Table 3 Quotes from study participants organized by qualitative theme
Code | Sub-code | Quote |
|---|---|---|
Theme 1: Exposure to contraceptive information facilitated by salon environment | ||
Salon characteristics | Facilitators | Confidential space: ""They would be happy talking to us because the salon is the only place that we meet; I do not know where my clients live so I cannot go to their neighbours and gossip about them." [Stylist] |
Female-oriented: “I don’t think there is anything that would make me feel uncomfortable because in this salon we are all women and we know these things.” [Client, 22 yo] | ||
Comfortable around other clients: "I think these services can be offered at the salon because at the salon even when you are waiting you are with people that you know so even the conversations that you are having they tend to make you not worry about the time that you spending at the salon." [Client, 25 yo] | ||
Barriers | Concerns regarding confidentiality: "Salons are public places. Imagine you are here to get your prevention pills from the salon and you bump into someone that you know, even your neighbour, everyone would know that you getting contraception from the salon." [Client, 24 yo] | |
Client characteristics | Facilitator | Investment of time: "As working women we hardly get time to go to the clinic but with the salon we don’t take chances. We make it a must that we go to the salon because as women we value our beauty through our hair styles. So for this reason I think it’s a good thing." [Client, 28 yo] |
Recommendations | Ensuring confidentiality: "I think a mobile clinic is the solution because no one can tell what you are doing inside." [Client, 18 yo] | |
Theme 2: Attention to contraceptive information facilitated by stylist–client relationships | ||
Stylist characteristics | Facilitators | Prioritize happiness of clients through services: "The role of the hair stylist is to always make sure that women always look their best and to keep the hair healthy and their self-esteem up.” [Stylist] |
Prioritize happiness of clients through friendliness: "They see us as helpful people in their lives because anytime that they feel down they always come to the salon to do their hair and suddenly they feel okay." [Stylist] | ||
Learning about clients' lives: “Sometimes our clients just come to the salon just because they want to sit and chat with us.” [Stylist] | ||
Connecting over shared experiences: "Personally, I am a person that loves to talk. Sometimes a client comes to the salon to do her hair and I automatically start a conversation talking about my problems. As I talk about my problems, the client becomes comfortable enough to start talking about their problems. We end up giving each other advice. This relationship is not only limited to myself and my clients. I am like this to everyone, even with my colleagues." [Stylist] | ||
Stylist investment of time: "When the clients come to the salon, we become counsellors to them because some clients spend like 3–4 h at the salon. So when you are with a client for so many hours, even the problems or situations that they have in their lives you can talk to them and advise them." [Stylist] | ||
Referring to clients like kin: "My clients are my friends; I perceive them as my friends and my sisters." [Stylist] | ||
Prioritizing client trust: "When the clients come to the salon, we become counsellors to them because some clients spend like 3–4 h at the salon. So when you are with a client for so many hours, even the problems or situations that they have in their lives you can talk to them and advise them." [Stylist] | ||
Barriers | Unfamiliar to newer clients: "With new clients it can be tricky because some clients are cheeky especially when you haven’t established any relationship with them. But for those who know you, they will be comfortable.” [Stylist] | |
Client characteristics | Facilitators | Trust in stylist: "To be honest [my preference to hear reliable information about contraception] would be my stylist because I trust her. In the world today you need someone you can trust." [Client, 24 yo] |
Barriers | Discomfort discussing contraceptives: "We have to come up with a way to approach clients because some perceive this topic as very delicate." [Stylist] | |
Contraceptive access outside of salons | Barriers | Treatment by clinic staff: "A clinic is a scary place, nurses are rude and judgmental." [Client, 24 yo] |
Theme 3: Comprehension—salon facilitates environment within which clients and stylists can learn about contraceptives | ||
Stylists' and clients' and past contraceptive usage | Barriers | Preconceptions about contraceptive usage: "Well I have heard stories that the loop is not guaranteed that you will not get pregnant—some women have fallen pregnant with the loop inside them." [Client, 27 yo] |
Client characteristics | Barriers | Stigma against education level of stylists: "Some of the clients have very low regard for us with the idea that since we do hair, we are uneducated." [Stylist] |
Stylist characteristics | Barriers | Stylists perceived as untrustworthy or rude: "We might talk and say all that we like but hair stylists are not known for their ability to keep secrets. Stylists are always talking…" [Stylist] |
Perceived as preoccupied or busy: "The stylist already has a job, to do hair. Sometimes you would come to the salon seeking advice and find that the stylist is busy." [Client, 31 yo] | ||
Facilitators | Willingness to be trained: "You must provide training for us so that we are knowledgeable in the topics that we will be discussing with our clients. It would be very unfortunate and embarrassing to start a conversation with our clients and when they ask questions about what we are discussing, we can no longer respond." [Stylist] | |
