Hearing native voices: contraceptive use in Matemwe Village, East Africa.

Although fertility declines have been documented in various parts of Africa, fertility rates remain high in Tanzania. Widespread resistance to modern contraception is one factor associated with high fertility in Tanzania. The aim of this study was to identify cultural barriers to modem contraceptive use in Matemwe village, Zanzibar. In May 2003, more than 50 in-depth interviews were conducted with community leaders, health care workers and couples in Matemwe. Despite free and easy access to contraceptives, only 2% of Matemwe women participated in the village's family planning programme. Several factors were found to influence contraceptive use, including strong Muslim beliefs, male dominance over females (especially in polygynous relationships), and limited exposure to modern ideas via education and travel. Interviews indicated that in order to lower fertility in Matemwe, cultural barriers to family planning must be confronted. Successful implementation of a family planning programme hinges on the ability of policymakers to integrate modern ideas about contraception with Matemwe's traditional religious and political culture.