St Antony's College
Thesis: Understanding diversity in hormonal contraceptive side-effects in Ethiopia: a mixed methods approach.
Research: Contraceptive side-effects are the leading reason why women don’t use contraception even when they want to prevent pregnancy. However, little is known about variation in contraceptive side-effect experiences and what causes some women to experience a greater burden than others.
My research aims to better document variation and understand causes of contraceptive side-effect experiences using both quantitative and qualitative methodologies in and around the city of Adama in Ethiopia.
I utilise a mixed-methods exploratory sequential design with 1) in-depth interviews and focus group discussions on perceptions about variation in contraceptive side-effects followed by 2) a risk factor analysis for discontinuation due to side-effects in secondary Demographic and Health Survey data, and 3) descriptive and risk factor analysis of our own primary longitudinal side-effect data, collected using a locally specific measurement instrument that was based on our initial qualitative findings.
This project utilises a biocultural anthropology approach to critique the current one size fits all model of contraceptive development and the use of an assumed biological norm in global health policy. This project also responds to calls from reproductive rights and justice advocates for greater focus on the development of improved, reduced side-effect methods of contraception.
Stevens, R. et al. (2022) ‘Anemic Women are More at Risk of Injectable Contraceptive Discontinuation due to Side Effects in Ethiopia’, Studies in Family Planning, 53(1), pp. 193–208. doi: 10.1111/sifp.12186.
Alvergne, A. and Stevens, R. (2021) ‘Cultural change beyond adoption dynamics: evolutionary approaches to the discontinuation of contraception’, Evolutionary Human Sciences, 3, p. e13. doi: 10.1017/ehs.2021.8.
Alvergne, A., Stevens, R. and Gurmu, E. (2017) ‘Side effects and the need for secrecy: characterising discontinuation of modern contraception and its causes in Ethiopia using mixed methods’, Contraception and Reproductive Medicine. London, 2(24). doi: 10.1186/s40834-017-0052-7.