Attitude of women towards family planning methods and its use ...

Kathmandu University Medical Journal (2005) Vol. 3, No. 3, Issue 11, 259-262
Original Article
Attitude of women towards family planning methods and its use –
Study from a slum of Delhi
Kumar S1, Priyadarshni A2, Kant S3, Anand K4, Yadav BK5
1Assistant professor, Dept of Community Medicine, BPKIHS, Dharan, 2Physiotherapist, Dept of Orthopaedics,
BPKIHS, Dharan, 3Additional professor, Center for Community Medicine, AIIMS, New Delhi, 4Associate
professor, Center for Community Medicine, AIIMS, New Delhi, 5Senior Instructor Dept of Community Medicine,
BPKIHS, Dharan, Nepal


Abstract
Background: To predict the need of family planning methods, family planning managers often rely on unmet need
derived from measure of contraceptive demand. However women’s intention and her background knowledge of
family planning methods not received as much attention as a measure of family planning methods demand.
Objective: To know the attitude of women regarding use of family planning methods and to find out the factors that
restricts its use, and the change in pattern of use over a period of one year. Methods: This was a prospective study.
One (Block G) out of eight blocks was selected randomly. Using convenient sample method, families were selected
starting from a point in the selected block (Block G). 40 women of childbearing age group (15- 49 years) were
enrolled. All women were followed for a period of one year. Results: Weakness was narrated as the commonest
side effect from all family planning methods. More than 70% women told that irregular menstruation from Oral
Contraceptive pills and ill health from tubectomy as the other side effects. Demands for more children and for son
preferences were the leading reason for not using any methods followed by afraid of side effects and health
problems. There was negligible change in the use of family planning methods during the period of the study.
Conclusion: Effective family planning methods use should be advocated through adequate counseling about the
correct use, side effects and their proper management and their benefit in the back ground of custom and belief.

Key words: Family planning, Contraceptives, Family planning methods, Attitude.


ndia was the first country to start family planning
Human fertility is determined by many factors such
I programme long back in 1952. In the first 50 years
as customs, morals and habits of social groups with
there have been many changes. The name of family
regard to marital obligation of life2. Acceptance of
planning programme was changed to family welfare
family planning methods varies within and between
programme and lastly to the present Reproductive
societies. There are many factors which is
and Child Health. The changes were done to increase
responsible for such variation at community, family
the acceptance of family planning methods.
and individual level. Socioeconomic environment,

culture and education are few of them that play a
International conference on population and
vital role.
development ( ICPD) endorsed the definition of

reproductive health as a state of physical, mental, and
However it has been seen that women do not practice
social well-being in all matters relating to the
family planning methods even though she has good
reproductive system at all stages of life1. Good
knowledge. A study from Rajasthan showed 60.8%
reproductive health implies that people are able to
had knowledge regarding family planning methods
have a satisfying and safe sex life and that they have
but only 19% were using and that irregularly3.
the capability to reproduce and the freedom to decide
Another side of the picture is desire of children and
if, when, and how often to do so. Men and women
use of these methods. Despite having knowledge
should be informed about and have access to safe,
women and men did not use these methods because
effective, affordable, and acceptable methods of
they need more children4.
family planning of their choice, and the right to

appropriate health-care services that enable women to
Correspondence
safely go through pregnancy and childbirth.
Dr. Sanjay Kumar
Assistant Professor, Department of Community Medicine

B. P. Koirala Institute of Health Sciences, Dharan, Nepal
Email: sanjay131@yahoo.com

259

---

The present study examined the attitude of women
Result
towards use of family planning methods and to find
The study was conducted in a slum of south Delhi.
out the factors that restricts its use. It also tried to
Forty families were followed up. There were 40
find out the change in pattern of use of family
women out of 177 in the child bearing (15-49) age
planning methods over a period of one year.
group. (Table 1). More than half were in the upper

lower socioeconomic status and only few (10%)
Methods
belonged to joint family.
The study was carried out in one of the slums located

near Nehru Place in south Delhi, India. This slum is
More than 90% subjects told that weakness is the
getting medical and other health services from
main side effect from OCP followed by irregular
government and non government agencies. AIIMS
menstruation (55.5%) and headache. For other family
(All India institute of Medical Sciences) delivers its
planning methods also weakness as a side effect was
services to this slum. Services are delivered through
leading the table. 85 % (34) women narrated
mobile health clinic on Mondays, Wednesdays and
weakness after tubectomy, 41.6% (15) after
Fridays through out the year. The study was
vasectomy and 88.8% (32) after CuT. Backache and
undertaken by postgraduate student him self as part
cramps were other side effects known to the women
of field training exercise. This was a prospective
(Table 2).
study with randomized cluster sampling. One (Block

G) out of eight blocks was selected randomly. A
Almost 2/3rd women did not adopt family planning
cohort of forty families was selected as a convenient
method because they want more children or a son.
sample starting from a point in the selected block
Many of them did not prefer any of the family
(Block G). Families residing in the area for more than
planning methods due to its side effects (50%) and
6 months and planned to stay for more than a year
other health problems (50%). Husbands also did not
was included in the study. All the relevant
allow using family planning methods in a number of
information was recorded from married women in the
cases (15%). Only a small fraction (5%) was unaware
age group of 15-49 years present in that family. Semi
regarding family planning methods (Table 3).
structured questionnaire were used to collect

information. Information regarding demographics,
We also followed these women for the change in
use of any family planning methods, and reason for
pattern of use of contraceptive methods over a period
not using any methods were collected at the
of one year. There were very small changes in the
beginning of the study. Families were followed up for
pattern of use of family planning methods in this
a period of one year. Family visits were done once in
period. Few of the women started taking OCP and
a week through out the year. Information regarding
got CuT inserted at the end of the study. The change
any change in the use of family planning methods
in the pattern of use was statistically not significant
was collected at the end of the study. Analysis was
(Table 4)
done using STATA statistical tool to calculate Z
score and p value.



