Indmedica Home | About Indmedica | Medical Jobs | Advertise On Indmedica
Search Indmedica Web
Indmedica - India's premier medical portal

Indian Journal of Community Medicine

Fertility Pattern And Family Planning Practises In A Rural Area In Dakshina Kannada

Author(s): Padma Mohanan, Asha Kamath, B.S. Sajjan

Vol. 28, No. 1 (2003-01 - 2003-03)

Deptt. of Community Medicine, Kasturba Medical College. Manipal Academy of Higher Education, Mangalore - 575 001

Keywords: Fertility, Child woman ratio, Couple protection rate, Primary sterility, Secondary sterility

Research question: What is the fertility pattern among rural community and what are the factors influencing most common methods of contraception?

Objective: To find out the distribution of family planning practices with respect to socio-demographic factors like religion, income, and Mother's literacy status.

Study design: Cross-sectional.

Setting: A rural community of Asaigoli village 20 kms. from Mangalore taluk of Dakshina Kannada.

Study Population: Married women in the age group 15-49 years living with their spouses who were residents of Asaigoli.

Study variables: Socio-demographic variables like religion, income, family type and mother's literacy, number of living children and contraception use.

Statistical analysis: Chi-square test.

Results: Seventy one percent of women with 3 or more children were acceptors of permanent methods of contraception. Couple protection rate was 28%. Non-acceptors of family planning methods were higher among the Muslims. Education level of the respondents was not influencing the acceptance of family planning methods.

Conclusion: Couple protection rate is poor indicator of fertility measures.


The age and sex composition of a population plays an important role in population analysis since the social, economic and cultural characteristics of communities vary. Understanding the demographic behavior of the community helps to note the development status of the community in fertility regulation, mortality, education and health status.

By fertility is meant the actual bearing of children 1 . It is a measure of rate at which population adds to itself by birth and normally assessed by relating number of births to size of some section of population such as number of married couples or number of women of child bearing age. When fertility remains high population tends to grow at a higher rate than before as mortality is controlled. Human fertility is determined by all customs, morals and habits of social groups with regard to marital obligations and life. Age at marriage, caste and education affect fertility. Many demographers who correlate fertility pattern with socio-economic and cultural factors opine that the economic and social development decreases with family size. Family planning is defined by WHO as "a way of thinking and living that is adopted voluntarily, upon the basis of knowledge, attitudes and responsible decisions by individuals and couples, in order to promote the health and welfare of the family groups and thus contribute effectively to the social development of a country."

Material and Methods:

The study was conducted in a rural community 20 kms away from Mangalore city. Asaigoli village and its neighboring area with a population of 6317 living in 1002 houses having low socio-economic status was selected using census register and area map of village panchayat.

Married women in the age group of 15 to 49 years constituted the sample. Information was recorded on an interview schedule and a house to house survey was conducted for this purpose.

A total of 1007 women were interviewed. Due to unavoidable reasons 25 of the respondents were excluded from the study. Of the remaining 982 women in the reproductive age group, 66 were pregnant, 16 had primary sterility and 4 reported of secondary sterility. Thus a total of 896 women constituted the study sample. The Christian representation was very small (8%) in comparison to the Hindus and Muslims.


Table I: Age structure and contraception use.

Age (yrs) Acceptors Non-Acceptors Total
No. % No. %
15 - 19 0 24 100 24
20 - 24 11 9.2 108 90.8 119
25 - 29 49 28.3 124 71.7 173
30 - 234 63 41.2 90 58.8 153
25 - 39 50 45.5 60 54.5 110
40 - 44 66 36.3 116 63.7 182
45 - 49 13 9.6 122 90.4 135
Total 252 28.1 644 71.9  

X2= 88.4; p<0.0001.

Among the 896 women, 52.4% were between 15 and 34 years, which is the crucial period in the reproductive span. It was further highlighted that the acceptors of contraception were more in the higher age group (Table I), which was highly significant.

Table II: Methods of contraception and number of living children.

no. of living children No. of couples with methods of contraception Non-Acceptors Total
Temporary methods Permanent methods
0     107 107
1 - 2 12 70 250 332
3 - 4 0 121 148 269
≥5 1 48 139 288
Total 13 239 644 896

X = 106.7; p<0.0001.

The acceptors of the different family planning methods of contraception were analysed based on the number of living children. It was found that 70.7% of the women with 3 or more children were among the acceptors of permanent methods of contraception as against 29.3% with 1 or 2 living children (Table II). This was highly significant.

Table III: Religion and contraception use.

Religon Acceptors Non-Acceptors Total
No. % No. % No. %
Hindu 167 37.4 280 62.5 447 100
Muslim 74 18.5 327 81.5 401 100
Christian 11 22.9 37 77.1 48 100
Total 252 644 896

X 2 = 38.09; p<0.0001.

Among the non-acceptors of methods of family planning, muslims were seen to be more (81.5%) as shown in Table No. III and it was highly significant.

Table IV: Family planning practices and educational level of females.

Education Acceptors Non-Acceptors Total
No. % No. % No. %
Illiterate 100 27.4 265 72.6 365 100
Primary 88 32.1 186 67.9 274 100
Secondary 55 24.9 166 75.1 221 100
PUC and above 9 25.0 27 75.0 36 100
total 252 644 896

X2= 3.5; p>0.05.

Most of the females were either illiterate or educated upto primary level (71.3%). Level of education of the respondents was not an influencing factor for acceptance of family planning methods.

