Facteurs Socio-Culturels Et Contextuels Freinant L’usage Des Contraceptifs Modernes Dans Le Territoire Pronataliste De Basankusu, Republique Democratique Du Congo : Modèle Amélioré Et Axes Stratégiques D’accès.

Abstract

In a context of rapid population growth in the Democratic Republic of Congo (DRC), the use of modern contraceptives remains low, particularly in rural and culturally pronatalist areas such as the Basankusu territory. Despite efforts by the government and technical partners to promote family planning, deep resistance persists. This study aims to analyze the sociocultural and contextual factors that hinder the adoption of modern contraceptive methods in this territory, where large families are socially valued (Bongaarts, 2017; UNFPA, 2021). A mixed-method approach was adopted. Quantitatively, a sample of 384 women aged 15 to 49 was selected using stratified random sampling. Data were collected using structured questionnaires. Qualitatively, semi-structured interviews were conducted with religious leaders, healthcare providers, husbands, and wives, supplemented by focus groups, to better understand the underlying social and cultural dynamics. The results reveal that the major barriers to contraceptive use include cultural norms valuing large families, social pressure from spouses and elders, misinformation about side effects, and the influence of certain religious doctrines (Cleland et al., 2012; D’Angelo et al., 2020). Furthermore, the lack of appropriate communication and low confidentiality in health centers deter women from using contraceptives. Multivariate statistical analyses confirmed that education level, women's decision-making autonomy, and access to information were significantly associated with modern contraceptive use (p < 0.05). In conclusion, this study highlights the importance of adopting family planning strategies that are sensitive to local cultural realities. It recommends an inclusive community approach, couples education, cultural training for providers, and advocacy with religious leaders to strengthen the social acceptability of contraception (WHO, 2019). These measures would improve access to reproductive health services in a context heavily influenced by traditions.