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Perceptions matter: Narratives of contraceptive implant robbery in Cape Town, South Africa.

Authors
  • Krogstad, Emily A1, 2
  • Atujuna, Millicent1
  • Montgomery, Elizabeth T2
  • Minnis, Alexandra M2
  • Morroni, Chelsea3, 4
  • Bekker, Linda-Gail1
  • 1 Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa. , (South Africa)
  • 2 Women's Global Health Imperative, RTI International, San Francisco, CA, USA.
  • 3 Women's Health Research Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. , (South Africa)
  • 4 Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK.
Type
Published Article
Journal
Culture, health & sexuality
Publication Date
Mar 01, 2021
Volume
23
Issue
3
Pages
383–396
Identifiers
DOI: 10.1080/13691058.2020.1714739
PMID: 32216584
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Uptake of contraceptive implants has declined in South Africa since their introduction in 2014, with side effects and inadequate health provider training cited as primary contributors underlying a poor community perception of implants. In this paper we explore a theme that emerged unexpectedly during analysis of our research in Cape Town that may be an additional factor in this decline: narratives of women being assaulted by robbers who physically remove the implants for smoking as drugs. Narratives were described consistently across interviews and focus groups with youth (aged 18-24 years) and in interviews with health providers, with six participants (two young people, four health providers) sharing personal experiences of robbery. While there was a range of perspectives on whether narratives are based on real experiences or are myths, there was strong consensus that narratives of implant robbery may be influencing women's decisions around implant use in Cape Town. This is a potent example of how perceptions of new products can affect uptake and offers important lessons for implementers to reflect on in planning for rollout of other health technologies.

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