Findings from a mixed-methods journey map study of barriers to family planning in western Kenya.
Laura E Britton, Katherine Tumlinson, Caitlin R Williams and 4 others
PMID 36394947WHAT IT FOUND
Women and providers disagreed on what stopped family planning.
Both ranked stockouts as critical, but women also flagged partner discouragement, rude counselling, and hidden fees. Providers saw fees as frequent but unimportant, missing women's price sensitivity.
Key findings
01Stockouts were the only barrier both clients and providers rated as frequent, impactful, and important.
02Providers and women disagreed on the importance of informal fees and partner discouragement, with providers underestimating how much these deter women.
03Disrespectful treatment, including scolding or shouting, was reported by nearly half of women in workshops and observed in about 10% of mystery client visits.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Journey mapping is an emerging technique with no established best practices. Barriers were classified as important based on an arbitrary majority cutoff. The study excluded women under 18 and those engaged in transactional sex. Providers did not consent to mystery client observations, limiting ethical transparency. Participants' rankings may have reflected what they believed researchers could fix rather than actual impact.
Declared interests
The study was supported by the National Institutes of Health. No other conflicts of interest are reported.
The easy way to misread this
Do not interpret this as evidence that journey mapping improves clinical outcomes. The study describes perceptions and barriers; it does not test an intervention or prove that addressing these barriers reduces unintended pregnancy.