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Indian Journal of Community Medicine

Epidemiological Correlates of Contraceptive Prevalence in Rural Population of Dehradun District

Author(s): A. Kansal R. Chandra, S.D. Kandpal, K.S. Negi

Vol. 30, No. 2 (2005-04 - 2005-06)

Abstract:

Research question: What is the contraceptive prevalence among ever married women aged 15-49 years and the various factors affecting it? Objectives: 1. To find out the contraceptive prevalence among ever married women aged 15-49 years in rural population of Dehradun District. 2. To study the different variables affecting the contraceptive prevalence among married women. Study design: Cross-sectional descriptive study by interview method. Setting: Twenty villages from Doiwala block of Dehradun District. Participants: 2278 ever married women aged 15-49 years. Study Variables: (a) Outcome variable: Contraceptive prevalence. (b) Predictor variables : age, religion, educational status of wife, occupation of husband, number of living sons, experience of child loss. Statistical analysis: Percentages, Chi-square test, Logistic regression analysis. Results: Contraceptive prevalence was found to be 49.86% in the rural area of Dehradun district. The most commonly used method was tubectomy (28.88%) while only 1.98% of the women reported that their husbands were sterilized. Among the spacing methods, condoms, Oral Contraceptive Pills (OCPs) and Intra Uterine Contraceptive Devices (IUDs) were used by 11.68%, 4.78% and 1.71% of the couples respectively. Younger age of the women, illiteracy, Muslim religion, no living son in the family and experience of child loss were found to be associated with low use of contraception.

Key Words: Contraceptive Prevalence, Ever married Women, Logistic Regression Analysis, Couple Protection Rate

Introduction

India was the first country in the world to formulate the National Family Planning Programme in the year 1952 with the objective of "reducing the birth rate of the extent necessary to stabilize the population at a level consistent with requirement of National economy"1.

The extent of acceptance of contraceptive methods still varies within societies and also among different castes and religious groups. The factors responsible for such varied picture operate at the individual, family and community level with their roots in the socio-economic and cultural milieu of Indian Society2.

The state of Uttaranchal was created in the year 2000. The higher level of literacy and better socio-demographic indicators provided Uttaranchal with distinct advantage over its parent state of Uttar Pradesh, but very limited data is available on contraceptive practices in the newly formed state.

Keeping in view the above points, the present study was designed to find out the contraceptive prevalence and identifying the different variables which affect the contraceptive prevalence among the rural population of Dehradun district.

Materials and Methods

The present study was conducted among ever married women in the age group of 15-49 years in 20 villages of Doiwala block of Dehradun district during the period, October 2003 to March 2004. A multistage stratified random sampling technique was used for the selection of villages. From each village 20% of the estimated Ever Married Women (EMW) were covered by using random sampling technique. Personal interview method with house to house visit was adopted as the study method and data was collected on a predesigned and pretested questionnaire. Data compilation and analysis was done by using SPSS package.

Results

The total number of Ever Married Women in the age group of 15-49 years studied was 2,278. Proportion of married women is highest (24.41%) in the age group of 25-29 years. Majority (73.31%) of the women were Hindus. Literacy rate amongst women was found to be 58.25%. Most of the women (73.71%) belonged to lower socio-economic class.

Table-I shows that out of 2,778 women interviewed 49.86% were current users of contraception at the time of the study. Most commonly used method was tubectomy (28.88%). Among spacing methods, condoms, OCPs and IUDs were used by 11.68%, 4.78% and 1.71% of the couples respectively. Contraceptive use was maximum (72.64%) in 35-39 years age group. The difference of contraceptive use in different age groups was statistically significant (p<0.001).

Table-II reveals that contraceptive use rate was low (25.65%) among Muslims and higher among Sikhs (63.70%) and Hindus (55.70%). This difference was found to be highly significant (p<0.001). While the most preferred method among Hindus was sterilization (37.60%), the condom was most popular among Muslims (10.81%).

Education of wife affected the contraceptive use rate. Contraceptive use rate was 46.17% among illiterate women while it was 56.93% among those who were educated up to high School. This difference was found to be significant (p<0.001)

It was observed that, out ot of 364 women, whose husbands were in Government service 61.27% used a family planning method while this rate was only 43.34% among those whose husbands were labourer. However there was no significant difference between the various type of contraceptive use and occupation. This difference was found to be significant (p<0.001).

Table I - Current Use of Contraceptive Methods among married Women

Methods of Contraception (%)
Bio-Social Characteristics Condom OCPs IUDs Tubect-omy Vasect-omy Others No.of Women Using any Method
Age Group
15-19 2.42 0.00 0.00 0.00 0.00 0.00 124 2.42
20-24 5.90 4.36 1.03 2.56 0.00 0.00 390 13.85
25-29 18.17 8.45 3.24 14.75 0.72 1.62 556 46.95
30-34 19.43 6.64 2.61 38.63 1.42 0.71 422 69.44
35-39 12.58 5.03 0.94 49.69 3.46 0.94 318 72.64
40-44 6.22 0.41 1.24 54.77 5.81 1.66 241 70.11
45-49 0.88 0.00 0.00 49.78 4.41 0.00 227 55.07
Total 11.68 4.78 1.71 28.88 1.98 0.83 2278 49.86
X2 = 488.6, df =6, p<0.001

