Pregnant and Powerless: Exploring Barriers to Contraceptive use among Women in Mogadishu, Somalia

Background: With a maternal mortality ratio of 692 per 100 000 live births and modern contraception prevalence of 1%, understanding factors hindering Somali women from using modern contraception is key to developing and implementing locally adopted public health responses. The purpose of this qualitative study was to explore factors impeding Somali women in Mogadishu from using modern contraception Methods: We conducted a qualitative study using semi-structured, in-depth interviews with 21 married women aged >18 years, living in different neighborhoods in Mogadishu between July-December 2018. We recruited the participants using a convenience sampling method. Results: The findings show that health communication messages and contraceptive information provided by health providers (medical barriers) constitute a significant obstacle to women's access to modern contraception services. Other barriers included prevalent religious fallacies among women and fear of permanent infertility upon modern contraception. Conclusion: Training health providers in the principles of modern contraception, in addition to the medical ethics that govern their responsibility to provide correct and relevant information to their patients, is vital for increasing modern contraception use among Somali women. The findings of this study may be used for designing public health interventions that promote acceptance and the use of modern contraception among both women and men in Somalia.