The knowledge and awareness about among married women in urban field practice area of Rama medical college hospital and research centre, Mandhana, Kanpur

 

Pankaj Kumar¹, Bandana Kumari^2*

 

Abstract              Background: A multi-pronged strategy aimed at sustained IEC efforts focusing on safety and beneficial effects of various contraceptives, clearing of misconception about side effects of contraceptives by family planning counselors and equal involvement of both husband and wife as one unit should be able to bring out an outcome favourable in terms of contraception use. Methods: The study of factors influencing family planning practices was carried out among 350 married women aged 18-49 years in the urban field practice area of Rama Medical College Hospital and Research Centre, Kanpur during the period of January 2017 to December 2018. Results: In the study group, majority 135(38.6%) were aged between 26-33 years of age. Majority 309(88.3%) were Hindus, 14(4%) were Muslims and 13(3.7%) were Christians in the study. Majority 121(34.6%) had secondary level of education, 41(11.7%) were illiterates, 16(4.6%) were Post Graduate. Majority 174 (49.7%) of current users have accessed contraception from Urban health center, 80 (22.9%) from private pharmacy and 96(27.4%) from tertiary level hospital and 264 (75.4%) had no fear and 86 (24.6%) had fear from the side effect of contraceptive. 187(53.4%) women know about emergency contraceptive and 163(46.6%) do not know about emergency contraceptive . Conclusion: In order to improve contraceptive use what we need today is multiple resources to educate couples, their parents, family members and society too, so what we can reach upto masses. Women must be made aware about their right i.e, protecting their own health . Good counseling practices along with clinical work are the need of time, for these women should be educated , be economical independent.

Key Word: contraceptive methods.

 

INTRODUCTION

India is the second most populous country in the world, next only to China, where as seventh in land area. With only 2.4% of the world's land area, India is supporting about 16.87% of the world's population. The population of India 1.21 billion in 2011, (2001 is 102.8 crores), average exponential growth rate 1.95% in 2001, and the decadal growth of population is 17.6% in 2011(21.52% in 2001).¹ The death rate declines still further and the birth rate tends to fall. The population continues to grow because births exceed deaths. India has entered this late expanding phase. At the beginning of the century, Dr Pyare Krishnan wattal (1916) observed that our country's increasing birth rate was a social danger. In his words, "if we want to go to the root of it (increasing birth rate), we must look at the causes that give rise to this high birth rate, much more seriously than to the secondary causes that give rise to high death rate".²"Women and men in many countries still lack adequate access to contraceptives, unless they are given the option of controlling their fertility, severe environmental and health problems loon in the coining century throughout large parts of the world"³. More than 100 million women in developing countries or about 17% of all married women would prefer to avoid a pregnancy but are not using any form of family planning⁴. India was the first country in the world to formulate the national family planning programme in the year 1952 with the objective of "reducing the birth rate to the extent necessary to stabilize the population at a level consistent with requirement of national economy"⁵. The family planning programme has undergone transformation in terms of policy and actual programme implementation. There occurred a gradual shift from clinical approach to the reproductive child health approach and further the National Population Policy (NPP) 2000 brought a holistic and a target free approach which helped in reduction of fertility. The objectives, strategies and activities of the Family Planning division are designed and operated towards achieving the family welfare goals and objectives stated in various policy documents (NPP: National Population Policy 2000, NHP: National Health Policy 2002 and NRHM: National Rural Health Mission) and to honour the commitments of the Government of India (including ICPD: International Conference on Population and Development, MDG: Millennium Development Goals, FP 2020 Summit and others).⁶ The family welfare programme is mainly based on a "Cafeteria approach"; where by a number of methods of contraception are offered to the eligible couples. The national family welfare programme, in India, has traditionally sought "to promote responsible and planned parenthood through voluntary and free choice of family planning methods, best suited to individual acceptors". However, these methods have not been widely accepted by a large number of the eligible couples, as these methods do not meet their psycho-social requirements. Thus, inspite of various efforts on the government's part, the percentage of eligible couples using contraception (couple protection) rate is only 56.3%⁷

 

METHODS

The study will be carried out among married women in the reproductive age group of 18-49 years in the field area of UHTC (urban health training centre, Kalyanpur) of Rama medical college hospital and research centre, Mandhana, Kanpur.

UHTC provides health care to 12 mohallas of ward 18 and 42 of urban area of kalyanpur, out of which 03 mohallas namely Kalyanpur Khurd, Janakipuram and R.K Puram are selected for study by systematic random sampling method.

It is a community based cross-sectional study. Urban field practice area (U.H.T.C, Kalyanpur) of Rama Medical College hospital and research center, Mandhana, Kanpur. Married women in the reproductive age group of 18- 49 years, residing in urban field practice area (U.H.T.C, Kalyanpur) of Rama Medical College hospital and research centre, Mandhana.

Inclusion Criteria :

• Women who are married, age of 18 – 49 yrs.
• presumed to be sexually active.
• Pregnant and Postpartum amenorrhoeic women are also included

Exclusion Criteria :

• Those who are not willing to participate.
• Widow women

Study Period was January 2017 to December2018. And it was Systematic random sampling method.

