Background: Family planning plays a critical role in promoting reproductive health by enabling individuals and couples to make informed decisions regarding childbearing. While modern contraceptive methods offer a range of safe and effective options, myths, gender biases, and cultural taboos continue to impede their optimal use, particularly in semi-urban and rural regions of India. This study seeks to evaluate knowledge levels, identify prevailing misconceptions, and assess the extent of male participation in contraceptive decision-making. Materials and Methods: A descriptive, cross-sectional, community-based online survey was conducted among 420 adult men and women across rural and semi-urban areas of Himachal Pradesh between January and March 2025. A bilingual, pre-validated questionnaire covering socio-demographic details, contraceptive knowledge, perceptions, myths, and male participation was administered via Google Forms. Convenience sampling was employed, and data were analyzed using SPSS Version 26.0. Knowledge scores were categorized into four levels: Very Good, Good, Fair, and Poor. Results: The majority of participants (39.0%) were aged 18–25 years, with women representing 56.4% of the sample. Awareness of commonly used contraceptive methods was generally high, with 82.6% identifying the purpose of modern contraception and 80.7% recognizing condoms' role in STI prevention. However, misconceptions persisted regarding implants, injectables, and the safety profile of contraceptive pills. While 75% of respondents exhibited Good or Very Good knowledge, 25% demonstrated only Fair or Poor understanding. Encouragingly, 83.6% acknowledged male involvement as vital in family planning decisions. Social media and community health programs emerged as the preferred platforms for promoting contraceptive awareness. Conclusion: Although awareness of modern contraceptive methods in Himachal Pradesh is steadily improving, significant knowledge gaps and lingering myths remain, particularly concerning less familiar contraceptive options. A gradual cultural shift toward male engagement in family planning is evident but requires reinforcement. Sustained, culturally sensitive educational campaigns, enhanced community health worker training, and inclusive outreach initiatives are essential to bridge knowledge gaps, dispel myths, and promote shared responsibility in reproductive health.
Family planning is a cornerstone of reproductive health, empowering individuals and couples to make informed decisions about if and when to have children. While historically discussions around contraception have largely centered on women, modern family planning advocates for shared responsibility, emphasizing the crucial role of both men and women in achieving optimal reproductive outcomes. The availability of a wide range of modern contraceptive methods—ranging from oral pills, intrauterine devices (IUDs), condoms, injectables, implants, to emergency contraception—has greatly expanded choices for individuals. However, widespread myths, misinformation, cultural taboos, and gender norms continue to hinder the effective use of contraception, especially in rural and semi-urban parts of India [1-4].
In Himachal Pradesh, despite notable improvements in literacy rates and healthcare infrastructure, challenges persist regarding contraceptive awareness and usage. Discussions about contraception often remain confined to women, and societal perceptions still predominantly view family planning as a female responsibility. Men’s active participation in contraceptive decisions is limited, further reinforcing gender disparities in reproductive health practices. In addition, misconceptions surrounding modern contraceptives—such as fears of infertility, health risks, and moral concerns—continue to deter many couples from utilizing safe and effective methods, leading to unintended pregnancies, increased maternal health risks, and population growth pressures [5-8].
The promotion of informed contraceptive choices requires dismantling these deep-seated myths and fostering an environment where both men and women are equally educated, empowered, and engaged in family planning. Understanding the existing levels of awareness, identifying prevalent misconceptions, and gauging male involvement are crucial steps toward designing effective, culturally sensitive reproductive health programs [9,10].
This study aims to evaluate the awareness and perceptions of modern contraceptive methods among men and women in Himachal Pradesh. By assessing knowledge gaps, exploring attitudes toward different contraceptive options, and analyzing the extent of male participation in family planning decisions, the research seeks to provide actionable insights for strengthening reproductive health strategies and promoting shared responsibility in contraception.
Study Design
A descriptive, cross-sectional, community-based online survey was conducted to assess awareness, knowledge, and perceptions regarding modern contraceptive methods among men and women in Himachal Pradesh. The cross-sectional approach was chosen to capture diverse community insights at a single point in time.
Study Area and Population
The study targeted adult men and women aged 18 years and above, residing in both rural and semi-urban areas of Himachal Pradesh. Participants represented a mix of educational backgrounds, occupations, marital statuses, and socio-economic groups to ensure comprehensive coverage of the population’s contraceptive knowledge and attitudes.
Study Duration
Data collection was carried out over a three-month period, from January to March 2025.
Sample Size and Sampling Technique
Assuming a 50% awareness rate of modern contraceptive methods (due to limited prior data specific to Himachal Pradesh), a 95% confidence level, and a 5% margin of error, the minimum sample size was calculated to be 384 participants. To account for incomplete or invalid responses, the sample size was increased to 420 participants. A convenience sampling method was employed, with survey links disseminated through social media platforms (WhatsApp, Facebook, Instagram), community groups, healthcare centers, and local non-governmental organizations working in the field of public health.
