1

PONDICHERRY INSTITUTE OF MEDICAL SCIENCES

( Unit Of Madras Medical Mission)

Kalapet, Puducherry

DEPARTMENT OF COMMUNITY MEDICINE

Interns Rural Posting

(Study period 1/2/2014-28/2/2014)-Chunampet

Title: “Determinants and knowledge on contraceptive

usae among women of reproductive age group in a rural

area of Kancheepuram district, Tamil Nadu”

2

INVESTIGATORS:

Prof.Dr.(Brig)Zile Singh Dr.Venkatachalam.J

HOD Assisstant Professor

PG IN CHARGE: Dr.Vishnu Prasad, 2nd year Post Graduate

INTERNS:

Dr.Abilash

Dr.Anantha Vigneshwari

Dr.Anisha Raymond

Dr.Antony Rosario

Dr.Balraj

Dr.Nirmal Krishna

Dr.Raghuram

Dr.Umar Basha

Dr.Vutla Kavya

3

ACKNOWLEDGMENTS

We’d like to take this opportunity to express our heartfelt gratitude

to the Head of Department of Community Medicine, Dr.(Brig) Zile

Singh, who gave us his timely and sincere guidance in the goings about

of this project. We also thank our co-guide, Dr.Venkatachalam.J, Assis-

tant Professor of the Department of Community Medicine, who was with

us every step of the way with advice and support to help us attain our

objectives.

We also thank Dr. Vishnu Prasad, 2nd year Postgraduate student of

the Department of Community Medicine who supported us in the com-

pletion of the project. We extend our thanks to Dr.Arun.S and

Dr.Gopinath, RMO, Chunampet and the support staff at the Rural Health

Center in Chunampet who helped us make this project a success.

Finally, we are greatful to all the study participants for their

cooperation as well as for spending their valuable time in proving us the

necessary details for the purpose of our study.

4

S.NO PARTICULARS PAGE NO

1 INTRODUCTION 5

2 OBJECTIVES 8

3 REVIEW OF LITERATURE 10

4 MATERIALS AND METHODS 16

5 RESULTS 20

6 DISCUSSION 48

7 SUMMARY AND CONCLUSION 53

8 REFERENCES 55

9 ANNEXURE –I QUESTIONNAIRE 58

CONTENTS

5

INTRODUCTION

6

INTRODUCTION

Global contraceptive usage was 63.3% in 2010 which

was 9% more than that in 1990. Also in the last two decades

the Unmet need for Family Planning decreased from 15.4%

to 12.3% worldwide. These changes were seen in almost all

regions of the world except in regions where family plan-

ning coverage was already high. However, different regions

showed different levels of changes.1 Although India was the

first nation to have an official National Family Planning

Programme in 1952, the target was on health of the women

rather than population control. Then census of 1971 re-

vealed an alarming population growth which necessitated

adoption of population control strategies in India. NFHS-III

2005-06 (National Family Health Survey) in India revealed,

the contraceptive prevalence rate was 56% while in the past

decade it was 48%. 2 Providing universal Family Planning

services is an important strategy to reduce maternal morbid-

ity and to control population growth. 10% of all pregnancies

are mistimed and 11% of all pregnancies are unwanted in

India.2 The number of unintended pregnancies can be

7

brought down by proper utilization of family planning ser-

vices. Worldwide the unmet need for Family Planning de-

creased during the past two decades, but the number of

women with unmet needs remained the same due to popu-

lation growth. In India female sterilization is the most

commonly preferred method of contraception accounting

for 76% of all methods, while in Tamil Nadu it was 90%.

But the usage of temporary methods of contraception re-

mains low, which is mostly due to social stigma and cul-

tural misbeliefs4-5, lack of knowledge6-7 and concern about

side effects.4,7-9 Women’s decision on use of contraceptive

methods is influenced by several social constraints and so-

cial circumstances including family sex composition and

gender preference. Worldwide, when contraception is used

properly and effectively to avoid unwanted pregnancy it

can reduce maternal deaths to 25%-35%.10,11 Thus this

study aims at measuring the prevalence of unmet needs of

family planning and its determinants in a rural area of

Kancheepuram district, Tamil Nadu, South India.

