Journal of Health & Medical Economics

Keywords

Contraception; Sexually transmitted diseases; Family planning

Background

As per census 2011 the population of India is 1.33 billion [1]. The growth of population of India is on a higher pace & it is estimated that with the current rate of growth it may easily surpass China by 2028. India’s family planning interventions dates back to 1952. Being the world’s first Country to adopt population policy, it has seen steady growth in terms of achievement of targets. Initially, these efforts were organized under the National Family Planning Programme which was renamed in 1977 as the National Family Welfare Programme. Since 2005, these efforts constitute an integral component of the National Rural Health Mission which has been lately renamed as National health Mission [2]. The pace of growth in terms of achievement of FP goals had been relatively low which can be correlated with total unmet need for contraception at national level being 20.5% (DLHS -3 2007,08) [1].

Limiting population’s growth is important aspects of a country’s program as it will help in improving the overall growth & development by impacting on the living standards & quality of life of people. To ensure that people have different choices to control or manage their fertility, strategies for ensuring availability of effective contraceptive choices are being made available. This resulted the focus of family planning programs in India from being just as a driver of population control to improving the overall health of mothers & newborn. This had been achieved by giving choices to females on reversible methods of contraception which can be used for limiting pregnancies, dealing with unwanted pregnancies & also to create space between children [3]. The availability of spacing methods have also helped in reducing unwanted abortions, protection from sexually transmitted diseases including HIV [4]. Although there are so many choices available to females on family planning methods but still the uptake of these methods have been relatively low. A report published in WHO suggests that the contribution of India in maternal deaths is of 20% [5]. If family planning specially spacing methods can be implemented properly it can help in averting 30% of maternal deaths [5]. Of all the methods which are available for females for spacing, it has been noticed that oral contraceptive usage has been relatively low due to the myths & misconceptions associated with it [6]. Aims & Objective of the study is to find out the current levels of knowledge, awareness & attitude towards the use of oral contraceptive pills among females of reproductive age group & also to identify the reasons for not using it.

Method

Data Source

The study is based on the primary data collected from ten beauty Parlors located in urban areas of Raipur. The length of study was of 7 days & all the clients belonging to age group of 19-29 years were given a questionnaire to fill. In order to have a thorough representation of entire Raipur, the Parlors were selected from all the corners of Raipur city. The selection of parlors were based on the criteria that they should be in the catchment of slums of people who have a earning quintile of 6 lakhs per annum. The study was based on collecting information from married young females of age group 19-29 years through a prestructured questionnaire.

Total Respondents

The study was conducted in 10 Beauty Parlors located in urban locations of Raipur city which had proximity with slums. The activity was continued for 7 days in all 10 parlors with an average footfall of 20 clients per day. A total of 900 respondent’s data was captured. The clients who were unmarried or those above age of 29 years were excluded from the study.

Study Design

The study is primarily a qualitative study in which the data has been collected on the basis of pre designed questionnaire. The questions were based on the current knowledge, myths & misconceptions & potential external barriers which are hampering the uptake of OCP among married females. The clients coming to urban beauty parlors were targeted for the study & were shared with a simple questionnaire in which they had to choose from the available options. The study is specifically designed for urban poor, married young females of age group 19-29 years.

Results

Awareness about OCP as a method of contraception: (Table 1).

Table 1. Awareness of OCP as a method of contraception.

Of the total respondents, 83% of married females had knowledge about OCP being a method of contraception (Table 2).

Table 2. Source of information about OCP.

Of the total respondents 500 (55%) had awareness about OCP’s through health care provider, 300 (33%) through peers which included their family and friends & 100 (11%) got the information through social, print & audio media (Table 3).

Table 3. Practice of OCP as a preferred method of contraception.

Out of the total females only 5.6% responded of using OCP as a method of contraception. 61% had been using other methods which included both permanent & temporary methods of contraception & 33% were not using any methods (Table 4).

Table 4. Reasons for not using OCP as a method of contraception.

The responses of females for not using OCP were analyzed. 800 out of the 900 respondents had myths of getting obese & face multiple side effects due to the use of OCP. Almost 700 females had myth of being unable to conceive after its prolonged use. A total of 500 females complained of having general lethargic feeling & unable to contribute productively in household chores after using OCP’s. Almost 200 females had myth of the pills getting deposited at their stomach (Table 5).

Table 5. Support from Home/Peers on use of contraceptive.

The respondents upon asking whether they will face any kind of resistance from their family & peers on use of contraception revealed that 30% of them were opposed by husbands upon use of OCP in general or any kind of FP methods. 38% of Mother in Laws & other elders opposed upon use of family planning methods. There were 18% of peers & elders who were supportive & almost 11 % had no opinion about it.

Discussion

Family Planning is defined by WHO as, “a way of thinking and living that is adopted voluntarily upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of family groups and thus contribute effectively to the social development of a country”⁹.

The growth of a nation can be ensured only if its population growth can be managed & controlled. The current study was carried out to understand what are the barriers specific to uptake of OCP as a method of family planning choices among married females. It revealed that there is enough awareness of OCP as a method of contraception. Health workers, social media & peers have been the source of information for getting knowledge about OCP, however due to these multiple channels of information it has also added to raising many myths & confusion about the use of pills. The myths on use of OCP as a method of contraception are many. The most common myth being its use causes obesity & other multiple side effects. There was also a very common myth about OCP’s that its prolonged use creates problems in further conception. As there are many myths associated with OCP’s there is an urgent need to use multiple platforms and innovative approaches to target people to make them understand about OCP’s & make it a preferred choice of contraception.

Acknowledgments

Authors would like to thank the parlor owners for allowing to conduct the study & also for their active participation in data collection.

References

1. http://www.dataforall.org/dashboard/censusinfoindia_pca/
2. Chaurasiya AR, Singh R (2019) 40 years of planned family planning efforts in india.
3. Almualm YA (2008) Knowledge, Attitude and Practise of Husbands towards Modern Family Planning In Mukalla, Yemen. Malaysian J Med Sci 15: 76-77.
4. Weldegerima B, Denekew A (2008) Women’s knowledge, preferences, and practices of modern contraceptive methods in Woreta, Ethiopia. Res Social adm Pharm 4: 302-307.
5. Bhanot (2011) Park’s Textbook of preventive and social medicine.
6. Srivastav A, Khan MS, Chauhan CR (2014) Knowledge, attitude and practices about contraceptive among married reproductive females. Int J Scient Study 1: 2-4.