World Contraception Day will shine a light on the growing need for contraception awareness and education regarding reproductive and sexual health. World Contraception Day (WCD) is a worldwide campaign centres around a vision where every pregnancy is wanted. The WCD’s mission is to improve awareness of contraception and to enable young people to make informed choices on their sexual and reproductive health with a vision for a world where every pregnancy is wanted [1]. Contraception or birth control, is one of the most important aspect of family planning and to ensure overall physical and mental health for the mother, father and the baby. Contraception is also commonly known as birth control and there are many ways are available for both gender to make birth control easier and simpler [2]. Women in the past used “Natural method” for family planning, this method emphasizes on observing the menstrual period and avoiding sexual intercourse until the menstrual cycle is over. The modern technology has brought other methods of family planning which the women are practicing. However, it is very difficult for the less educated women especially tribal women to practice the modern method of family planning because of the technicalities involved in their uses thereby creating attitudinal differences between the tribal women and their educated counterparts in other facet of life [3]. Despite the availability of highly effective method of contraception, this campaign to raise awareness about, contraceptive methods advance several human rights including the right to life and liberty, freedom of opinion, decision and expression and right to life and work and education related safe and unprotected sex so that no pregnancy is unplanned and unwanted. Such pregnancies can result in abortion and carry an excess risk of morbidity and mortality. The risk of pregnancy with on unprotected sexual intercourse e.g. Lack of contraceptive use, condom breakage, missed pills or sexual assault, emergency contraception can be used to prevent an unwanted pregnancy [4]. 

Objectives

• To assess the awareness, practices and barriers of family planning method among reproductive age group women in selected tribal area of Bhandardara

• To find out relationship between the awareness and practices of family planning among reproductive age group women

A Descriptive study with survey approach was used awareness, practices and barriers of family planning method among reproductive age group of women undertaken in Bhandardara (shendi). The Data were collected from 100 reproductive age group of women who are selected by convenient sampling technique to meet the inclusion criteria. The self-prepared and validated structured questionnaire in multiple choice format (for assessment of awareness), check list (for assessment of practices) and modified 5 points rating scale (for assessment of barriers) was used for the data collection. Before the data collection the purpose of interview schedule was explained to women and consent were taken from participate the study. The question was asked as per interview schedule.

Inclusion Criteria

• Women’s above 18 year of reproductive age group

• Women residing in shendi at Bhanadrdara

• Present during data collection period and willing to participate in study

Data Collection Instrument 

Description of the Tool: After obtaining the permission from the concerned authority and informed concerned from the sample, collect the data the structured questionnaire scheduled consist of following sections:

• Section A: Demographic data of reproductive age group of women like Age, Education, Occupation, Religion, Monthly income, no of children

• Section B: Description of characteristics like Age at marriage, Parity, Previous abortion, previous information regarding contraceptive, Type of contraceptive awareness regarding family planning methods

• Section C: It Consist of structured questionnaire to assess the introduction of reproductive system awareness, it has 28 items, which includes the subareas like introduction of reproductive system (11 items), Methods of permanent contraceptive (11 items) and temporary (06. Each item has structured questionnaire consists one correct answer and for one correct answer has 1 score and maximum 28 score for 28 items

• Section D: It consists of 16 items regarding practices of contraception among reproductive age group of women. Each items have to options like Yes (1) and No. (0)

• Section E: It consists of modified 5 points (strongly agree, agree, uncertain, disagree and strongly disagree) rating scale used to assess the Barriers of contraceptive, it has 10 items each item maximum score for strongly agree was 5

Content Validity

Tool was validated by sixteen experts. Their suggestions were incorporated and final draft was made.

Pilot Study

The Pilot study was conducted 10 eligible couples in selected Songoan village to assess feasibility of the study and to decide the plan for data analysis. Pilot study indicates that tool is feasible and practicable.

Reliability

Split half method was used to test the reliability of structured questionnaire (r = 0.9), practices on check list (r = 0.7) and barriers was checking reliability using rating scale was (r = 0.8). The tool was found to be reliable.