8

OBJECTIVES

9

AIM:

To study the prevalence of unmet needs of family planning and its determinants

OBJECTIVES:

To measure the prevalence of unmet needs of family planning

To study the determinants of contraceptive usage

Our Intern, Dr.Abilash was interviewing with one of our

study participants

10

REVIEW

OF

LITERATURE

11

REVIEW OF LITERATURE:

The time since family planning services stared getting attention, there

has been many studies in the past on prevalence, acceptance and usage of var-

ious contraceptive methods. It was during the late 20th century contraceptive

usage has gained momentum. However in many developing countries the un-

met needs for family planning still remained considerably high, which is

mostly due to lack of knowledge, lack of access and social stigma. There

have been a few studies in the past which attempted to estimate the contra-

ceptive prevalence and pattern of contraceptive usage.

Unmet Needs of family planning:

Varying levels of unmet needs of family planning have been reported

from different regions of the country. National Family Health Survey (NFHS)

reported the prevalence of unmet need for family planning as 13% during the

year 2005-06 while it was 16% during 1998-99 in India. 2,12 Though in Tamil

Nadu the unmet need was much less, that is 9% during the year 2005-06,

which reduced from 13% in the year 1998-99.13

In a study by Ilene S et al done in 6 cities of Uttar Pradesh, the most populous

state of India showed a varying prevalence of unmet need for family planning

from 12% in Moradabad to a maximum of 20% in Aligarh. In Allahabad and

Moradabad more percentage of women in the slum have an unmet need for

12

family planning when compared to non-slum people. Also the unmet need for

limiting was more when compared to spacing .14

Yadav K et al in a study observed that prevalence of unmet needs of

family planning in Haryana to be 17.5% for married women, and also unmet

need was significantly higher among married women when compared to

men.15

A study done in Kancheepuram district by Prateek SS et al revealed that

the unmet need for contraception was 51.6% among women of reproductive

age group (15-49) years attending general outpatient department in Urban

Health Center.16

Contraceptive usage pattern and its prevalence:

Female sterilization remains the most preferred method of contraception

among married women, which accounted for 87% of contraceptive use during

1998-99 and it became 90% during 2005-06 in NFHS III in Tamil Nadu. But

nationally female sterilization accounted for 71% of all contraceptive use in

NFHS II and 66% in NFHS III. 77% of the female sterilization operations

were acquired from Government facilities in Tamil Nadu, however nation-

wide it was 84%.2,12,13

In a study done by Srividhya V et al in Bangalore, 73.9% of the study

participants have not used any method of contraception before sterilization.

13

While 15.8% of the study subjects used IUD, the commonest method of con-

traception used for spacing.17

Patro BK in a study in Delhi observed that nearly 74% of the women

already had 2 children when they first used a contraceptive method and 21%

used a contraceptive method for the first time after first child birth. Also most

of the study subjects used contraception to limit the family size than for spac-

ing. Only 2% of them used contraception before the first child was born.18

Sharma V et al in a study done in Lucknow found that 47% of women in

rural area haven’t used any family planning method in the past.19

68% of the married woman in a Mumbai slum are currently using a con-

traceptive method as observed by Makade KG et al in their study. The study

results also show that 28% of them are using Oral Contraceptive Pills fol-

lowed Condoms (18%) and female sterilization (11%). Although Copper-T

was the most preferred method of contraception it was used by only 9% of the

married woman.20

Perceptions and Knowledge of Contraception:

Almost all women have knowledge about contraceptive methods in India, fe-

males sterilization is the most known contraceptive method. However the

knowledge on temporary methods of contraception was still considerably low.

