Access to Norplant Removal: An Issue of Informed Choice

This paper presents data from a qualitative study to examine women's experiences in using and discontinuing use of Norplant at four family planning clinics in Dakar, Senegal. Focus group discussions and individual interviews were conducted between June and August 1996, with 81 current and past Norplant users and 14 providers. The study found that a woman's desire to limit future childbearing and her husband's support for method use increased her acceptance of side effects and use of the method. Counselling that women perceived to be thorough and that included discussion of other options also had a positive effect on acceptance and use. Finally, the study identified ways in which providers attempted to control decision-making about treatment and discontinuation in all four clinics. Such attempts had a negative impact on women's experiences using the method. Findings from the study suggest the need fur a more client-centered approach to Norplant service delivery, one that emphasises consideration of individual circumstances during counselling and that ensures client control over decisions about continued use of the method.