Needs, beliefs and barriers for contraceptive use among women in a low resource setting in Tamil Nadu: a qualitative study
Keywords:Awareness, Beliefs, Barriers, Contraception, Focus group, Spacing methods
Background: The decline in fertility rate based on the National Health Profile is attributed to the choice of permanent sterilisation as the preferred method of contraception among Indian women. The uptake of spacing methods has declined over the years in many parts of India related to low awareness about options other than sterilisation. Hence understanding the needs, beliefs and barriers of women regarding contraceptive use can identify the factors behind their choice of contraceptive methods. This study aims to explore the needs, beliefs and barriers of women in using different methods of contraception in a low-resource area of urban Vellore, Tamil Nadu.
Methods: A qualitative study was conducted in three underserved areas of urban Vellore served by the secondary care hospital of a private academic institution. A descriptive qualitative method was chosen. Focus group discussion was carried out among study participants. Thematic analysis was used to analyse data.
Results: The need for contraceptive use was felt after completing the families determining the type of method chosen. Fear of impending side-effects of commonly available spacing methods of contraception limited their use. The results highlight the forceful use of intra-uterine device among study participants reflecting the incentive-based family planning services implemented in most Indian states.
Conclusions: Our study reinforces that neither the availability of contraceptives nor forceful implementation of policies will increase the utilisation of contraceptives. There is a need for community-based education on the indications, types and side-effects of reversible methods of contraception.
Romero National Health Profile; 2018. Available at: http://www.cbhidghs.nic.in/WriteReadData/l892s/Before%20Chapter1.pdf. Accessed on 25th July 2019.
Oliveira IT, Dias JG, Padmadas SS. Dominance of sterilization and alternative choices of contraception in india: an appraisal of the socioeconomic impact. PLoS ONE. 2014;9(1):e86654.
Family Planning - A Right and Choice. Available at: https://www.jsk.gov.in/upload/report/2016/12/585256c2e8d98unfpa.pdf. Accessed on 25th July 2019.
Singh A, Pallikadavath S, Ram F, Ogollah R. Inequalities in the advice provided by public health workers to women during antenatal sessions in rural India. PLoS ONE. 2012;7(9):e44931.
Moursund A, Kravdal O. Individual and community effects of women's education and autonomy on contraceptive use in India. Population Studies. 2003;57:285-301.
NFHS IV State Reports. Available at: http://rchiips.org/nfhs/NFHS-4Reports/TamilNadu. pdf. Accessed on 25th July 2019.
Makade KG, Padhyegurjar M, Padhyegurjar SB, Kulkarni RN. Study of contraceptive use among married women in a slum in Mumbai. Nat J Com Med. 2012;3(1):41-3.
Pricilla RA, David KV, Siva R, Vimala TJC, Rahman SPMF, Angeline N. Quality of antenatal care provided by nurse-midwives in an urban health centre with regard to low-risk antenatal mothers. Ind J Comm Med. 2017;42(1):37-42.
Sandelowski M. Focus on research methods: whatever happened to qualitative description? Res Nurs Health. 2000;23:334-40.
Marshall MN. The key informant techniques. Family Practice. 1996;13:92-7.
Prateek SS, Saurabh RS. Contraceptive practices adopted by women attending an urban health centre. Afr Health Sci. 2012;4:416-21.
Sharma V, Mohan U, Das V. Sociodemographic determinants and knowledge, attitude, practice: a survey of family planning. J Family Med Prim Care. 2012;1(1):43-7.
Annual Report of Department of Health and Family Welfare 2016-17. Available at: https://mohfw.gov.in/sites/default/files/6201617.pdf
Target driven sterilization. Available at: https://www.hrw.org/news/2012/07/12/india-target-driven-sterilization-harming-women. Accessed on 25th July 2019.
Swamy HT, Bhanu M, Kumar BSN, Shivaraj NS. A qualitative study on the determinants of contraceptive use in a rural setting. Int J Comm Med Public Health. 2017;4(6):1943-50.