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Choice and access: family planning services in Yemen

Is contraception acceptable in countries in the Arab world? How can fertility rates be brought down whilst empowering women to make choices about their sexual and reproductive health? Marie Stopes International carried out a study in Yemen to find out how to increase the use of family planning services in the public and private sector.

Fertility in Yemen, at 6.5 children per woman, is amongst the highest in the world. Many Yemeni women would prefer to have fewer children. The study finds that family planning services appear to be accepted by Yemeni men and women. Such services are seen as a way of spacing births rather than limiting them, of allowing women to rest between births and to raise each child properly.

Five clinics in the Sana’a Governorate were chosen to take part in the study and 15 discussion groups were held to find out people’s knowledge and views about contraception. The groups were divided into married men, married women over the age of 20, and married women under the age of 20. Attitudes to condoms were negative, as is common in many parts of the world, because people associated them with adultery while women were concerned about the side effects of taking the pill or using the coil. 21 per cent of Yemeni women use some form of contraception, half rely on the traditional method of breastfeeding and half rely on modern methods.

The study found that:

the contraceptive pill and the ‘coil’ (intra-uterine device) were the most common contraceptive methods that women planned to use
health problems from using contraception included bleeding and persistent pain
people had a low opinion of the way doctors behaved and the general quality of care
there was a lack of privacy in the clinics, a lack of cleanliness and clients were kept waiting for long periods
people received little information and did not know how to deal with any side effects of contraception use.

In order to encourage the use of contraceptives in Yemen the report recommends that:

the quality of services provided must be improved, in particular the behaviour of the staff at clinics towards patients
women need to see female doctors
patients need a greater choice of contraceptive
visitors to the clinics require greater privacy
the length of time people have to wait must be reduced
work must take place within the community to make sure women seek help for any side effects and to dispel myths surrounding contraception.

In Yemen, availability of contraception and a desire to use them are not in themselves enough. It is essential to improve the quality of care in health centres and family planning clinics in order to see an increase in contraceptive use.

Source(s):
‘Privacy and precise appointments: challenges for the Yemen reproductive health programme’, Marie Stopes International working paper one, by L. Risi, S. Chapman and F. Jaffar, February 2002 Full document.

Funded by: World Health Organisation

id21 Research Highlight: 2 June 2003

Further Information:
Marie Stopes International
153-157 Cleveland Street
London
W1T 6QW
UK

Tel: 44 (0)20 7574 7400
Fax: 44 (0)20 7574 7417
Contact the contributor: msi@stopes.org.uk

Marie Stopes International

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