Table 6 Themes/categories (users and practitioners) classified according to the steps of the “Comprehensive Framework for Contraceptive Counseling by Holt [8]
Step 1 | Step 2 | Step 3 |
|---|---|---|
Explore the needs, preferences and previous experiences with contraceptives, to adapt communication to specific needs and concerns | Facilitate decision-making for the choice of method providing up-to-date information on all options: effectiveness, mechanism of action, side effects, contraindications, barriers to use, etc., neutrally and comprehensibly | Respect the choice of method in a context of shared decision-making, incorporating information for the use of the method and its monitoring |
User FG categories | ||
Various sources of information, sometimes unreliable or not verified | Lack of information about the different methods in relation to their effectiveness, composition, mechanism of action, protection against sexually transmitted infections, cost, etc.) | Practitioner’s reluctance to cede power of decision |
Prescribing the method requested by the user, without exploring their needs | User’s reluctance to take the decision | |
Concern for the side effects of the methods | Distrust in the practitioner upon receiving biased information or a lack of details regarding the methods | Opinions on accessibility to information outside the physician’s office () |
Unexplored misconceptions and myths | ||
Practitioners FG categories | ||
Choice based on environmental influences | The importance of providing up-to-date information on effectiveness, cost, safety, prevention STI, SE… of the various methods | Predominant paternalistic approach |
Health system that hinders good monitoring | ||
Difficulties in communication with the user (diverse languages and cultures, excessive caseload and lack of knowledge of contraception) | Practitioners’ lack of specific training in contraception, a hindrance to adequate, neutral counselling | Need to improve accessibility to information for practitioners and users (DST) |