Understanding family planning practices among rural tribals of Dibrugarh District. Assam.
An Expert Committee(1971) of WHO defined Family Planning 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 family group and thus contribute effectively to the social development of a country" (2).
For centuries, Assam is inhabited by people belonging to different caste and creed, races and ethnic groups and the tribals constitute one such group. The National Population Policy 2000 gave special emphasis on the urgency of their upliftment.
According to The Office of the Registrar General, India, 2001 census (3), the Total Fertility Rate of Scheduled Tribes in rural area is 3.26, which work out to be higher in comparison to 2.83 of the total rural population.
Keeping the above points in mind the present study was undertaken in a rural tribal community.
METHODOLOGY: The present study was carried out in the tribal dominated villages under Borboruah Block of Dibrugarh District from July 2007 to June 2008. The Block is situated at a distance of 12 Kms away from Dibrugarh town. The total tribal population of the Block is reported to be 24,294.
The study population comprised of eligible couples with the wives in the age group of 15-45 years.
The sample size was calculated using the formula n = [z.sup.2]pq/[L.sup.2] where z = 1.96, p is the positive character, q=1-p, L is allowable error.
In Assam, 27% of the currently married women of reproductive age group are protected against conception (NFHS 3, 2005-2006). So considering p = 0.27 and allowable error at 5%, the sample size for the present study is calculated to be 303. Multistage sampling technique was used for selection of the sample. At the first stage, out of the 6 Blocks of Dibrugarh, Borboruah Block was selected because 27.5% of the total Scheduled Tribe population of the district is present in this Block, which is quite a significant number. Secondly villages were selected by stratifying them according to the presence of tribal and non tribal communities. Of all the villages only tribal dominated villages were selected which were 30 in number. The tribal dominated villages were randomly selected for the study. The interview was taken by house to house visit. Since the required sample size was not fulfilled in the first village, so another two villages were randomly selected and thus a total of three villages were visited to get the required sample size.
The three villages chosen for the study were Dulia Gaon, Lalmati Tinsukia and Notun Bolai Gaon situated at a distance of 3 kms, 18 kms and 18 kms respectively from Borborua PHC of which Dulia Gaon and Notun Bolai gaon becomes non motorable during the summer season because of rains. The main occupation of the people is cultivation. Some of the families have access to newspapers and Television, but are ignorant of the different services being delivered at a health facility.
In the PHC, there is provision of counseling and prescribing OCP and barrier methods, but as there are no specialists, hence the beneficiaries need to visit Assam Medical College, a tertiary care centre for Intrauterine devices and terminal methods. The distance from the villages to Assam Medical College is 15kms, 30kms and 30kms respectively. Chi square test was used for the analysis.
RESULTS: The study was conducted amongst the eligible couples with wives in the age group of 15-45 years of Borboruah Block in Dibrugarh District of upper Assam. Couples with pregnant wives were excluded from the study.
Table1 shows that only 29.7% practiced approved methods of family planning. Table 2 reveals that none of the husbands underwent vasectomy.
In Table 3 significant association was observed between the practice of family planning methods and educational status of the husbands up to high school and higher education.
Table 4 reveals that the acceptance of family planning method is significantly associated with increase in age of wives.
Table 5 showed that the reasons for never practicing any methods of family planning were lack of information in 22.89% of the couples, 22.38% couples wanted children and 20.9% were afraid of side effects.
DISCUSSION: The couple protection rate was 29.7% in the present study. In another study Mohanan P. et al (2003) recorded a couple protection rate of 28.1%4.
In the study, vasectomy was not practiced by any of the male partners which corroborates with the findings of Reddy R. et al (2003)5 and Puri A. et al (2004)6
Chandhick N. et al(2003) at their study revealed that since in rural areas husbands are the decision makers7, their approval is strongly associated with acceptance of family planning practices. Aggarwal H. et al (2005) observed that the education of husbands were related to the use of contraceptive methods8. The present study revealed that acceptance of family planning method increases with increase in educational status of the husbands up to high school and above.(p < 0.05)
The present study showed that the practice of family planning method is associated with the increase in age of the wives is similar to the finding of Oyedukun Amos O (2007) from Nigeria9 and Chakraborty N. et al (1993) from Bangladesh10.
An important finding in this study was that the total couple protection rate was low. Most of the couples did not use the family planning methods because they were unaware and uninformed about the use and availability of the various methods. They also wanted children and feared of the side effects.
The results of the present study that the reasons for not practicing any methods of family planning were lack of information in 22.89% of the couples, is somewhat similar to the results of Ram Rama et al(2000-01-2000-03)11
CONCLUSION: Sustained IEC efforts, motivation and education of the couples and easy availability of the family planning methods in the remote, un reached areas is expected to favour the acceptance of the methods by the rural tribal community in near future.
