Married women's modern contraceptive method selection in Wolaita, South Ethiopia: a modified grounded theory exploration.

Background: Once women decide to use modern contraception, choosing among available methods becomes a decision that is fundamentally their right. While the World Health Organization (WHO) and Ethiopia's Ministry of Health promote long-acting reversible contraceptive (LARC) methods due to their significant health and economic benefits, short-acting injectables remain the most widely used method, accounting for use by over 50% of contraceptive users in Ethiopia. This persistent divergence highlights a crucial gap in understanding the factors that truly influence women's individual method selection. Comprehending these factors is essential to support informed and empowered contraceptive choices, improve reproductive health outcomes, and advance progress towards increasing LARC uptake.

Objective: To develop a comprehensive theoretical understanding of how married women select among modern contraceptive options in Wolaita, South Ethiopia.

Methods: This study used a grounded theory to collect and analyze data from 43 participants. The participants were recruited purposively and theoretically, included married women using modern contraception and healthcare workers. Data collection involved four focus group discussions (FGDs) with 35 participants and eight individual interviews with healthcare workers. The collected data were analyzed using Strauss and Corbin's mode of analysis, specifically employing the constant comparative method. The analysis process included open, axial, and selective coding to explore and categorize the data. ATLAS.ti-7 software was used to guide data analysis.

Results: A theoretical model revealed that 'finding an appropriate method for mentality' is the core process driving married women's selection of modern contraceptive options. This process is primarily influenced by their 'Desire for an effective method,' alongside various underlying concerns such as fears related to method administration and side effects. Women navigated these concerns by consulting others and observing others' experiences. Additionally, intervening factors, such as method availability and the opinions of significant others, played a crucial role in shaping their method selection. Ultimately, women chose a contraceptive method that aligned with their perspectives and met their expectations.

Conclusion: A comprehensive approach is needed to improve the uptake and satisfaction with modern contraceptive methods while reducing reliance on a single option. By addressing the concerns and managing the intervening conditions identified within the process of 'finding an appropriate method for mentality', informed method selection can be promoted, ultimately enhancing reproductive health outcomes.