledged that those methods have high failure rates. However, fear of side effects or previous negative experiences with modern methods motivated use. - A good number of midwives, especially those who work in rural areas explained that they personally use, or have used at one point, traditional FP methods. Many success stories of using traditional FP methods were cited by midwives in those areas. This was not often the case among the East Amman health care providers. They had a solid belief that modern FP methods were the solution for many health, economic and social problems. Urban problems seemed to be more vivid in East Amman, which served as a driver for being proactive in advocating modern FP methods - As for decision makers and supervisors, they stated an additional reason: Some health care providers in the areas in question (Mafraq and Maan) were accused by decision makers to be advocates as well as personal users of traditional FP methods. - One of the main barriers to use of modern FP methods as agreed by the vast majority, was lack of true knowledge about the methods. While awareness levels towards the methods are high, the understanding of the actual mode of action and side effects of each method that is offered in a HC is not sufficient to increase the use of modern family planning methods. If the effort that could be directed to introduce SDM is exerted in increasing the awareness towards those aspects across both the beneficiaries and the health care providers, it is assumed that the use of modern FP method would increase.