Recommendations | Audiovisual media: "I think we should have posters and condoms. Posters and condoms can show clients that there is a health initiative going on in this salon. And when they see the posters the clients will ask about the health services that are being offered." [Stylist] | |
Healthcare provider on-site: "I think having a nurse on site would help because if we encounter problems or difficult questions we can always ask a nurse." [Stylist] | ||
Peer mentors: "I think it’s a peer mentor. I believe a nurse is only trained to administer injections. Whereas a peer mentor is also trained to approach people and build relationships and explain health service to people." [Client, 29 yo] | ||
Stylist support for client education: "I think there should be trainings and counselling that educates the people on the benefits of this programme, this way they can come willing because they will understand that this programme is aimed at helping them." [Stylist] | ||
Theme 4: Belief that accepting contraceptives in salons is feasible | ||
Stylist characteristics | Facilitators | Overall buy-in: "As soon as the clients are aware of the services that are offered they will come. Even now, my clients are asking about you, they asking for your number and asking when you will be coming back to the salon." [Stylist] |
Perceived contraceptive need: "We talked about receiving health services such as contraceptives and testing for HIV, then the benefits that can arise is in the decline of unintended pregnancies among the youth because the youth is the biggest audience in the salon." [Stylist] | ||
Stylist interest in services and knowledge: "This programme will also be helpful to us as stylist in the salon because we will also get information that will help us grow because there is nothing more valuable than information." [Stylist] | ||
Motivated by additional business: "I think this will help retain our client because a client will know that I have a treatment that I am receiving from that salon or from that stylist, this helps because it helps keep clients coming to this particular salon." [Stylist] | ||
Barriers | Lack of education or health-related training: "I think we would have challenges with the injection because we have no training in administering injections. We can maybe give people pills and condoms." [Stylist] | |
Client characteristics | Facilitators | Overall buy-in: "I am comfortable with receiving contraceptives at the salon." [Client, 35 yo] |
Perceived contraceptive need: "I think women need help with preventing pregnancy. There are a number of women who have children that were not planned; hence they sometimes cannot afford to provide for these children." [Client, 24 yo] | ||
Destigmatizing sexual health: "I think this programme should start in schools so that more people can understand that using contraceptives is not a bad thing. In fact using contraceptives is a good thing because people are having sex anyways so having protection is the most reasonable thing to do." [Client, 29 yo] | ||
Recommendations | Trained individuals administering contraceptives: "The salons are open Monday to Sunday, you can have someone or a nurse coming on a Tuesday to administer the injection to willing participants because we cannot have someone from the salon injecting us." [Client, 24 yo] | |
Theme 5: Decision-making process facilitated by existing stylist–client social relationships, encouragement by other clients sharing contraceptive decision-making | ||
Salon characteristics | Facilitators | Observation and reinforcement in salons: "I think some other clients are not sure what to do in life, so the more they come to the salon and see other clients, they start to assimilate behaviour and even style in terms of dress code and hairstyle that they want to do." [Stylist] |
Stylist characteristics | Facilitators | Non-judgment: “We don’t judge people that they are coming to the salon for a specific thing” [Stylist] |
Relating to clients: "I would prefer a stylist because we have developed a relationship with the stylist and we talk with the stylists. We are general comfortable with ordinary people like us." [Client, 28] | ||
Validating client decisions: "Everyone coming to the salon will be here for the same reason, to do their hair and it will only be after we have shared our information that the client may decide anything else. Even those who come to the salon because they don’t want to go to the clinics will receive the same treatment as those who are here to do their hair." [Stylist] | ||
Client characteristics | Facilitators | Observation and reinforcement with contraceptives: “"I can say I had adequate information on using the injection as a contraception method because most of my friends are using the injection as prevention." [Client, 22 yo] |
Theme 6: Continued learning and guided contraceptive usage in salons | ||
Recommendations | Adherence strategies: "I think an SMS would work perfectly because everyone can receive an SMS, you don’t have to have data/bundles to receive an SMS." [Client, 46 yo] | |
Support groups: "A [mobile app] group is better because people would be free to voice their opinions and help each other." [Client, 24 yo] | ||
Incentives: "I don’t want to lie, people like getting free things, so if you say you are giving out vouchers or money, the place will be crowded with people." [Client, 22 yo] | ||
SRH supplies: "So instead of bring us stuff just to make us happy, you can bring us feminine stuff that would also educate us." [Client, 25 yo] | ||
Other health services: "I think there should be a programme that provides testing facilities for women. These should be facilities where women can test for all disease and facilities that are close to women and where women can feel comfortable. These facilities should provide testing services for HIV, Pap smear, and should also provide contraceptives because people are reluctant on going to the clinic." [Client, 24 yo] | ||