Data Collection Procedure

The written approval by the Institutional Ethics Committee (IEC)/Institutional Research Committee (IRC) of Pravara Institute of Medical Sciences (DU), Loni Reg No: PIMS/CON/R/IEC/PG/007/2020 Prior to collection of data written permission will be obtained from the Sarpanch of Bhandardara (shendi) And informed written consent was obtained from all reproductive age group of women participated in the scientific work and through interview schedule structured questionnaire asked to the women and recorded the data.

Planned for Data Analysis

Descriptive and inferential statistics was used for data analysis. The collected data was organized, tabulated and analyzed by using descriptive statistics i.e. mean standard deviation and percentage. The inferential statistics like t test, Chi-square test and association test were used.

Table 1 show that most of the samples 33% were in the age group of 31 to 35 years. Majority of the women’s 34% were taken secondary education. In samples 52% were home maker and 78% were Hindu and 25% were having monthly income in Rs. 5,000 and 61% women’s have 2 children.

Table 1: Demographic Description of Samples by Frequency and Percentage

It interprets that women are having average score of barriers

in use of contraceptive.

Table 2 show that most of the samples 62 % were in the age at marriage of 21 to 25 years. Majority of the women’s 51 % were parity 2. In samples 78 % were had previous abortion. In samples 65% were have not used any contraception. Awareness of contraception have 60 %.

Table 2: Maternal Characteristics On Contraception of Samples by Frequency and Percentage

Table 3 show that most of the samples 21 % and 20 % source of information was from Public/private health sector andHealth professional. Majority of the contraceptive available in market Mala D/Mala N 45 %. In samples cost of contraceptive they known were 44 %. In samples 55% were have get the contraception from drug shop.

Table 3: Description of Characteristics On Availability of Contraception

Area wise distribution of mean, SD and mean % of awareness on Contraceptive among eligible women’s shows that overall awareness score was 13.88±4.68 which is 49.57 % of maximum score. It seems that Female had average to average awareness regarding contraception (Table 4).

Table 4: Assessment of Awareness On Contraceptive Among Reproductive Age Group Women’s n = 100

Area wise distribution of mean, SD and mean % of practices on Contraceptive among eligible women’s. Depict that overall score practices were 10.35±2.35 which is 64.68 % of maximum score. It seems that Female had to good practices regarding use of contraception (Table 5).

Table 5: Assessment of Practices On Contraceptive Among Reproductive Age Group of Women’s

Item wise assessment of rating scale of responses of participant towards barriers of contraceptive among reproductive age group of women’s shows that majority of them 60 % agree the correct response of participant It is inconvenient to use due to sexual dysfunction and 56% was agree with Some contraceptive have hormonal imbalance in the women’s. ‘‘Lack of knowledge prevents the of contraceptive is participant score is 53%. Whereas 44% and37% felt that some contraceptives have chance to failure at many time and Use of Contraceptives have some side effects the participant given correct response of answer (Table 6).

Table 6: Assessment of Barriers of Contraceptive Among Reproductive Age Group of Women’s N = 100

Comparison of mean, SD of awareness with regards to age group of <20 years shows that reproductive age group of women’s had good awareness as score is increased in mean value in is varies from 14.10” which indicates the “good awareness” In relation to practices with regards to age group of 26-30 shows that reproductive age group of women’s had good practices as score is increased in mean value in is varies from 12.16” which indicates the “good practices”. Hence it can be interpreted that the improving the awareness regarding contraception irrespective of their age (Table 7).

Table 7: Area Wise Comparison of Mean, SD and Mean% Of Awareness and Practices Score of Participants Regarding Family Planning Among Reproductive Age Group of Women’s According to Their Age n = 100

Comparison of mean, SD, mean% of awareness of participant on family planning among reproductive age group of women according to their education shows that the participant who had similar level of education had good level of awareness. In relation to practices of participant on family planning among reproductive age group of women according to their education shows that the participant who had secondary and above secondary education had good level of Practices. Hence it can be irrespective of education all women had similar ie. Good awareness and good practices score of women reproductive age group (Table 8).

Table 8: Comparison of Mean, SD of Awareness and Practices Score According to Education n = 100

Comparison of the occupation mean, SD of awareness score shows that irrespective of occupation of all women had similar ie. Good awareness. In relation to practices of occupation of all women had similar ie. Good practices. Hence it can be irrespective of education all women had similar ie. Good awareness and practices score of women reproductive age group (Table 9).

