Determinants of Contraceptives Use amongst Youth: An Exploratory Study with Family Planning Service Providers in Karachi Pakistan

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Abstract

Introduction:

In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers’ perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi.

Method:

Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived.

Results:

Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers’ improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area.

Conclusion:

Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods.

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Most cited references 24

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Intentions to use contraceptives in Pakistan: implications for behavior change campaigns

Sohail Agha (2010)

Background Since 1990-91, traditional method use has increased at a faster rate in Pakistan than modern method use. The importance of hormonal methods or the IUD has diminished and that of traditional methods has increased in the method mix. There is a need to identify factors motivating and deterring the adoption of specific family planning methods among married men and women in Pakistan. Methods In addition to social and demographic characteristics of respondents, a representative household survey collected information on psychological correlates of family planning behavior from 1,788 non-pregnant wives and 1,805 husbands with not-pregnant wives. Males and females were from separate households. Principal components analysis was conducted to identify the underlying constructs that were important for each gender. Multinomial logistic regression analysis was conducted to determine the correlates of male and female intentions to use contraceptive methods. Results Amongst women, the perception that her in-laws support family planning use was the strongest determinant of her intentions to use contraceptive methods. A woman's belief in the importance of spacing children and her perception that a choice of methods and facilities with competent staff were available were also powerful drivers of her intentions to use contraceptive methods. The strongest obstacle to a woman's forming an intention to use contraceptive methods was her belief that family planning decisions were made by the husband and fertility was determined by God's will. Fears that family planning would harm a woman's womb lowered a woman's intentions to use methods requiring procedures, such as the IUD and female sterilization. The perception that a responsible, caring, husband uses family planning to improve the standard of living of his family and to protect his wife's health was the most important determinant of a man's intention to use condoms. A husband's lack of self-efficacy in being able to discuss family planning with his wife was the strongest driver of the intention to use withdrawal. A man's fear that contraceptives would make a woman sterile and harm her womb lowered his intention to use modern contraceptive methods. Conclusions These findings highlight the importance of having secondary target audiences such as mothers-in-law and husbands in family planning behavior change campaigns implemented in Pakistan. Campaigns that stress the importance of child spacing are likely to have an impact. Client perceptions of the quality of care are important determinants of intentions to use contraceptive methods in Pakistan. Client concerns that the IUD and sterilization procedures might harm a woman's womb and cause sterility should be addressed. The findings suggest that there is a need to assess the actual quality of service delivery in Pakistan.

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The Provider Perspective: Human after All

James D Shelton (2001)

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Adolescent fertility and family planning in East Asia and the Pacific: a review of DHS reports

Elissa Kennedy, Natalie Gray, Peter Azzopardi … (2011)

Background Adolescent pregnancy has significant health and socio-economic consequences for women, their families and communities. Efforts to prevent too-early pregnancy rely on accurate information about adolescents' knowledge, behaviours and access to family planning, however available data are limited in some settings. Demographic and Health Survey (DHS) reports are recognised as providing nationally representative data that are accessible to policymakers and programmers. This paper reviews DHS reports for low and lower middle income countries in East Asia and the Pacific to determine what information regarding adolescent fertility and family planning is available, and summarises key findings. Methods The most recent DHS reports were sought for the 33 low and lower middle income countries in the East Asia and Pacific region as defined by UNICEF and World Bank. Age-disaggregated data for all indicators relevant to fertility and current use, knowledge and access to family planning information and services were sought to identify accessible information. Reported data were analysed using an Excel database to determine outcomes for adolescents and compare with adult women. Results DHS reports were available for eleven countries: Cambodia, Indonesia, Marshall Islands, Nauru, Papua New Guinea, Philippines, Samoa, Solomon Islands, Timor-Leste, Tuvalu and Vietnam. Twenty seven of 40 relevant DHS indicators reported outcomes for adolescent women aged 15-19 years. There were limited data for unmarried adolescents. A significant proportion of women commence sexual activity and childbearing during adolescence in the context of low contraceptive prevalence and high unmet need for contraception. Adolescent women have lower use of contraception, poorer knowledge of family planning and less access to information and services than adult women. Conclusion DHS reports provide useful and accessible data, however, they are limited by the failure to report data for unmarried adolescents and report age-disaggregated data for some indicators. Further research is required to better understand the barriers that both married and unmarried adolescents face accessing reproductive health information and services, and their information and service delivery preferences.

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Author and article information

Journal

Journal ID (nlm-ta): Glob J Health Sci

Journal ID (iso-abbrev): Glob J Health Sci

Title: Global Journal of Health Science

Publisher: Canadian Center of Science and Education (Canada )

ISSN (Print): 1916-9736

ISSN (Electronic): 1916-9744

Publication date (Print): May 2013

Publication date (Electronic): 05 January 2013

Volume: 5

Issue: 3

Pages: 1-8

Affiliations

[1 ]Community Health Sciences Department, Aga Khan University Karachi, Pakistan

[2 ]Willows Foundation Pakistan, Pakistan

[3 ]Rawal Medical College, Rawalpindi, Pakistan

[4 ]Community Health Sciences Department, Aga Khan University Karachi, Pakistan

Author notes

Correspondence: Noureen Aleem Nishtar, Health Systems Division, Community Health Sciences Department, Aga Khan University Karachi, Pakistan. Tel: 92-321-243-5354. E-mail: noureen.aleem@ 123456aku.edu

Article

Publisher ID: GJHS-5-1

DOI: 10.5539/gjhs.v5n3p1

PMC ID: 4776775

PubMed ID: 23618469

SO-VID: 8fadaaf0-b0e3-44f4-9309-1eecfb36c30c

License:

This is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/3.0/).

Determinants of Contraceptives Use amongst Youth: An Exploratory Study with Family Planning Service Providers in Karachi Pakistan

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Abstract

Introduction:

Method:

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Special Issue: Social pedagogical work with children, youth and their families with refugee and migrant background in Europe

Most cited references 24

Intentions to use contraceptives in Pakistan: implications for behavior change campaigns

The Provider Perspective: Human after All

Adolescent fertility and family planning in East Asia and the Pacific: a review of DHS reports

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