Nearly half of all pregnancies globally (approximately 121 million) are unintended. South Africa is no exception: 65% of pregnancies between 2015 and 2019 were unintended, and 36% ended in abortion, according to the State of World Population 2022 report. This high rate of pregnancy costs the country billions and impacts lives significantly.
In a country with high unemployment (particularly prevalent amongst the youth), and persistently high HIV and gender-based violence rates, contraception is a hugely important issue that clearly needs a rethink, says Dr. Chido Siame, Clinical Care Lead at Kena Health.
“This World Contraception Day, we need to give serious thought to how to readjust our approach to contraception—and technology could well be the key. While the availability of free contraception at public health clinics is a notable achievement, the high pregnancy rate and persistent unmet needs for contraception show that there is still work to be done,” she says. “Unfortunately, it’s also a reality that, in this society at least, contraception is a women’s issue more than a man’s one, so the context of female empowerment has to be taken into account.”
A study of contraceptive use and sexual behaviour among South African women shows that multiple factors impact the use of contraception. Important factors are the attitude of male partners, long waiting periods, erratic supply of contraceptives at public health clinics, and substandard or biased counselling from nurses. Further factors would include the stigma attached to contraception in some communities (because it is presumed to indicate promiscuity), how easy various contraceptive methods are to use and side effects.
An important driver is that many women are ill-informed about the female reproductive system and how it works, as well as the full range of contraceptive alternatives open to them.
“Education is clearly an important intervention that needs to happen,” comments Dr. Chido Siame. ”Research also shows a strong link between the attitudes of healthcare providers and the uptake of contraception. Improved patient/ provider counselling is essential, along with the need to maintain confidentiality.”
She argues that given the constraints of the public health system, technology can play an essential role in providing South African women with the private, high-quality and affordable advice and counselling they need to understand their contraceptive options.
A good example is the Kena Health smartphone app, which addresses many issues preventing women’s access to contraception. Using the app, anyone can chat with a registered doctor, nurse or mental health professional in total privacy, something that’s very important given the stigma that can be attached to contraception.
Critically, Kena Health experts can help customers decide on the best contraception method.
Eighty percent of patients are women, and a third of all consultations have been related to women’s health, specifically sexually transmitted diseases and contraception—testimony to the need for such a service in South Africa.
“Because all consultations are done on a cell phone, women are assured of privacy and convenience—no need to waste a whole day standing in a clinic queue. Even more important, the clinicians are professionals able to deliver top-quality advice sympathetically. The consultations are also highly affordable at R185 and can be renewed even more cheaply for R120. Prescriptions are sent directly to the customer’s phone, and can then be redeemed at the pharmacy,” she concludes. “We are developing new ways of making it easier for women to address this pressing issue.”
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