Table 9: Comparison of Mean, SD of Awareness and Practices Score According to Occupation n = 100

Comparison of the parity mean, SD of awareness score shows that irrespective of their parity of reproductive age group of women’s had average awareness towards contraception. In relation to practices score shows that irrespective of their parity of reproductive age group of women’s had good practices regarding contraception. Hence it can be interpreted that the improving the awareness regarding contraception irrespective of their parity (Table 10).

Table 10:   Comparison of Mean, SD of Awareness and Practices Score According to Parity n = 100

Paired ‘t’ value was calculated to analyze the awareness score and Practices score of contraception. Significant difference was found between awareness and Practices score of various aspects contraception. The overall “t” value among women of awareness was 3.04 and in Practices 4.55 which is statistically significant (Table 11).

Table 11:   Association of the Awareness and Practices Among Reproductive Age Group of Women’s Paired ‘t’ value of Awareness and Practices Regarding Contraception n = 100

df-100, Table value-2.00, p<0.05 level

Chi square value were calculated to find out the correlation between Awareness with demographic variables regarding contraception. Finding reveals that women’s there was is significant association found between Awareness score and demographic variables like Age, Education and parity (Table 12,13).

Table 12:   Association of the Awareness Score with Their Selected Demographic Variables n = 100

df-1, table value -3.8, p≥0.05 not significant

Table 13:   Association Between the Practices Score with Demographic Variables n = 100

DF-1, table value -3.8, p≥0.05 not significant

Description of Socio Demographic Characteristics of Participants

Findings of the present study shows that highest percentage 33% of females were in the age group of 31-35 years and the highest percentage of male 38.33%, it was consisting with study carried out by Mithun Mog, Shekhar Chauhan, Ajit Kumar Jaiswal and Arobindo Mahato also observed that highest percentage of 52.6% females were from 31-30 years’ age group [5].

Assessment of Maternal Characteristics of Participants

Majority 62% of women’s according to their age at marriage had 21-25 years of age, group similarly study conducted by Arti Jadhav, Bharti W. there were highest percentage of 69.1% females who married before at age of 21-25 [6,7].

Assessment of Scores of Awareness of Contraception Among the Reproductive Age Group of Women’s

In the present study female 49.57% had ‘average awareness about contraception similar study conducted by Darryl Monica Serafine Aranha 61.72% had an average knowledge of contraception.16 also similar study carried out by Kankana De had knowledge of awareness was 40% [8], Shahina Begum, Saritha Nair, Balaiah Donta, C. P. Prakasam had average awareness score was 40.6% [9].

Assessment Scores of Practices Regarding Contraception Among the Reproductive Age Group of Women’s

In the present study average findings of women’s were in mean SD 13.884.68 which is 49.57% awareness which shows that ‘average awareness and mean SD 10.352.25 which is 64% ‘good practices’, similar study conducted by the similar study conducted by S Pandey and S Thitame found that, mean SD was 26.65±5.1 and 17.97±1.08 which is 41.40%, 69.6 % awareness and about practices reveals that good awareness and good practices towards reproductive age group of womens [6].

Assessment Scores of Barriers of Contraception Among Participants

Findings of the present study shows that highest percentage 48% barriers of contraceptive among reproductive age group of women’s. some identifiable barriers to contraceptive use includes the majority of them 60 % sexual dysfunction, 56% hormonal imbalance, Lack of knowledge 53%, contraceptives have chance to failure 44% and 37% side effects of contraceptive. Ultimately it seems that barriers of contraception among the reproductive age group of women has neutral score. the similarly study conducted by Prateek SS, Saurabh RS that unacceptance by family/husband/religion, perceived fear of side effects and lack of knowledge are the most common reasons towards lesser use of contraceptive methods [9].

Association of Awareness and Practices Paired T’ Test with Socio-Demographic Variables Reproductive Age Group of Women’s

Paired ‘t’ value was calculated to analyze the awareness score and Practices score of contraception. Significant difference was found between awareness and Practices score of various aspects contraception. The overall “t” value among women of awareness was 3.04 and Practices 4.55 which is statistically significant.