14

61% of women have heard or seen a message about contraception in media in

the recent past, while this percentage was much higher among males (92%).2

A study done in Lucknow by Sharma V et al indicates that more than 90%

women are aware of the male and female sterilization methods, Condoms,

IUCD (Intra-Uterine contraceptive devices) and traditional methods of con-

traception. Health workers in rural area

and media in urban area remained as a major source of Information about

family planning to the women. 19

Makade KG et al in a study done in a Mumbai slum reported that 87%

of the married woman are aware of Oral Contraceptive Pills and Copper-T

(Cu-T) and 80% of them are aware about female sterilization. Decision on

contraceptive usage is taken mutually by Husband and Wife in in 41% of the

cases and in 30% of the cases the decision was taken by the husband. Nearly

85% of the study subjects are aware about the place of availability of contra-

ceptive services.20

15

One of our intern Dr.Balraj was interviewing with one of our study respondents

Intern Dr.Aneesha was getting consent from one of our study participants

16

MATERIALS

AND

METHODS

17

METHODOLOGY:

Study Setting: The Study was carried out in Chunampet panchayat, a rural

area in Kancheepuram District, Tamil Nadu, South India. Also the field prac-

tice area of Rural Health Training Center, Pondicherry Institute of Medical

Sciences.

Study Design: Community Based Cross Sectional Study

Study Population: All women between 15-49 years of age in the study area,

who gave consent to participate are included in the study

Study Period: 1st Feb 2014 to 28th Feb 2014

Study Tool: Pretested Structured Questionnaire

Study Variables: Socio-Demographic profile, Personal details, Knowledge

about Contraceptives, Contraceptive usage pattern, Perceptions on Family

planning and family size were studied.

Sample Size: The required Sample Size was calculated to be 452, based on

the National prevalence of Unmet needs for family planning, 13% from

NFHS III2, with precision taken as 10%. Sample size was calculated using the

formula Z2PQ/d2

Sampling: Streets were selected randomly and all the households in the

street were included in the study. In every household all the available and

18

eligible women were explained about the study and recruited. The study was

explained regarding the benefits and implications of study to all the partici-

pant in their own language and their voluntary informed written consent was

sought before interviewing the participants.

Operational Definitions:

Unmet Need for Family Planning: The percent with an unmet need for

family planning is the number of women with unmet need for family plan-

ning expressed as a percentage of women of reproductive age who are mar-

ried or in a union. Women with unmet need are those who are fecund and

sexually active but are not using any method of contraception, and report not

wanting any more children or wanting to delay the birth of their next child.21

Statistical Analysis: MS Excel 2010 was used for data entry. Data validation

is MS excel was used to avoid errors in data entry. SPSS Version 21 was

used for statistical analysis.

19

Intern Dr.Vutla Kavya was measuring BP of our study respondents

Intern Dr.Anadha Vigneshwari was explaining about merits of family planning

20

RESULTS

21

RESULTS:

Figure 1. Education status of study respondants (n= 505)

Maximum (26%) of our study respondants completed high school followed by middle

school. 25% of the study population were illiterate.

22

Figure 2. Distribution of Population based on Occupation (n= 505)

Most of our study participants were house wives, Semiskilled and Unskilled labourers.

23

Interns Dr.Umar Basha and Dr.Nirmal Krishna were interviewing with the study respondents.

24

Figure 3. Distribution of study respondants based on Religion (n= 505)

Most of the study participants were Hindus (97.4%), while Muslims and Christians were

1% each.

25

Figure 4. Distribution of the study respondants base on the Marital status (n= 505)

Nearly 90% of our study participants are married, while 5% of them were widow and 2% are

separated.

26

Figure 5: Perception of the study subjects on Ideal age for marriage for Women

(n = 505)

Nearly 70% of the study participants responded that 20-23 years is the ideal age for a Girl to

get married

27

Figure 6: Perception of the study participants about ideal no of children a couple can have (n=505)

Nearly 77% responded that ideal number of children a couple can have is 2 and 17% of the participants responded that ideal number of a children a couple can have is 3.

Figure 7: Perception about giving birth to more number of children leads to health

problems (n=505)

About 54% responded that giving birth to increased number of children can lead to health problems.

28

Figure 8: Perception about spacing between two children can cause health problems

(n=505)

About 45% responded that less spacing between two children can lead to health problems and 35% of our participants did not know that whether less spacing

between two children leads to health problems

Figure 9: Perception of the study participants regarding ideal spacing

between two children (n = 505)

Nearly 49% responded that ideal spacing between two children is 3-4 years

and 42% responded ideal spacing as 1-2 years

29

Figure 10: Pattern of Gender preference (n=505)

Only 29% of our participants prefers to have male child while 56% have no preference.

Figure 11: Individuals insisted to have a child with specific gender (n=505)

14% of our participants have been insisted by someone to have a child with specific gender.

30

Figure 12: Insisted Gender (n=42)

Majority of our participants (80%) have been insisted to having a male child and the rest (20%) have been insisted to have a female child.

Figure 13: Knowledge of contraceptive measures (n=505)

Nearly 84% of our participants have ever heard about atleast one contraceptive measure.

.

31

Figure 14: Contraceptive preference of our participants (n=427)

Approximately 81% of our respondents prefer to use sterilization as a contraceptive method

and 9% prefer to use Intrauterine contraceptive devices.

32

Figure 15: Knowledge about using contraceptive methods can prevent Sexually

Transmitted Diseases (n=427)

Among those who have heard of a contraceptive method, about 22% of them responded that contraceptives can prevent STD

33

Figure 16: Knowledge about the contraceptive method that can prevent Sexually

Transmitted Diseases (STD) (n=97)

Nearly 51% of the participants those who said STDs can be prevented by the use of

Contraceptive methods, responded that condoms can prevent STD.

34

Figure 17: Participants who have ever used a contraceptive measure

(n = 505)

Nearly 72% of the respondents have ever used atleast one form of contraceptive method,

whereas rest of the study participants have not used any contraceptive method.

35

Figure 18: Source of information about contraceptive method (n=310)

Nearly half of the respondents have stated that the source of information about the contraceptive methods was obtained through media and 29% of the respondents have gained

knowledge about contraceptive methods from Doctors/ Nurses, the rest from health worker, friends and relatives.

36

Figure 19: Place from where the contraception facility was obtained (n=309)

Majority of our participants have obtained contraception from government facilities.

37

Figure 20: Perception regarding failure of contraceptive measures (n=287)

Majority of our participants have never had a contraceptive failure while only a 2% had experienced contraceptive failure.

Figure 21: Knowledge of husband about usage of participant’s contraceptive

measures (n=309)

`

In our study population, about 90% of the husbands know about the type of contraceptive method used by their wives.

38

Figure 22: Decision regarding usage of contraception (n=309)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

7.76% 4.20%

70.55%

12.94%

1% 3.23%

Per

cen

tage

Majority of our study population have made their decision on contraceptive usage

mutually by both husband and wife, and 7.76% of the women made their own decision

regarding contraceptive usage.

39

Figure 23: Usage of contraceptive measure by partner (n=457)

In our study population, majority of participant’s partner did not use any form of contraceptive measures

Figure 24: Insisted not to use a contraceptive measure (n=457)

Nearly 2% of the individuals who have ever heard of a contraceptive measure are insisted by someone not to use a contraceptive measure

40

Figure 25: Current usage of contraceptive measure (n=505)

Nearly half of our participants were currently using contraceptive measure and 48% of them were not using contraceptive measure now.

Figure 26: History of abortion (n=505)

Nearly 93% of our participants had no abortion while 7% had history of abortion.

41

Figure 27: Prevalence of Unmet Needs of Family Planning among women of reproduc-

tive age group (15-49) years

Unmet need for Family Planning =

Women (Married or in an Union), who are not using contraception, are fecund, and desire to either stop childbearing and postpone their next birth for atleast 2 years + Pregnant women whose current pregnancy was unwanted or mistimed + women in postpartum amenorrhoea who are not using contraception and, at the time they became pregnant , had wanted to delay or prevent pregnancy

___________________________________________

Total number of women of reproductive age (15-49) who are married or in an union

42

Figure 28: Unmet needs of family planning for spacing and limiting (n=135)

54% of the Unmet need was for Limiting and 45% of the Unmet need was for Spacing.

43

The unmet need for family planning was more for individuals aged 15-25 years when

compared to older age groups and the difference was found to be statistically significant.

This shows the younger age group requires more emphasis on family planning and

adequate fertility control.

Table 1. Association between current age of the participant and Un-

met Need for Family Planning

Current Age of the Participant

(in years)

Unmet Need for Family

Planning Total p - Value

Present

(%)

Absent

(%)

15-25 55 (47.4%) 61 (52.6%) 116 (100%)

p < 0.0001

26-35 48 (26.8%) 131 (73.2%) 179 (100%)

36-49 32 (22.9%) 108 (77.1%) 140 (100%)

Total 135 (31%) 300 (69%) 435 (100%)

44

The unmet need for family planning was found to be approximately similar among the women

who got married between the age groups of 19-23 and 24-30 years. However for those who got

married between 15-18 years the unmet need for family planning was less

Table 2. Association between age on marriage and Unmet need for family plan-

ning

Age on Mar-riage

Unmet Need for Family Plan-

ning Total n (%) p -Value

Present (%) Absent (%)

(15-18) Years 31 (26.3%) 87 (73.7%) 118 (100%)

p = 0.422

(19-23) Years 87 (32.7%) 179 (67.3%) 266 (100%)

(24-30) Years 17 (33.3%) 34 (66.7%) 51 (100%)

Total 135 (31%) 300 (69%) 435 (100%)

45

In our study the unmet need for family planning was more in women whose education

was high school and above than those whose education middle school and below.

Table 3. Association between education of the participant and Unmet Need

for Family Planning

Education of the Par-

ticipant

Unmet Need for Family

Planning

Total p-value

Present (%) Absent (%)

Middle

School

and below

69 (27.1%) 186 (72.9%) 255 (100%)

p = 0.033 High school

and above 66 (36.7%) 114 (63.3%) 180 (100%)

Total 135 (31%) 300 (69%) 435 (100%)

46

The unmet need for family planning was the highest among the participants with

percapita income < Rs.1000 whereas with the increase in percapita income the unmet

need for family planning decreases.

Table 4. Association between Per Capita Income and Unmet Need for Family

Planning

Per Capita Income of

the Partici-pant

(in Rs.)

Unmet Need for Family Plan-

ning

Total p - Value

Present (%) Absent

(%)

<1000 41 (34.2%) 79 (65.8%) 120 (100%)

p = 0.347

1000-1999 64 (32.2%) 135 (67.8%) 199 (100%)

>2000 30 (25.9%) 86 (74.1%) 116 (100%)

Total 135 (31.0%) 300 (69.0%) 435 (100%)

47

The unmet need for family planning was more for the women whose family size is less

and vice versa.

Table 5. Number of children and the Unmet Need for Family planning

Number of Chil-

dren

Unmet Need for Family

Planning Total p - Value

Present (%) Absent (%)

0-1 55 (46.2%) 64 (53.8%) 119 (100%)

p < 0.001

2 60 (31.3%) 132 (68.8%) 192 (100%)

3 and

more 20 (16.1%) 104 (83.9%) 124 (100%)

Total 135 (31%) 300 (69%) 435 (100%)

48

DISCUSSION

49

DISCUSSION:

Our study was done in a rural area of Kancheepuram District, Tamil Nadu,

the state which has got success stories in terms of Health Indicators including

provision of adequate family planning services and many others. Despite good

coverage with contraceptive services in Cities and Urban region, the Unmet need

for family planning remains considerably higher in some parts of the state. As

the population pattern of the country is changing, more women will be in repro-

ductive age group in the near future. Henceforth provision of adequate family

planning service to the general population should be assured with more empha-

sis to the rural areas.

Our study results showed that the prevalence of unmet needs of family

planning in our study population is 31% among the married women of reproduc-

tive age group. This was much higher than the prevalence of unmet needs for

family planning reported by Ilene S et al in 6 cities of Uttar Pradesh which

showed varying prevalence between (12 – 20) % in different regions.14 Another

study in North India, Haryana done by Yadav K et al showed the prevalence of

Unmet need for family planning as 17.5%.15

The NFHS data has showed the prevalence of unmet need for family planning as

13% nationally and 9% in Tamil Nadu, which is much lower when compared to

our study results.2,13 On the other hand a much varying prevalence of 51%

among women of reproductive age group was reported by Prateek SS et al in a

50

study done at Kancheepuram district, Tamil Nadu. However the participants of

the above study were those who attended the OPD of an Urban Health Center.16

In our study it was observed that nearly 84% of our participants have heard

about atleast one method of contraception. As per the data of NFHS III, 61% of

women have heard or seen a message about contraception in media in the recent

past, while this percentage was much higher among males (92%).2 Another study

done in Lucknow by Sharma V et al states that more than 90% women are aware

of the male and female sterilization methods, Condoms, IUCD (Intra-Uterine

contraceptive devices) and traditional methods of contraception.19 Makade KG et

al in a study done in a Mumbai slum reported that 87% of the married woman are

aware of Oral Contraceptive Pills and Copper-T and 80% of them are aware

about female sterilization.20

In our study 81% of those who have heard about contraception said that

they would prefer to use female sterilization as the method of contraception and

9% prefer to use Intrauterine contraceptive devices. Our results are little lower

than the NFHS data which revealed the prevalence of female sterilization as 90%

during 2005-06 (NFHS III) in Tamil Nadu.13 And nationally female sterilization

accounted for 71% of all contraceptive use in NFHS II and 66% in NFHS III.12,2.

51

From the studied population, the contraceptive prevalence rate was found

to be 72% that was much higher than the NFHS data which showed the contra-

ceptive prevalence rate to be 48% and 56% during the year 1998-99 and 2005-06

respectively12,2, while the contraceptive prevalence rate of Tamil Nadu was 61%

during the year 2005-06 by NFHS-TN III.13

In our study, among the participants who have used contraception, 80%

have obtained it from government facilities while in India and Tamil Nadu the

government services have covered 84% and 77% of contraceptive users respec-

tively. 2,12,13

Regarding the family structure and composition, nearly 77% have respond-

ed that ideal number of children a couple can have is 2 and 49% have responded

that ideal spacing between two children is 3-4 years and 42% as 1-2 years.

Male child preference was seen among 29% of our participants while 56%

have no preference. According to NFHS, many Indian families showed strong

preference towards male children.2 Among the participants with preference to-

wards either male or female child, majority had their own gender preference

while 14% have been insisted by someone else to have a child with specific gen-

der.

22 % of our study subjects responded that contraceptive methods can pre-

vent sexually transmitted diseases, of those who have heard of a contraceptive

52

method. And almost half of them have said that the condoms can prevent

STDs method. And almost half of them have said that the condoms can pre-

vent STDs.

From our study it was found that Media is the most effective means of

creating awareness while counselling by doctors and nurses have also played

a minor role. In majority of our study population the decision on contracep-

tion was made mutually by both husband and wife. These results were con-

sistent with that of the NFHS III data.2

53

CONCLUSION

54

CONCLUSION:

The contraceptive prevalence rate was found to be 72%

in our study area. In the studied population, the unmet need

for family planning was found to be 31% and the usage of

male contraception was not rampant. The decision on con-

traception was influenced by the family size, sex composi-

tion and gender preferences. The unmet need for spacing

was more than the unmet need for limiting.

