In-depth | What contraceptives are available in SA and which ones are most popular?
Statistics suggest that people in South Africa do, in principle at least, have access to and are aware of these contraceptive methods, albeit not at the desired levels.
Clinical Excellence at Discovery Health, says “family planning is not a prescribed minimum benefit, therefore medical schemes apply discretion on how contraceptives are covered”. “We have very progressive, enabling policies and guidelines, which speak to contraceptive choice and the need for an expanded method mix because research does show that the more choice you have, the more likely women are to use methods and to continue on methods as well,” she says.
Overall, according to previous surveys, two- or three-month injectables were the most popular, with male condoms and the pill following. Female sterilisation, implants, and the IUD lag behind, respectively. “Long-term reversible contraceptives are really great for contraception as they last for many years,” Gilbert explains, saying this does not require consistent medication adherence or regular clinic visits. However, barrier methods like male and female condoms provide protection against sexually transmitted infections as well as pregnancy.Pleaner explains the main factors around choosing contraception are efficacy and continuation.
Makua acknowledges that stockouts have previously been a problem, but says that commodities are currently available everywhere. Similarly, there were fears about the implant causing irregular bleeding while inserted, and infertility once removed. In addition, she says access may be limited by “long queues at health facilities, young women feeling embarrassed to be seen at the clinic for contraceptives, lack of parental approval and support, [and] lack of boyfriend or partner’s approval and support”.
“We’ve realised that there’s a lot of peer pressure when it comes to the choice of methods to an extent that, in case the method that they choose is not eligible for them, they prefer not to use an alternative method. And that’s where it looks as if the access is limited,” she says.Makua says that government interventions are focused on a “multi-sectoral approach to reduction in unplanned pregnancies, issues of gender-based violence, economical dependency, and educational levels of women”.
This could include community mobilisation and education campaigns, including the involvement of guardians and men.
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