The sample size is calculated by taking the prevalence rate of contraceptive use (56.3%) at 5% significance level and 10% error 350 About 10% more than sample size interviewed) UHTC provides health care to 12 mohallas of ward 18 and 42 of urban area of kalyanpur, out of which 03 mohallas namely kalyanpur khurd, janakipuram and R.K puram having population of 3000+1500+1000 respectively = 5500 (As population of females aged 18-49 is 220 per thousand )

Thus total female population 18-49 of above three mohallas= 5500x220/1000 =1210

1210/310 = 3.90 rounded off to ~ 4 above age group females interviewed every 4^th house of all 03 study mohallas.

Data was processed on the software SPSS (Version 21.0), and Microsoft Excel 2010. Rates, ratios, proportions were calculated and cross tables with variables to ascertain ‘association’ were made. Statistical test for significance was applied on Chi-square distribution of the data analysis and of variance (ANOVA).

 

RESULTS

Observations of study are presented under following headings.

Part-A

• Demographic profile of respondents            and their statistical distribution (N = 350).
• Prevalence of contraceptive among various groups
• Type of Contraceptive methods adopted among various groups.
• Various     factors affecting adoption of contraception.
• Decision of husband
• source of information about various contraceptive methods
• availability of family welfare programme
• fear of side effect
• Knowledge of emergency contraceptive and no. of subjects using emergency contraceptive.

Part -B

• Awareness about injectable contraception.
• Source of information about injectable contraceptive.
• Side effects of injectable contraceptive among various age groups
• Acceptability of injectable contraceptive among study subjects
• Reasons for not using injectable contraceptive
• Statistical analysis of variance (ANOVA).

Table 1: Age of respondent

Above table shows statistical analysis of age of respondents participated in present study. The mean age of respondents (N=350) is 32.559 years with minimum 21years and maximum 46 years, median 30 years (with standard error of mean 0.42123 and standard deviation 7.88042)

 

Table 2: Distribution of the study subject according to the Age

In the above table it is observed that majority of the women were between 26 and 33 years age group which is the most crucial in the reproductive span. Among the 350 women, 135 (38.6%) were between 26 and 33 years, 83 (23.7%) were between 34 and 41 years, 67 (19.1%) were between 18 and 25 years, 65 (18.6%) were between 42 and 49 years of age.

 

Table 3: Distribution of the study subjects according to type of contraceptive used

The above table show 58(16.6%) female was using OCP, 52(14.9%) was using IUCD, 31(8.9%) was using condom 22 (6.3%) was using DMPA, 31(8.9%) has got sterilization and 12 (3.4%) was practiced natural method and 144 (41.1%) was not using any type of contraception.

 

Table 4: Distribution of the study subjects according to the Type of contraception using currently in different age group

In the above table in age group 18-25 maximum 14 (20.9%) were using OCP, 10 (14.9%) were using IUCD and no one were practiced natural method. In age group 26-33, maximum 30(22.2%) were using OCP and minimum 4(3%) were using natural method of contraception.

Table 5: Distribution of study subjects according to the educational status and current type of contraception

In the above table, in illiterate group maximum7(17.1%) were using IUCD, in primary group maximum 9(20%) were using OCP, in middle maximum 11(15.9%) were using IUCD, in secondary group maximum 22(18.2%) were using OCP, in higher secondary group maximum 8(17.4%) were using OCP,. In graduate group maximum 3(25%) were using OCP as contraceptive method.

  

Table 6: Distribution of study subjects according to the occupational status and current type of contraception

In the above table among the home maker maximum 39(16.2%) were using OCP, among unskilled 17% were using OCP, overall OCP were used maximum as contraceptive method.

 

Table 7: Distribution of study      subjects               according  to the Socioeconomic status and current type of contraception

Above table show in upper class maximum 11(26.2%) were using oral contraceptive pills. sterilization methods were maximum 14.9%% in upper lower class. IUCD were maximum 31.4% used in upper middle class. Condom uses maximum in upper middle class. Injectable maximum used by upper class.

 

Table 8: Distribution of study subjects according to Religion and current use of contraception

In the above table maximum 180 (58.3%) hindu family were using contraceptive in study population. In muslim 35.7% were using and 64.3% were not using any contraception. Among chtistian 76.9% were using and 21.4% were not using any contraceptive method.

Table 9: Distribution of the study subjects according to the husband's opinion towards contraception

In the above table, it was observed that majority 250 (71.4%) husbands agree for use of contraception and 100 (28.6%) disagrees for contraception.

Table 10: Distribution of study subjects according to fear of side effect from contraceptive

In the above table 264(75.4%) had no fear and 86(24.6%) had fear from the side effect of contraceptive.

 

Table 11: Distribution of study subjects according to knowledge about injectable contraceptive

Above    table      shows    only138(39.4%)  women know     about    injectable contraceptive and 212(60.6%) do not know about injectable contraceptive.

Table 12: Distribution of study subjects according to acceptability of DMPA

Above table show acceptability of DMPA is 6.3%, of which 0.9% users had own decision, and 5.4% accepted after counseling.

Table 13: Distribution of study subjects according to reason for not using injectable contraceptive

Above table shows the main cause of not using injectable contraceptive was lack of awareness in 212 (60.6%) women. 34.9% women had fear of side effect.

Table 14: