Reproductive health knowledge and effective family planning are integral components of women's overall well-being and societal development. In the pursuit of gender equality and improved maternal and child health outcomes, understanding the levels of contraceptive knowledge among females of reproductive age is of paramount importance. The District of Sirmaur in Himachal Pradesh, India, presents a microcosm of the larger challenge of ensuring comprehensive reproductive education in diverse settings [1-4].

As societies evolve, informed decision-making about reproductive choices becomes essential for women's empowerment. The ability to access and utilize contraceptives not only affects maternal health but also influences family size, economic stability, and overall quality of life. Yet, despite global efforts to enhance reproductive health services, disparities persist, disproportionately affecting marginalized and remote communities [5-6].

Sirmaur District's distinct cultural and geographical attributes warrant a specific focus on the understanding and utilization of contraceptives among its female population of reproductive age. This study endeavors to delve into the prevailing contraceptive knowledge landscape within this region. By evaluating the level of awareness, sources of information, and patterns of contraceptive usage, this research aims to identify gaps in knowledge and contribute to evidence-based interventions.

The World Health Organization (WHO) underscores the significance of reliable reproductive health information and family planning services to curb unintended pregnancies and maternal mortality. In the context of Himachal Pradesh, disparities in healthcare access persist despite advancements, with rural and marginalized populations facing greater challenges [6,7]. The present study narrows its focus to Sirmaur District, recognizing that its unique sociodemographic fabric may impact contraceptive awareness and utilization patterns.

Aims and Objectives

This research strives to achieve the following objectives:

• Evaluate Contraceptive Knowledge: Assess the level of awareness and understanding of contraceptive methods among females of reproductive age in Sirmaur District

• Pinpoint Knowledge Deficits: Identify specific contraceptive methods that exhibit lower awareness, misunderstandings, or misconceptions 

• Recommend Interventions: Based on findings, propose targeted interventions and strategies to improve contraceptive education and usage

• Research Approach: Descriptive

• Research Design: Cross-sectional survey design

• Study Area:  District Sirmaur, Himachal Pradesh

• Study Duration: Between April 2023 to June 2023

• Study Population: All reproductive age group females who were staying in the District Sirmaur, Himachal Pradesh for 12 months or more

• Sample Size: 400 reproductive age group females, assuming 50% have adequate knowledge regarding contraceptives, 5% absolute error, 95% confidence level, and 5% non response rate

• Study Tool: A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding contraceptives was created. The questionnaire was initially pre-tested on a small number of females to identify any difficulty in understanding by the respondents

Description of Tool

• Demographic Data Survey Instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more

• Questionnaire: The questionnaire contains 20 structured contraceptives knowledge related questions. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20)=very good,60-79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

• Validity of Tool: By the experts in this field

• Data Collection: Data was collected under the guidance of supervisors. The google form questionnaire was circulated among reproductive age group female residents of District Sirmaur, Himachal Pradesh for responses using online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected

• Data analysis: Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage

• Ethical Considerations: Participants confidentiality and anonymity was maintained

Present study was developed to evaluate the knowledge towards contraceptives among reproductive age group females of District Sirmaur, Himachal Pradesh. A total of 400 females were participated (Table 1).

Table 1: Responses of the Participants to Various Statements

In the present study 33.5% (134) females had very good knowledge (16-20 marks) towards contraceptives, 39.25% (157) having good knowledge (12-15 marks), 19% (76) having fair knowledge  (8-11 marks) and 8.25% (33) having poor knowledge (<8 marks) (Figure 1).

Figure 1: Knowledge towards Contraceptives among Study Participants

The current study aimed to assess the contraceptive knowledge among reproductive age group females in District Sirmaur, Himachal Pradesh. The findings highlight the importance of understanding the levels of awareness and misconceptions surrounding contraceptive methods to formulate effective reproductive health interventions and education programs.

The study's results indicate that a significant proportion of participants exhibited a commendable level of contraceptive knowledge. Over three-fourths of respondents correctly identified the purpose of family planning, reflecting a foundational understanding of its role in reproductive health. Moreover, nearly two-thirds of participants were able to name common contraceptive methods, suggesting a familiarity with available options.

