Salman Safdar, Bazmi Inam S N, Amir Omair, Shaikh Tanveer Ahmed, Ejaz Alam S.
Contraception: A Rural Perspective.
J Coll Physicians Surg Pak Jan ;12(7):421-4.

Objective: Fertility in rural areas of Pakistan has remained relatively higher in comparison with urban areas, with corresponding low contraceptive prevalence rates. There is, therefore, a need for better understanding of contraceptive practices in rural areas. Design: Cross-sectional study. Place and Duration of Study: This study was conducted in rural areas of Taluka Hala, District Hyderabad, between July and August 2000. Materials and Methods: A multistage sample of 1,150 households was drawn from a population of 247,257 living in 30,653 households. Structured knowledge, attitude and practice (KAP) questionnaires regarding family planning were administered to male and female respondents in sample household. Results: A total of 1,178 married women and 1,146 married men were interviewed. The mean age of female respondents was 29 + 6 years. At the time of the interview 19% women in the sample were pregnant. The contraceptive prevalence rate was 28.2 % (C.I. 95%: 24.8, 31.6). The mean and median age of contraceptive users was 29 + 6 and 28 years respectively. 87% women had experienced their first pregnancy by 20 years of age. The contraceptive being used include; injections (9.2%), pills (8%), intra-uterine contraceptive devices (4.5%), female sterilization (4.6%), condoms (1.6%) and male sterilization (0.2%). High proportion of males (87%) and females (92%) could correctly identify at least one contraceptive method along with the source of its availability. Thirty-nine percent either wanted more children or personally disapproved contraceptive practice, 17% said their husbands disapproved of contraception. The other categories of non-practicing women included those who had poor access to contraceptives due to lack of knowledge or cost (10%) and those who were afraid of the side effects (17%). Three percent women cited religious reasons for not practicing any form of contraception. Besides these, 14% women cited other non-specific reasons for not practicing contraception. Conclusion: The results suggest that women are experiencing pregnancy at an early age with only 28.2% adopting contraceptive technology later in life. A high proportion (64%) of women do not use contraceptives either because of fear of side effects or poor access to it due to socioeconomic barriers. Family planning interventions should focus on young females in order to delay pregnancy by increasing their acceptance and access to contraceptive technology. These programs should offer a method-mix of natural and modern contraceptive choices, which can be acceptable to a wider clientele.

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