55

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unmet_need_fp/en/

58

Determinants and knowledge on contraceptive usage among women of reproductive

age group in a rural area of Kancheepuram district, Tamil Nadu

Socio Demographic Profile

1.Name of the participant: 3.Age :

2.Address ĉ Contact no. :

4.Education: 1. Illiterate 2. Primary 3. Middle 4. High 5. Higher Secondary schooling 6. Graduate and above

5.Occupation: 1.Unskilled 2.Semi Skilled 3.Skilled 4.Professional 5.Unemployed 6.House Wife 7.Student

6.Per capita income = Monthly Income from all sources / Tot. family members = /

7.Religion: 1.Hindu 2.Muslim 3.Christian 4.Others

8.Birth Order: 9.No. of Siblings:

10.Marital status: Unmarried /Married / Separated / Widow

11.Age on marriage: 12.Age of Spouse:

13.Education of Spouse: 14.Occupation of Spouse:

15.What do you think is the ideal number of children a couple can have? (0, 1, 2, 3, >4)

16.How many children do you have? ( 0, 1, 2, 3, >4)

17.Which gender children do you prefer? 1.Male 2.Female 3.No Preference

18.Have you ever been insisted on having a child with specific gender? Yes/No If yes, what gender and by whom

19.Have you ever heard of any contraceptive measures? Yes / No If no go to 30

20.If yes which method do you prefer to use?

21.Have you ever used any contraceptive methods? Yes / No If no go to 30 If yes Details?

Methods Order of usage

Duration of usage

Preference Purpose Side Effects/ Reason for changing methods of contraception

Sterilization Limiting

IUD Spacing/Limiting

Pills Spacing/Limiting

Injectable Spacing/Limiting

Condom Spacing/Limiting

Emergency Pill

Spacing/Limiting

Rhythm Spacing/Limiting

Withdrawal Spacing/Limiting

Folk Spacing/Limiting

22.Have you stopped using any contraceptive measure because of side effects? Yes/ No

23.Source of Information/ Advise regarding contraceptive use: 1.Media 2.Doctor 3.Health Worker 4.Relatives 5.Friends

24.Place from where contraceptive facility was obtained? 1.Govt 2.Private

59

25.Have you been informed about the choice of Contraception that you are using? Yes / No

26.Whether you had any contraceptive failure? Yes/No If yes Specify the method

27.Do you think contraceptives can prevent STDs? Yes/No If yes Which method?

28.Does your husband know about what contraception you are currently using? Yes/No

29.Decision about contraception usage is made by? 1.Self 2.Husband 3.Both self and Husband 4.Insisted by relatives 5.Insisted by friends 6.Insisted by Doctor/Health Worker

If No

30.Does your partner use any contraception? Yes/ No If yes What?

31. Do you know from where family planning services can be availed? Yes/ No

32.If yes Where?

33.Has anyone insisted you to not use contraceptive measures? Yes/No If yes, Specify

34.Do you wish to use any contraceptive measure now? Yes/No

35.What do you think is the ideal age for a girl to get married?

36.Do you think that having more children can lead to health problems of the mother? Yes/No

37.How many Children do you have? Male: Female:

38.Do wish to have more children? Male: Female:

39.Have you used any contraceptive measure before 1st child?

40.Do you think that less spacing between children can lead to health problems? Yes/No

41.What do you think is the ideal spacing between 2 children? ( 1, 2, 3, 4, 5, >6 ) years

42.Age of the mother while the 1st child was born?

43.Whether you had any unwanted pregnancies? Yes/No If yes How many times?

44.Have you ever had abortion? Yes /No If yes How many times?

45.What is the reason for abortion? 1.Medical Grounds 2.Unwanted pregnancy 3.Contraceptive failure 4.Gender Preference

Signature & Name of the Participant:_______________________________(InformededConsent)

Signature & Name of the Intern: ________________________________

Signature & Name of the PG:

(Dr.R.Vishnu Prasad)

Remarks of the Investigator:______________________________________________________________

Referred Y N