Barriers to uptake of bilateral tubal ligation family planning method among grand-multiparous women in the Copperbelt province, Zambia


  • Mathew Nyashanu Department of Health and Allied Professions, Nottingham Trent University, Nottingham, United Kingdom
  • Katentemuna Cathrine Musosnda Ministry of Health, Department of Health Promotion, Ndola, Copperbelt, Zambia
  • Hope Namputa Ministry of Health, Department of Health Promotion, Ndola, Copperbelt, Zambia
  • Mandu Stephen Ekpenyong Department of Nursing and Public Health, Manchester Metropolitan University, Manchester, United Kingdom
  • Thamary Karonga Department of Nursing and Midwifery, Northrise University, Ndola, Copperbelt, Zambia



Community, Maternal, Multiparity, Patriarchy, Stigma


Background: Use of Bilateral Tubal Ligation (BTL) family planning method has been met with resistance by some women owing to its clash with certain personal values in their lives. In some cases these barriers have led to unintended pregnancies, which in turn cause complications, especially in grand-multiparous women (women with many children). This qualitative study explored the barriers towards the uptake of BTL among grand-multiparous women.

Methods: The study used an exploratory qualitative methodology to explore the barriers to uptake of BTL. Semi structured interviews were utilised to collect data. Twenty-five semi-structured interviews were held with grand multiparous women who were attending clinics for family planning services. All interviews were tape-recorded and transcribed verbatim. A thematic approach underpinned by some aspects of the silences framework was utilised for data analysis.

Results: The study revealed that barriers to the uptake of BTL included desire to maintain productivity, pressure from spouses, stigmatization of family planning, safety fears and loss of self-esteem.

Conclusions: There is need to engage all stakeholders in communities to make sure that fears and doubts on the use of BTL are allayed. Furthermore there is need to roll out more health promotion and raise awareness on the importance of family planning.


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Original Research Articles