This study explores women’s decision-making around modern contraceptive methods (MCMs) in sub-Saharan Africa, focusing on the influence of integrating family planning (FP) services with childhood immunizations. Conducted in Benin, Ethiopia, Kenya, Malawi, and Uganda, the study involved 94 semi-structured interviews and 21 focus group discussions (253 participants) with women, health providers, and community members.
Results show that women’s desire to space or limit births was often motivated by health, welfare, and economic benefits, but their decisions were influenced by societal barriers such as fears of side effects, community stigma, and disapproving husbands. Despite these obstacles, some women used MCMs covertly to improve their families’ well-being. The integration of FP and immunization services provided repeated opportunities for health providers to address misinformation and improve access to MCMs. This integration expanded women’s autonomy and decision-making power, allowing them to make more informed choices about contraceptive use, even when societal norms were restrictive.
