Exploratory observational analysis of access to contraception in Namibia: Socio-economic influences on quality of care
1
Content writer, The Feminist Health CIC, Reading, United Kingdom
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
In Namibia, contraceptive education of the public health sector remains limited with little to no informative consultations, whereas the private sector applies structured counselling guidelines. This raises questions about socio-economic position versus access to contraceptives, care quality and autonomy. Commonly used in Namibia, the medroxyprogesterone acetate injection (Depo-Provera), along with norethisterone enanthate, has a history of use as apartheid era population control method, discussed by Judith A. M. Scully in the Cambridge University Press.
METHODS:
This exploratory observational study used a qualitative framework combining reflective documentation of personal experiences, observations across differing socio-economic healthcare contexts, and secondary analysis of reports and guidelines from the United Nations Population Fund and FP2030. Up-to-date national contraception data were not publicly available, limiting quantitative comparison.
RESULTS:
Demographic and Health Surveys (2013) indicated that 72% of women obtained contraceptives from public dispensaries and 12% from private dispensaries. Injectable methods were most used (43%), then hormonal pills (9.1%), then intrauterine devices (1.2%) and implants (0.2%). Ministry of Health data (1992) showed disparities by education and residence: 94% of urban residents versus 74.1% of rural residents knew where to obtain contraceptives, as did 96.1% of women with secondary or higher education compared with 67.3% with no formal education. The 2018 Commodity Gap Analysis by the Reproductive Health Supplies Coalition reported 2.75 million injectable doses, 95% administered through the public sector, compared with 27,800 implants (59% public sector), 1,130 intrauterine devices (29%), and 716,000 cycles of hormonal pills (72%).
CONCLUSIONS:
Education, income, and geographic location shape contraceptive decision making through differences in counselling quality, reproductive education, availability, and affordability. Addressing these inequities is essential to advancing Sustainable Development Goal indicator 3.7 and the 18th World Congress on Public Health 2026 theme, “Health Without Borders: Equity, Inclusion, and Sustainability.”
In Namibia, contraceptive education of the public health sector remains limited with little to no informative consultations, whereas the private sector applies structured counselling guidelines. This raises questions about socio-economic position versus access to contraceptives, care quality and autonomy. Commonly used in Namibia, the medroxyprogesterone acetate injection (Depo-Provera), along with norethisterone enanthate, has a history of use as apartheid era population control method, discussed by Judith A. M. Scully in the Cambridge University Press.
METHODS:
This exploratory observational study used a qualitative framework combining reflective documentation of personal experiences, observations across differing socio-economic healthcare contexts, and secondary analysis of reports and guidelines from the United Nations Population Fund and FP2030. Up-to-date national contraception data were not publicly available, limiting quantitative comparison.
RESULTS:
Demographic and Health Surveys (2013) indicated that 72% of women obtained contraceptives from public dispensaries and 12% from private dispensaries. Injectable methods were most used (43%), then hormonal pills (9.1%), then intrauterine devices (1.2%) and implants (0.2%). Ministry of Health data (1992) showed disparities by education and residence: 94% of urban residents versus 74.1% of rural residents knew where to obtain contraceptives, as did 96.1% of women with secondary or higher education compared with 67.3% with no formal education. The 2018 Commodity Gap Analysis by the Reproductive Health Supplies Coalition reported 2.75 million injectable doses, 95% administered through the public sector, compared with 27,800 implants (59% public sector), 1,130 intrauterine devices (29%), and 716,000 cycles of hormonal pills (72%).
CONCLUSIONS:
Education, income, and geographic location shape contraceptive decision making through differences in counselling quality, reproductive education, availability, and affordability. Addressing these inequities is essential to advancing Sustainable Development Goal indicator 3.7 and the 18th World Congress on Public Health 2026 theme, “Health Without Borders: Equity, Inclusion, and Sustainability.”
| eISSN: | 2654-1459 |
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