Inclusion and Exclusion Criteria
Inclusion Criteria:
Residents of Himachal Pradesh aged 18 years and above.
Ability to read and comprehend Hindi or English.
Willingness to provide informed electronic consent.
Exclusion Criteria:
Individuals unwilling to participate or unable to complete the survey.
Duplicate or incomplete survey submissions.
Data Collection Instrument
A structured, bilingual (Hindi and English) questionnaire was developed using Google Forms and validated through a pilot test with 30 participants (excluded from the main study). The questionnaire consisted of four sections:
Socio-Demographic Details: Age, gender, education, occupation, marital status, and place of residence.
Knowledge of Modern Contraceptive Methods: Awareness of different contraceptive options such as oral contraceptive pills, condoms, IUDs, implants, injectables, and emergency contraception.
Perceptions and Myths: Attitudes toward contraceptive use, beliefs regarding side effects, fertility concerns, and cultural acceptability.
Male Participation in Family Planning: Assessment of men’s involvement in contraceptive decision-making and shared responsibility in reproductive choices.
Data Collection Procedure
Participants accessed an introductory page before the survey, which outlined the study’s objectives, emphasized confidentiality, voluntary participation, and obtained electronic informed consent. To maintain data integrity, settings were applied to restrict multiple responses from the same device and no personally identifiable information was collected.
Scoring and Categorization
Responses to knowledge-based questions were scored as:
Correct Response: 1 point
Incorrect/Don't Know Response: 0 points
Cumulative scores were categorized as:
Very Good Knowledge: ≥80% correct answers
Good Knowledge: 60%–79% correct answers
Fair Knowledge: 40%–59% correct answers
Poor Knowledge: <40% correct answers
Separate scores were analyzed for awareness, perceptions, and male involvement aspects.
Data Analysis
Survey data were exported from Google Forms to Microsoft Excel and analyzed using IBM SPSS Statistics Version 26.0. Descriptive statistics (frequencies, percentages, means, and standard deviations) were calculated to summarize participant characteristics and survey responses.
Ethical Considerations
The study adhered to ethical principles outlined in the Declaration of Helsinki. Participation was completely voluntary and anonymous. Electronic informed consent was obtained from all participants, and data confidentiality was strictly maintained. Participants were informed that the data would be used solely for academic and public health improvement purposes without any risk or personal consequences.
The socio-demographic profile of the 420 participants revealed a balanced distribution across key demographics, ensuring a well-rounded representation of the population in Himachal Pradesh. The majority of participants (39.0%) were aged between 18–25 years, followed by 34.3% in the 26–35 years bracket, 20.0% between 36–45 years, and 6.7% above 45 years. Females constituted a higher proportion (56.4%) compared to males (43.6%), reflecting strong engagement from women in reproductive health discussions. Regarding educational status, 36.7% had completed secondary education, 33.6% held undergraduate degrees, and 10.0% had pursued postgraduate studies, although a notable 19.8% had only primary or no formal education. Occupationally, homemakers were the largest group (30.0%), followed by private sector employees (21.7%), self-employed individuals (18.8%), government workers (14.5%), and unemployed or others (15.0%). In terms of marital status, over half of the respondents (55.2%) were married, 39.5% were single, and 5.2% were divorced or widowed, offering diverse insights into contraceptive awareness across different life stages.
Table 1: Socio-Demographic Characteristics of Participants
Variable | Category | Frequency (n) | Percentage (%) |
Age Group (Years) | 18–25 | 164 | 39.0 |
26–35 | 144 | 34.3 | |
36–45 | 84 | 20.0 | |
>45 | 28 | 6.7 | |
Gender | Female | 237 | 56.4 |
Male | 183 | 43.6 | |
Education Level | No formal education | 31 | 7.4 |
Primary school | 52 | 12.4 | |
Secondary school | 154 | 36.7 | |
Undergraduate degree | 141 | 33.6 | |
Postgraduate degree | 42 | 10.0 | |
Occupation | Homemaker | 126 | 30.0 |
Self-employed | 79 | 18.8 | |
Government employee | 61 | 14.5 | |
Private sector | 91 | 21.7 | |
Unemployed/Other | 63 | 15.0 | |
Marital Status | Single | 166 | 39.5 |
Married | 232 | 55.2 | |
Divorced/Widowed | 22 | 5.2 |
The assessment of participants' awareness and knowledge regarding modern contraceptive methods revealed encouraging levels of understanding, although some knowledge gaps remain. A significant 82.6% correctly identified the primary purpose of modern contraceptives as preventing unintended pregnancies, and 79.0% were aware of the effectiveness of oral contraceptive pills. Awareness about male condoms serving as a dual method for pregnancy and STI prevention was high (80.7%). Knowledge regarding the proper use and benefits of IUDs (75.2%), emergency contraception (72.4%), and injectables (68.3%) showed a reasonably strong foundation. However, misconceptions persisted, particularly regarding contraceptive implants (64.5%) and cancer risks linked to contraceptive pills, where only 63.1% responded correctly. Encouragingly, a large majority acknowledged that men can and should participate in contraceptive decisions (83.6%) and that access to contraception directly reduces unintended pregnancies (84.3%). Social media and community health programs were seen as the most effective channels for promoting awareness (84.8%), highlighting growing acceptance of modern outreach methods.