Association of Awareness and Practices ‘Chi Square Test’ With Socio-Demographic Variables Among Reproductive Age Group of Women’s

In the present study findings reveals that there was significant association found between awareness and attitude with socio demographic variables like age and the age at marriage of females at df-1, p>0.05 level, similarly a study conducted by by S Shinde, Dr. B Nagorao Rakshase found the association between education and the perspective of tribal women towards the use of contraceptives. Since the p-value is 0.01 which is statistically recognized significant in comparison to P value 0.05. The study also found the Association between education and knowledge of contraceptive methods [10].

Co-Relation Coefficient Between Awareness and Practices Regarding Contraceptives Among the Reproductive Age Group of Women’s

In the present study used Karl Pearson’s formula to find out correlation finding reveals that there was a mildly positive significant relationship existed between the Awareness and practices on contraception. ‘r’ value among the women’s (r = 0.07) has positive influence on enhancing awareness and modifying positive practices towards the contraception similar study was conducted by Manjubala, found that coefficient of correlation analysed awareness and practices (r = 0.06) showed that significant relationship, which reveals that when the knowledge level increases, the practices will also increase [11,12].

Recommendation

Based on the study findings following recommendations have been made: 

• Similar kind of study with the larger sample size can be carried out for the more valid result

• A comparative study can be done between the urban, rural and tribal population about the Awareness, practices and barriers of contraception

• Similar study may be conducted as an experimental study with the control group

• Similar study can be conducted to evaluate the effectiveness of health education package and structured teaching practice

• A qualitative study can be carried out on the lived experience of reproductive age group of women’s after using contraception

• A descriptive longitudinal study can be conducted to assess the contributing factors for the awareness, practices and barriers about contraception

Acknowledgment

Investigators are grateful to the management of Pravara Institute of Medical Sciences (DU), Loni, Chairman of Institutional Ethics/Research Committee for giving approval to the said topic, Sarpanch of shendi for permitting us to conduct the study and participants for having cooperated in the study.

1. India’s Family Planning Division. Minister of Health Family Welfare Government of India, 2020, https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception.

2. "The-various-ways-of-birth-control-for-men-and-women-and-the-role-they-play." Health Article, 2020, https://www.com/health/article/world-contraception-day-2020-/658343.

3. Abu Onimisi Hassan. "Perception and attitudes of market women towards family planning in an emerging urban centre, Anyigba, Kogi State." Confluence Journal of Environmental Studies, vol. 10, 2016, pp. 58-72, ISSN: 1597-5827.

4. "Family planning/contraception." World Health Organization, 8 Feb. 2018, https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception.

5. Mog, M. et al. "Family planning practices among tribal women: an insight from northeast India." Epidemiology: An Open Access Journal, vol. 10, no. 4, Feb. 2020, p. 1000386.

6. "Uneven progress and unequal access." Guttmacher Institute, 2017, https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide.

7. Jadhav, Arti and Bharti Weljale. International Journal of Obstetrics, Perinatal and Neonatal Nursing, vol. 6, no. 2, 2020, pp. 46-54.

8. Aranha, D. International Journal of Health Sciences and Research, vol. 5, no. 9, Sept. 2015, pp. 361-69, Original Research Article, ISSN: 2249-9571.

9. Begum, S. et al. "Prevalence of unmet need for contraception, mumbai." International Journal of Reproductive, Contraception, Obstetrics and Gynecology, vol. 3, no. 3, Sept. 2014, pp. 627-30.

10. Singh, S. et al. The Costs and Benefits of Investing in Sexual and Reproductive Health 2014. Guttmacher Institute, 2014.

11. Durowad, K. et al. "Barriers to contraceptive uptake among women of reproductive age in a semi-urban community of ekiti state, southwest Nigeria." Ethiopian Journal of Health Sciences, vol. 27, no. 1, Mar. 2017, p. 121, https://doi.org/10.4314/ejhs.v27i2.4.

12. Dash, Manjubala. Research Journal of Family, Community and Consumer Sciences, vol. 2, no. 10, Dec. 2014, pp. 6-8, ISSN: 2320-902.