Table V: Distribution of family planning practices and income.

Monthly Income Rps Acceptors Non-Acceptors Total
No. % No. % No. %
≤1,000 51 28.7 127 71.3 178 100
1,001 - 2,000 150 31.5 326 68.5 476 100
≥2,000 51 21.1 191 78.9 242 100
total 252 644 896

X2= 8.6; p<0.05.

The pattern of monthly income distribution was studied in detail among acceptors and non-acceptors of family planning methods and difference was statistically significant.

Table VI: Distribution of family planning practices and type of family.

Type of Family Acceptors Non-Acceptors Total
No. % No. % No. %
nuclear 154 39.8 233 60.2 387 100
Extended 28 19.7 114 80.3 142 100
Joint 70 19.1 297 80.9 367 100
total 252 644 896

X2= 45.9;p<0.0001.

An analysis of the family type showed that 43.2% were nuclear families and 41% were joint families. The acceptors of family planning methods were analysed in detail. It was observed that of the 3 types of families 39.8% of the women from the nuclear families and 19% from joint families were acceptors of family planning practices. This was statistically significant.

Table VII: Fertility indices in relation with the State and Nation.

Indices Study Area State* India
Crude Birth Rate 17.1 26.9 29.5
General Fertility Rate 64.8 104.7 119.2
Total Fertility Rate 2.1 3.1 3.6
Child/Woman Ratio 353 275 605
Couple protection rate 28.1 NA 44.3

*According to 1991 census; NA = Not available.

The different fertility indices, available for study population, were general fertility rate, total fertility rate, child woman ratio and couple protection rate and a comparison of these with State and National figures is given in Table VII.

Table VIII: Age specific fertility rate.

Age Group (yrs) Study Area State* % lower than State India % Lower than India
15 - 19 19.1 76.3 75.0 83.1 77.0
20 - 24 117.5 239.3 50.9 2327.0 50.4
25 - 29 125.0 175.1 28.6 198.5 37.0
30 - 34 79.4 89.5 11.3 121.6 34.7
35 - 39 45.5 44.1 -3.2 71.5 37.2
40 - 44 16.9 17.6 4.0 31.2 45.8
45 - 49 6.9 5.9 -17 11.9 46.5

* According to 1991 census.

The age specific fertility rate of the study population was highest in the age group of 25-29 years, decreasing on either side in the 5-year age group (Table VIII). The age specific fertility rates of the study population were lower than that of the State and India.


Majority (52.4%) of the women were in the age group of 15-34 years. Permanent method of contraception was accepted by 70.7% of the women with 3 or more children and only 29.3% accepted this method with 1 or 2 living children, which was statistically significant. This was in conformity with the statement that this is largely an irreversible and permanent method, couples prefer to adopt it after they have reached the desired family size and at older ages and higher parities.

Fertility aspects were correlated to socio-demographic variables like religion, type of family, household monthly income, number of living children and mother's literacy level. Religion played an important role in determining the attitudes of the people in limiting the family. This is looked upon as an attempt against the law of nature 3 . It may be noted from the data that this trend continues among people due to religious beliefs and practices. Among Muslim women, the non-acceptors of family planning methods were found to be highest (81.5%). Most of them reasoned their religious beliefs and husband's decision for non-acceptance.

The level of mother's education is a key determinant of her child's health. Schooling seemed to enhance a woman's ability to care for her children 4 . However, in this study we didn' t find any significant influence of education on acceptance of family planning methods.

The influence of income and type of family were also studied and found to be statistically significant. These two variables influenced the acceptance of family planning methods.

The different fertility indices, available for the study population, were general fertility rate, total fertility rate, child woman ratio, couple protection rate and age specific fertility rates. The total fertility rate for this community was lower as compared to that of the State and India. The Registrar General of India collected data on fertility on a national scale and found that females who married before the age of 18 years gave birth to a large number of children than those who married later 5 . In this study, the mean age at marriage was found to be 26 years.

Age specific fertility rate is the number of live births in a year to 1000 women in any specified age group. In the present study, the age specific fertility rate was much lower than that of Karnataka and India. In this study, age specific fertility rate was highest (125) in the age group 25-29 years, decreasing on either side in the 5 year group interval, unlike that of the State and India, where it is higher for the age group 20-24 years. This may be in view of the fact that in the State and India an early marriage increases the reproductive span and women with early first birth have more children than those who begin child bearing later as was found in the study group.

In this study an important finding was that the total couple protection rate was low inspite of all fertility indicators being low. This may be attributed to the fact that 16% of the couples were with women in the age group of 15-24 years either just married or in the process of completing their family, while 35.4% of the study sample were in the age group of 40-49 years, majority of them do not feel the necessity of accepting any one of the family planning methods because of completion of family or the perimenopausal period.


Low couple protection rate of 28.1% seems to be unrelated to fertility rates. In this area favourable fertility rates were due to delayed marriages in isolated small community. The results can't be generalized.


The authors are sincerely grateful for the guidance provided by Dr. N. Udayakiran, Professor of Community Medicine, Kasturba Medical College, Mangalore.


  1. Park JE. Text book of Preventive and Social Medicine,Simplex Printing Press, Jabalpur, 1989: 228.
  2. WHO. Tech. Rep. Ser., No. 482; 1990.
Access free medical resources from Wiley-Blackwell now!

About Indmedica - Conditions of Usage - Advertise On Indmedica - Contact Us

Copyright © 2005 Indmedica