Table 2: Awareness and Knowledge of Modern Contraceptive Methods Among Participants
Question | Options | Correct Responses (n) | Percentage |
What is the primary objective of modern contraceptives? | a) Treat infertility, b) Prevent unintended pregnancies, c) Enhance libido, d) Cure STIs | 347 | 82.6 |
Can oral contraceptive pills prevent pregnancy effectively? | a) Yes, b) No, c) Only in urban women, d) Only with medical supervision | 332 | 79.0 |
Is the male condom a reliable method for STI prevention? | a) Yes, b) No, c) Only for HIV, d) Only in monogamous relationships | 339 | 80.7 |
Does an intrauterine device (IUD) require daily administration? | a) Yes, b) No, c) Only for short-term use, d) Only in urban clinics | 316 | 75.2 |
Can emergency contraception be used as a regular method? | a) Yes, b) No, c) Only for adolescents, d) Only in rural areas | 304 | 72.4 |
Are injectable contraceptives safe for long-term use? | a) Yes, b) No, c) Only with doctor’s advice, d) Only for married women | 287 | 68.3 |
Can contraceptive implants provide multi-year protection? | a) Yes, b) No, c) Only in urban hospitals, d) Only for older women | 271 | 64.5 |
Is male sterilization a reversible contraceptive method? | a) Yes, b) No, c) Only in some cases, d) Only in urban centers | 294 | 70.0 |
Do modern contraceptives cause permanent infertility? | a) Yes, b) No, c) Only in women, d) Only with prolonged use | 336 | 80.0 |
Should couples consult healthcare providers before choosing contraception? | a) Yes, b) No, c) Only for new methods, d) Only in rural areas | 360 | 85.7 |
Is contraception solely a woman’s responsibility? | a) Yes, b) No, c) Only in rural areas, d) Only for unmarried couples | 349 | 83.1 |
Can condoms be used alongside other contraceptives for dual protection? | a) Yes, b) No, c) Only for STIs, d) Only in urban settings | 322 | 76.7 |
Are contraceptive pills linked to increased cancer risk? | a) No, b) Yes, c) Only in smokers, d) Only with long-term use | 265 | 63.1 |
Does access to contraception reduce unintended pregnancies? | a) Yes, b) No, c) Only in urban areas, d) Only for adolescents | 354 | 84.3 |
Can IUDs be used by women who haven’t given birth? | a) Yes, b) No, c) Only with medical approval, d) Only in urban clinics | 298 | 71.0 |
Is emergency contraception safe within 72 hours of unprotected sex? | a) Yes, b) No, c) Only for adults, d) Only in urban areas | 309 | 73.6 |
Do modern contraceptives violate cultural values? | a) Yes, b) No, c) Only in rural areas, d) Only for certain methods | 340 | 81.0 |
Which is NOT a modern contraceptive method? | a) Condoms, b) IUDs, c) Implants, d) Herbal remedies | 283 | 67.4 |
Can men actively participate in contraceptive decision-making? | a) Yes, b) No, c) Only in urban areas, d) Only for married couples | 351 | 83.6 |
What is the most effective way to promote contraceptive awareness? | a) Social media, b) Community health programs, c) Religious institutions, d) Family elders | 356 | 84.8 |
Knowledge score analysis further categorized participants based on their overall awareness of modern contraceptive methods. A substantial portion (49.5%) demonstrated a "Good" level of knowledge, correctly answering between 60%–79% of the questions, while 25.5% achieved a "Very Good" score, with 80% or higher accuracy. However, 19.3% of respondents were classified under the "Fair" category, and 5.7% fell into the "Poor" awareness group, indicating the need for continued educational efforts. These findings underscore that although awareness of contraception among the Himachali population is progressing, sustained, culturally appropriate initiatives are essential to close existing gaps and promote shared responsibility in reproductive health decision-making.
Table 3: Knowledge Score Classification
Knowledge Category | Score Range | Frequency (n) | Percentage (%) |
Very Good | ≥80% | 107 | 25.5 |
Good | 60%–79% | 208 | 49.5 |
Fair | 40%–59% | 81 | 19.3 |
Poor | <40% | 24 | 5.7 |
This study offers important insights into the current state of awareness, knowledge, and perceptions regarding modern contraceptive methods among men and women in Himachal Pradesh. The findings reveal a promising trend toward greater understanding of reproductive health choices, but they also uncover persistent myths, partial misconceptions, and gendered attitudes that must be addressed to achieve more equitable and effective family planning practices.
