Dr Arjit

A STUDY ON UTILIZATION OF FAMILY PLANNING PRACTICES/METHODS AND

AMONG THE URBAN SLUM POPULATION OF LUCKNOW CITY

Arjit Kumar, S.Srivastava,P. Bhardwaj, P. Gupta, J. P. Srivastava

Department of Community Medicine,

Era’s Lucknow Medical College

Lucknow ( Uttar Pradesh)

GREETINGS

By Dr. Arjit Kumar Junior Resident Deptt. Of Community Medicine

Era’s Lucknow Medical College

INTRODUCTION

India is home for three in-famous problems and those pre-fix with letter “P”.

They are “population explosion”, poverty, and pollution.

Population explosion is directly perpetuating the other two problems.

India is among the few countries in the world to accept family planning as a national programme.

Operationally Family Planning practices is vogue are women-centered and based on two methods/practices, they are Permanent and Temporary.

In N.R.H.M. the family planning

programme is implemented on cafeteria approach and is client-centered, demand-driven and need-based.

The need-based or client-centred approach starts from the bottom and the need is calculated from the population in sub-centre by the health-workers. So this is other-wise called bottom-up approach.

AIM OF THE STUDY

In this present study an attempt has been made to assess the magnitude and distribution of the family planning practices/ methods adopted or practiced and

The reasons for not using contraception.

MATERIAL AND METHODS

Reference population The reference population was taken as the

population residing in 530 urban slums of Lucknow city that are below poverty line.

Study population & Study unit Married women in the reproductive age group

(15-45 yrs. of age) who had delivered in last 2 years preceding the study were taken as study unit & such population was the study population.

Study Design Community based cross-sectional study was

conducted after taking approval from the ethical committee.

Total period of period The study was conducted for a period of one

year from August 2009 to August 2010. Sample Size: The Antenatal coverage amongst the

recently delivered women was found to be 60%. Taking P as 60 and Q as 40 and absolute error (L) 6%, sample size was calculated using the formula.

Since respondents are chosen by cluster sampling design effect due to complex sample design comes into picture taking into account design effect of 2, the sample size was 532 # 540

SAMPLING TECHNIQUE

The maternal care and other components of the Reproductive and Child Health programme were assessed using 30 cluster sampling technique.

Thus for the present study, Probability Proportionate to Size (PPS) method was adopted as the sampling strategy.

N=4 PQ/L 2

N= 4 ×60×40 =266 36 The desired number of women to be interviewed in

each cluster was 18. In each cluster the first house was chosen at random and from there on, the next nearest house was visited until the desired number of mothers were interviewed. If a household had more than one beneficiary, all were included in the survey.

QUESTIONNAIRE DEVELOPMENT & PILOT TESTING

The study was approved by the ethical committee of Era’s Lucknow Medical College and Hospital. The basic questionnaire of “Concurrent assessment of Health and Family Welfare Programmes and technical assistance to district of Uttar Pradesh” by the Department of Medical Health And Family Welfare, Uttar Pradesh was adopted and reframed as per the requirement of the study.

RESULTS

Yes No

Inje

ctio

n

Nirod

h

Copper

T

Mal

e st

erili

zation

Fem

ale

ster

iliza

tion

Ora

l con

trac

eptive

Pill

s0

20

40

60

80

100

120

63

37

1.1

34.146.8

53.5

79.7

95.7

Distribution of women according to Knowledge about contraceptive methods

Type of contraceptive

Percentage

an appreciable number of intensive HIV/AIDS-related programmes and policies are in existence, the effectiveness of these still needs to be evaluated.

Since most of the new infections occur in youth, any intervention in this age group is likely to have an impact on the disease trend

54

42.4

20.8

8.8

24.30.8

Distribution of women according to type of contraceptive methods used

Nirodh Oral Contraceptive Pills Copper T Male sterilizationFemale sterilization Injection

Private health facility

Government health facility

Local shops ,market & depots

No response

0 5 10 15 20 25 30 35 40 45

40.3

24.3

24.3

11.1

Distribution of women according to source for availing contraceptives

30.7

17.517.5

10.5

10.5

10.52.7

Distribution of women according to reasons for not using any method

of contraception.

Against religious belief Less knowledge Opposition & reluctance of husband Very costlyWish to extend family No need No response

DISCUSSION

KNOWLEDGE OF CONTRACEPTION

Similar findings were represented in the study done by Bhasin et al (2005)34, Agrawal Shraddha et al (2006)4, Dinesh and Kalia etal (2008)73 finds the highest awareness ranging from 65-68% regarding contraceptive methods which is corresponding to our observation. The DLHS-3 data shows the findings differently. It shows that 38.4% had knowledge about any method of contraceptives.

USAGE OF CONTRACEPTION

In the present study, 66.5% of the women were ever users of contraception where as 33.5%were the never users of contraception.

Similar finding were shown by, Bhasin et al (2006)34, NFHS-3 India16, Renjhen (2008). These studies show the usage of contraception between 50% – 75% the findings of these studies matches the findings of the present study.

Bhasin et al in their study showed that 75% of the subjects were users of any contraceptive method.

In the present study 54% of the women told that their husbands were currently using condoms for family planning and 36.6% of the women were using pills. It also shows that 24.3% of the women were sterilized and 20.8% were using copper-T. Very few were using other method of family planning. Similar findings were shown by Bhasin et al (2005)34, Agrawal Shraddha et al (2006), Dinesh and Kalia etal (2008)73, Renjhen et al(2008)

Condom was the most common method which constitute about 33.4% of contraception followed by oral contraceptive pills, tubectomy and intrauterine device 15.7%. The percentage use of female sterilization is 37.8% following was 9.8 for condoms, 3.8% for IUD and 3.2% for contraceptive pills.

In the present study, about 30.7% opined that the use of contraception was against religion and 17.5% did not have much knowledge about the safe use of contraceptives. Similar number gave the reason as reluctance of the husband, other reasons were financial constraints, wish to extend family, some of them have no need for contraception and others were not able to give any cause.

Similar reasons were given by the respondents in the studies done by Patil et al 2010)71, Bhasin et al (2006)34, D’Souza (2003)74, Rama etal (2000)76 and Das etal (2001)26 except that contraceptive was against religion which is the most common cause of not using contraception

CONCLUSIONS

More than half, (63%) had knowledge about any contraceptive methods about the conventional and permanent method of contraception.

More than half (66.5%) of the women were currently using contraception whereas 33.5% were not using any contraceptive technique even after having knowledge about them.

More than half of the women (54%) told that their husband were currently using Nirodh as a method of contraception and following were contraceptive pills, copper T and sterilization. Very few 2(0.8%) women were using other method of contraception i.e. (DMPA/injections).

Unmet need of contraception was present in about 57% of the women who want to use contraceptives in the near future.

Most of the women (43%) incurred contraceptive from private health facility where as women taking contraceptives from government depots and local shops were found to be same.

RECOMMENDATIONS

The newer F.P practices are to be popularized not only among the masses but also among the grass-root health workers those who really cater the health service.

The Male population has to be educated and motivated about vasectomy especially Non Scalpel Vasectomy (NSV) which is simpler and easier than tubectomy.

Health staff to be trained and conduct more awareness camp regarding RCH among the slum population, particularly the adolescent married girls and other RCH beneficiaries.

A certificate course on Reproductive Medicine can be started for the health workers, nurses, etc.

Thank you