Table II - Contraceptive Practice of EMW by Religion

Methods of Contraception (%)
Religion/Caste Condom OCPs IUDs Tubect-
omy
Vasect-
omy
Others No.of
Women
Using
any
Method
Not Using
any
Method
Hindu 11.60 4.10 1.80 35.30 2.30 0.60 1670 55.70 44.30
Muslim 10.81 7.63 1.48 4.03 0.64 1.06 472 25.65 74.35
Sikh 16.30 3.70 1.48 36.30 2.96 2.96 135 63.70 36.30
Christian 0.00 0.00 0.00 0.00 0.00 0.00 1 0.00 100.00
Total 11.68 4.78 1.71 28.88 1.98 0.83 2278 49.86 50.14
X2= 151.2, df =5, p < 0.001

Table III - Contraceptive Practices of Married Women by Number of Living Sons and Child Loss

Methods of Contraception (%)
Bio-Social Characteristics Condom OCPs IUDs Tubect-omy Vasect-omy Others Using any Method
No. of
living sons
0 2.99 1.00 0.60 1.00 0.20 0.40 6.18
1 17.91 6.50 2.82 23.93 1.47 0.61 53.25
2 10.82 5.17 1.57 50.16 3.92 1.41 73.04
3+ 11.15 5.57 0.93 42.72 2.17 0.93 63.47
X2 = 548.005, df =3, p < 0.001
Child loss
0 12.95 5.02 1.83 29.21 1.92 0.84 50.77
1 7.48 0.93 0.00 24.3 2.80 0.93 36.45
2+ 7.89 2.63 0.00 23.68 2.63 0.00 36.84
X2= 10.986, df =2, p < 0.001

Table-III reveals that only 6.18% of the women with no living sons were contraceptive users, whereas 63.47% of women with three or more living sons were using contraception. This difference was found to be highly significant (p<0.001).

Acceptance for permanent method of family planning increased with number of male children. Only 1.20% couples accepted sterilization (tubectomy-1.00% and vasectomy- 0.20%) without having a male child while the acceptance of sterilization was 54.08% (tubectomy-50.16% & vasectomy- 3.92%) among those women who were having two living sons.

Among the women who had not suffered any child loss, 50.77% were using conraceptive method, this figure was 36.84% for those who lost two or more children. This difference was found to be significant (p<0.01).

The variables which were found significant at <0.05 level in bivariate analysis were entered in multivariate logistic regression model to see the important factors affecting the contraceptive prevalence. It was found that younger age of women, illiteracy, Muslim religion, no living son in the family and experience of child loss were associated with low use of contraception.

Discussion

Couple Protection Rate (CPR) in the present study was found to be 49.86%, which is almost similar to National CPR (48.2%)3. This finding is also comparable with the findings of RCH survey4 (1998-99) in which the CPR was found to be 46% in rural area of Dehradun District. In the present study the prevalence of terminal methods was 30.86% and officially sponsored spacing method was 18.17%. These findings are comparable with the findings fo RCH survey (1998-99), Dehradun-25.6% of terminal methods and 22% of spacing methods. It was seen in the present study that use of contraception was maximum (72.64%) in 35-39 years age group to minimum (2.42%) in 15-19 years age group. Similarly contraceptive use was maximum in 35-39 years age group in NFHS-2, India3 (67.4%), NFHS-2, Uttranchal5 (65.3%).

The findings of contraceptive prevalence among different religion obtained any in our study is very close to the findings of a study conducted in Uttar Pradesh, in which the contraceptive prevalence among Muslims was just half (18%) than Hindus (36%)6.

According to NFHS-23 the contraceptive prevalence was 42.9% among illiterates and 57% among those who were educated upto high School or above. Similar findings were obtained in our study.

The contraceptive prevalence was 61.27% among those women whose husbands were in Government services. Similarly, in a study conducted among Government employees, it was found that out of the total currently married employees 67.1% had adopted any family planning method7.

"Male child Syndrome" is still a widely prevalent concept. It was evident from the fact that acceptance of family planning methods after delivery of at least one male child was significantly higher (53.25%) than those with no male child (6.18%) in the present study. These findings are comparable with a study conducted in rural area of South Delhi which revealed that contraceptive prevalence increased from 37.5% in those who were having no male child to 63% with three or more male children8.

After applying the multivariate analysis, the significant variables which were common in the present study and Bangladesh Fertility Survey (1984)9, were age of the respondents, educational status, number of living sons and experience of child loss.

Acknowledgement

Authors would like to thank Prof. S. Kishore and Dr. A.K. Srivastava for their co-operation.

References

  1. National Populaiton Policy-2000, Government of India.
  2. Rao AP, Somayajulu VV. Factors responsible for Family Planning acceptance with single child-findings from a study in Karnataka. Demography India 1999;28 (1) 65-73.
  3. National Family Health Survey-2, 1998-99, India, International Institute for Population Sciences, Mumbai.
  4. Reproductive and Child Health Project. Rapid Household Survey, 1998-99, IIPS Mumbai.
  5. National Family Health Survey-2, 1998-99, Uttaranchal, International Institute for Population Sciences, Mumbai.
  6. Khan ME, Patel Bella C. Reproductive Behaviour of Muslims in Uttar Pradesh. Journal of Family Welfare 1997;43 (1) : 13-29.
  7. Jain PK, Singal DS. Fertility Levels and Contraceptive Practices among Central Government Employees in India. Technical Report 1982; National Institute of Health and Family Welfare, New Delhi.
  8. Sharma AK, Grover V, Agrawal OP, Dubey KK, Sharma S. Pattern of Contraceptive Use By Residents of a Village in South Delhi. India Journal of Public Health 1997; 41 (3): 75-78.
  9. Ullah MS. Chakraborty N. Factors Affecting the use of Contraception in Bangladesh: A Multivariate Analysis. Asia- Pacific Population Journal 1993; 8(3): 19-30.

Dept. of Community Medicine,
Himalayan Institute of Medical Sciences,
Jolly Grant, Dehradun-248140, India
e-mail: [email protected]

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