The socio-demographic diversity of the participants — spanning various age groups, educational levels, and marital statuses — provided a well-rounded perspective of the region’s contraceptive knowledge landscape. The majority of respondents were young adults (18–35 years), an age group critical for reproductive decision-making, suggesting that the study effectively captured the voices of those most relevant to family planning interventions. The predominance of female participants (56.4%) highlights continued female-centered engagement with reproductive health topics, but the meaningful male participation (43.6%) in this survey is encouraging and indicates growing receptivity among men toward involvement in family planning discussions.
The overall knowledge about modern contraceptive methods among participants was fairly robust. Most respondents correctly identified the primary purpose of contraception as preventing unintended pregnancies and demonstrated solid awareness of common methods such as condoms, oral contraceptive pills, and intrauterine devices. Encouragingly, 85.7% of participants agreed that couples should consult healthcare providers before selecting a contraceptive method, underscoring an appreciation for informed decision-making. Furthermore, the majority recognized that contraception is a shared responsibility, countering the traditional notion that family planning is solely a woman's duty. The high acknowledgment of male participation (83.6%) reflects a critical cultural shift toward gender-inclusive reproductive health practices.
Despite these positive findings, notable gaps in knowledge were evident. Awareness about newer or less familiar methods — such as contraceptive implants and injectables — was comparatively lower, and misconceptions about the long-term safety and side effects of contraceptive pills persisted, with only 63.1% correctly identifying that contraceptive pills are not broadly linked to cancer. Similarly, the belief that emergency contraception should not be used as a regular method was understood by many, but there remains some uncertainty about its safe use window and role within family planning frameworks. Myths surrounding male sterilization, contraceptive-induced infertility, and cultural values linked to contraceptive use also lingered among a significant minority, suggesting that despite broader acceptance of family planning, deep-seated cultural narratives still influence personal choices.
The knowledge score classification further emphasized these observations: while 75% of participants exhibited "Good" or "Very Good" knowledge, about a quarter still fell into the "Fair" or "Poor" categories. This subset, likely comprising individuals from lower educational backgrounds or rural settings, is particularly vulnerable to misinformation and could contribute to lower uptake or misuse of contraceptive methods if not specifically targeted through tailored educational interventions.
The findings of this study have important implications for public health programming. To bridge the identified knowledge gaps, continuous and community-centered educational campaigns are needed, emphasizing correct information about a full spectrum of contraceptive options — including their benefits, side effects, and myths. Special focus must be placed on underrepresented or misunderstood methods, such as implants, injectables, and male sterilization. Health communication strategies should incorporate culturally sensitive approaches that resonate with local traditions while challenging misconceptions in a respectful manner. Moreover, engaging men as equal stakeholders in reproductive health through focused male-inclusive interventions, workplace seminars, and community dialogues can strengthen family planning outcomes and reduce the burden historically placed on women alone.
Furthermore, community health workers, who are trusted sources of information in rural and semi-urban Himachal Pradesh, should be systematically trained to deliver updated, evidence-based reproductive health education. Leveraging popular outreach platforms, such as social media and community health programs — both of which were widely endorsed by participants — could amplify the reach and impact of these efforts. Addressing stigma and normalizing open discussions around contraception, particularly among young couples, can also pave the way for better reproductive autonomy and healthier families [8,9].
Nonetheless, this study is not without limitations. The use of an online survey may have inadvertently excluded individuals with limited digital access, potentially skewing results toward more literate and technologically connected populations. Additionally, the reliance on self-reported knowledge raises the possibility of social desirability bias, wherein participants might overestimate their actual understanding. Future research incorporating mixed methods — including in-depth interviews, focus group discussions, and community-based participatory approaches — could yield richer insights into the nuanced cultural and socio-economic factors that influence contraceptive knowledge and decision-making.
This study underscores a growing but still incomplete understanding of modern contraceptive methods among men and women in Himachal Pradesh. While knowledge about commonly used options and the recognition of shared responsibility in family planning show encouraging trends, notable gaps and persistent myths remain, particularly regarding newer methods like implants and injectables. The findings also reflect a gradual cultural shift, with increased male involvement and a move away from traditional gender biases. However, the persistence of misinformation among a significant portion of participants highlights the urgent need for sustained, culturally appropriate educational efforts. Strengthening community health initiatives, leveraging digital and grassroots outreach, and promoting open, stigma-free discussions about contraception are essential strategies. By addressing these challenges, Himachal Pradesh can advance toward a more informed, equitable, and empowered approach to reproductive health and family planning.
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