Planned Parenthood as a Public Health Imperative: A Participatory Research Exploring the Use of Contraception by Indigenous Women of Chilcapamba, Ecuador

Background: Government policies have led to an increase in modern contraception use. Rural indigenous populations in countries like Ecuador, however, have relatively lower rates of utilization. Our objectives were to work with the community to identify perceived barriers for contraception use and determine solutions for an indigenous Ecuadorian community. Methods: Using a qualitative descriptive study design based on participatory research principles, focus groups and individual semi-structured interviews were conducted with women in the community as well as semi-structured interviews with physicians working at the regional hospital. All sessions were taped, transcribed, translated and analyzed using descriptive thematic analysis. Results: Women had basic knowledge about contraception, but also had many fears related to false beliefs about side effects. Women using modern contraception spoke of difficulties getting to a doctor to get a prescription. They had a relationship of trust with their partners although men were perceived to have preponderant decisional powers. Physicians suggested creating a mobile team to provide information about maternal health and to distribute contraceptives directly in the communities. Conclusions: There is need for rural communities to have better information and access to contraception. While the Ecuador national contraception policy has made an impact, several practical barriers prevented optimal implementation.