Table 1: Age group distribution of currently married women.
Age group ( in years)
Number
Percentages
< 29
25*
62.5
30 – 39
12
30.0
40 – 49
3
7.5
Total 40 100
* Include one woman in the age group of 15-19 years.



260

---

Table 2: Knowledge of side effects of family planning method *
Methods Side
effects
Number
Percentage
OCP Weakness
35
87.5
Irregular
Menstruation
28 70.0
Headache 6 15.0
CuT Cramps
3
7.5
Backache 6 15.0

Goes into abdomen
2
5.0
Weakness 32 80.0
Tubectomy Weakness
34
85.0
Ill
health 30 75.0
Vasectomy Weakness
15
32.5
* Multiple responses


Table 3: Distribution of currently married women according to the reason for not using any contraceptive methods#
Reason Number Percentage
Wanted a child
24
60.0
Wanted a son
24
60.0
Afraid of side effects
20
50.0
Religious reason
1
2.5
Husband oppose
6
15.0
Health problems*
20
50.0
Did not know
2
5.0
# Multiple responses
*Backache, Weakness, Menstrual problems.


Table 4: Distribution of currently married women according to the use of contraceptive methods
Methods
In the beginning of the At the end of study ( % )
P value
study ( % )
CuT
3 (7.5)
5(12.5)
0.456
OCP
3(7.5)
5(12.5)
0.456
Condom
4(10)
4(10)
1.0
Tubectomy
3(7.5)
3(7.5)
1.0
Not using any 27(67.5) 23(57.5) 0.355
methods
Total 40(100)
40(100)



Discussion
more than half of the women were from upper lower
This study was conducted in a slum area of South
socioeconomic status.
Delhi. Due to time constraints during field training
Another important factor that restricts use of
exercise we could cover and follow up only forty
contraceptive is the fear of side effects. In many
families. Majority of the women were in the age
countries such concern about side effect of
group 20-30 years. It has been seen that in this type
contraceptives originating from experience of friends
of community people prefer permanent method of
and rumors which are told and retold through the
contraception even than they know the other
communities have contributed to low contraceptive
methods. Study from Rajasthan showed that more
acceptance5. In the present study more than three
than 70% accepted permanent method after 3 or more
fourth women mentioned weakness as a side effect
children2.
after tubectomy and OCP use. The misconception of
There are many factor like religion, type of family,
weakness after sterilization was also observed by
household income, number of living children and
other researchers6.
mother’s level of education which affect pattern of
We observed that one of the reasons for not using
contraceptive use5. We could see from this study that
contraceptives was desire of more children and even

261

---

a son. Previous studies showed that the women with
2. Mohanan P, Kamath A, Sajjan B S. fertility
sons only desired fewer children and were more
pattern and family planning practices in a
likely to use contraception7. Other researcher could
rural area in Dakshina Kannada. Ind J
conclude that wanting more children was the main
Comm Medicine 2003; 27: 15-18.
reason behind not using family planning methods8.
3. Sharma V, Sharma A. Family planning
Findings from another study argues that couples who
practices among tribal of Rajasthan, India. J
have an abiding preference for son and daughters
Res Edu Indian Med 1991; 10 (4): 5-9.
will continue bearing children despite having
4. Khan W A. A study of knowledge, attitude,
reached their ideal family size until they are satisfied
and practice of family planning in West
with the sex composition of their family9.
Pakistan. Pak J Fam Plann 1967; 1: 1-10.
We find in this study that there was no significant
5. Shobha J. fertility and child survival, A
change in the use of contraceptives in a year. Another
study of selected slums of Hyderabad. The
study showed there was significant change over a
Indian J Soci Work. 1990; 1: 134-40.
period of ten years in use of family planning
6. Nag M . Some cultural factors affecting cost
methods10. This can be possible because we observed
of fertility regulation. Population Bulletin of
these women for a period of only one year.
the United Nation 1984; 17: 17-38.
Low rate of use of family planning methods indicates
7. Shrestha A, Stoeckel J, Taladhar J H.
the potential for improving management of use of
Factors related to non use of contraceptive
family planning methods in slums. A multipronged
among couples with an unmet need for
strategy aimed at sustained IEC efforts focusing on
family planning in Nepal , Katmandu, Nepal
safety and beneficial effects of various family
, New Era 1988; 81.
planning methods should be able to bring a change.
8. Malhi P, Singh S. Son preference and
However equal importance to clearing misconception
reproductive behaviour in rural Punjab.
about side effects of family planning methods by
Guru Nanak J Socio 1995; 16 (2): 31-40.
counselors should be given to increase acceptance.
9. Arnold F, The effect of sex preference on

fertility and family planning: empirical
Acknowledgement
evidence, population bulletin of United
Authors are sincerely grateful to Mr Surya Raj
Nations 1987; 23: 44-55.
Niraula for statistical analysis.
10. Singh RKN, Devi TI, Devi TB, Singh YM,

Devi TN, Singh NS. Acceptabil;ity of
Reference
contraceptive methods among urban eligible
1. International conference on population and
couples of Imphal, Manipur.I J Comm Med
development 1994; 5-13 September.
2004; 29: 13-17.




262

---