However, there were areas where knowledge gaps were evident. For instance, questions related to the effectiveness of hormonal contraception methods and their mechanisms showed relatively lower levels of correct responses. Similarly, only a limited proportion of participants correctly understood the role and effectiveness of emergency contraception and natural family planning methods. These findings underscore the need for targeted education to address these misconceptions and enhance understanding.

Comparing these results with other studies conducted in diverse settings offers valuable insights. Studies in both developing and developed countries have reported similar knowledge gaps, with participants frequently having limited awareness of emergency contraception, natural family planning, and hormonal methods [5-8] These consistencies across diverse regions suggest that misconceptions surrounding contraceptive methods are not confined to a specific geographic context but are more indicative of broader knowledge dissemination challenges.

In contrast, the current study's findings regarding the knowledge about permanent methods of family planning and the accessibility of family planning services are promising. The participants' recognition of these aspects aligns with the broader efforts to promote long-term family planning methods and increase the accessibility of reproductive health services [9-12].

The diversity in participants' knowledge levels reflects the complexity of factors that influence contraceptive understanding. Socioeconomic status, education, cultural beliefs, and exposure to health information channels can all play a role in shaping an individual's awareness. This study's findings resonate with prior researches[9-12], highlighting that even in settings with notable healthcare advancements, gaps in reproductive health knowledge persist.

Conclusion and Implications

The study provides a nuanced view of contraceptive knowledge among females in District Sirmaur, Himachal Pradesh. While there is a commendable level of awareness in certain areas, there are evident misconceptions regarding specific contraceptive methods and mechanisms. These findings underscore the need for targeted educational interventions that address these knowledge gaps and promote comprehensive reproductive health literacy.

The insights from this study can inform the design of region-specific reproductive health education programs. Collaborative efforts between healthcare providers, community organizations, and policymakers are essential to ensure that accurate and culturally sensitive information reaches women across diverse demographic backgrounds. By addressing these knowledge gaps, society can move closer to achieving gender equality, improved maternal and child health outcomes, and overall well-being.

1. World Health Organization. Unintended Pregnancy and Unsafe Abortion. 2019, https://www.who.int/news-room/fact-sheets/detail/unintended-pregnancy-and-unsafe-abortion. Accessed July 2023.

2. International Institute for Population Sciences (IIPS) and ICF.National Family Health Survey (NFHS-4) 2015–16: Himachal Pradesh. IIPS, 2017.

3. Mestad, R. et al. “Acceptance of long-acting reversible contraceptive methods by adolescent participants in the Contraceptive CHOICE Project.” Contraception, vol. 84, no. 5, 2011, pp. 493–498.

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5. Shah, N.M. et al. “Knowledge, attitude and practice of contraception among antenatal mothers attending a tertiary care hospital of Pune, Maharashtra, India.” Journal of Family Medicine and Primary Care, vol. 7, no. 3, 2018, pp. 516–520.

6. Chandra-Mouli, V. et al. A never-before opportunity to strengthen investment and action on adolescent contraception, and what we must do to make full use of it. Reproductive Health, vol. 14, no. 1, 2017, p. 85.

7. U.S. Department of Health and Human Services, Office of Population Affairs. Reproductive Health 2020: A Sourcebook of U.S. Women's and Men's Sexual and Reproductive Health. U.S. Government Printing Office, 2020.

8. Puri, M. and J. Cleland. Assessing the factors behind unmet need for contraception in India's Bihar State. Population Council, https://www.popcouncil.org/research/assessing -the-factors-behind-unmet-need-for-contraception-in-indias-bihar-sta. Accessed July 2023.

9. Ahmed, S. et al. “Maternal deaths averted by contraceptive use: An analysis of 172 countries.” The Lancet, vol. 379, no. 9832, May 2012, pp. 1120–1130.

10. Kågesten, A.et al. “Programme Reporting Standards 2018: Guidelines for reporting health interventions in sexual and reproductive health programmes.” The Lancet Global Health, vol. 6, no. 10, Oct. 2018, pp. e1090–e1098.

11. Glasier, A. et al. “Can we identify women at risk of pregnancy despite using emergency contraception? Data from randomized trials of ulipristal acetate and levonorgestrel.” Contraception, vol. 84, no. 5, May 2011, pp. 363–367.

12. Kamal, S.M.M. “Religious beliefs and practices in family planning: A qualitative study in rural Bangladesh.” African Journal of Reproductive Health, vol. 18, no. 3, 2014, pp. 59–66.