(1.) Census of India, 2001.
(2.) WHO(1971) Tech. Rep. Ser., No.442
(3.) Office of Registrar General of India.2001 census.
(4.) Mohanan Padma, Kamath Asha, Sajjan B.S. (2003) "Fertility Pattern And Family Planning Practices in a Rural Area of Dakshina Kannada". Indian Journal of Community Medicine. Vol. XXVIII, No.1, Jan-March.
(5.) Reddy Rajesh S., Premarajan K.C., Narayan K.A., Mishra Akshaya Kumar(2003) "Rapid Appraisal of Knowledge, Attitude and Practices related to Family Planning Methods Among Men Within 5 Years of Married Life." Indian J. Prev. Soc. Med Vol 34, No.1&2 Jan-June. pg 62-67
(6.) Puri A., Garg S., Mehra M.,(2004) "Assessment of unmet need for contraception in an urban slum of Delhi." ." Indian Journal of Community Medicine. Vol XXIX, No.3, July-September, 2004
(7.) Chandhick N., Dhillon B.S., Kambo I., Saxena NC.(2003) "Contraceptive Knowledge, Practices and Utilization of Services in the rural areas of India." (An ICMR Task Force Study). Vol. 57. Issue 7.pg 303-10
(8.) Aggarwal Hemla(2005) "Comparison of the Level of Awareness of Family Planning Measuresin the Urban and Urban-slum Women." Anthropologist, 7(1):35-40
(9.) Oyedukun Amos O.(2007), "Determinants of Contraceptive Usage: Lessons from women in Osun State, Nigeria." The Journal of Humanities & Social Sciences ISSN 1934-7227. Volume 1, Issue 2.
(10.) Chakraborty Nitai, Ullah Md. Shahid (1993) " Factors Affecting The Use of Contraception in Bangladesh: A Multivariate Analysis." Asia - Pacific Population Journal. Volume 8 No.3, pg 19-30
(11.) Ram Rama, Ghosh M.N., Bhattacharya Salil, Haldar Anima, Chatterjee Chitra, Naskar Narendranath (2000-01-2000-03) "Study of Unmet Need for Family Planning Among Married Women of Reproductive Age Attending Immunization Clinic in a Medical College of Calcutta." Indian Journal of Community Medicine. Volume 25. No. 1
Nabanita Nirmolia, Alak Barua
[1.] Assistant Professor, Department of Community Medicine, Assam medical College, Dibrugarh.
[2.] Professor, Department of Community Medicine, Assam medical College, Dibrugarh.
Dr Nabanita Nirmolia. C/O K C Nirmolia Gandhinagar, Huwoni Poth, Dibrugarh, Assam E-mail: email@example.com Ph:00919435130507
Table 1. Distribution of the couples according to their status of practicing family planning methods: Status of Practice Number Percentage Approved methods 90 29.70 Traditional methods 12 3.96 Non practicing 201 66.34 Total 303 100 Table 2: Distribution of the eligible couples according to specific family planning method adopted. Specific method No (%) Condom 3(2.94) Oral Contraceptive pills 22(21.57) Intra Uterine Devices 6(5.89) Tubectomy 59(57.84) Vasectomy 0 Safe Period 12(11.76) Total 102 Table 3: Distribution of the husbands according to their literacy status and family planning method practiced by the couples. Literacy Practicing F.P Non practicing F.P Total No (%) No (%) No Illiterate 2(15.38) 11(84.62) 13 Primary school 8(61.54) 5(38.46) 13 Middle school 17(47.22) 19(52.78) 36 High school & higher 75(31.12) 166(68.88) 241 education upto graduation Total 102 201 303 [chi]2 = 9.21; p < 0.05 Table 4: Age of the wives and status of family planning practice Age in years Practicing Non practicing Total No (%) No (%) 15-24 11(23.40) 36(76.60) 47 25-34 63(35.59) 114(64.41) 177 35-45 28(35.44) 51(64.56) 79 Total 102 201 303 [chi]2 = 16.55; p < 0.001 Table 5: Distribution of eligible couples according to the reasons for never practicing F.P. methods Reasons Eligible couples No % Opposition from wife - - Husband's Opposition - - Lack of information 46 22.89 Lack of knowledge 37 18.41 Afraid of side effect 42 20.90 Wants children 45 22.38 Lacks interest 31 15.42 Total 201 100
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|Title Annotation:||ORIGINAL ARTICLE|
|Author:||Nirmolia, Nabanita; Barua, Alak|
|Publication:||Journal of Evolution of Medical and Dental Sciences|
|Date:||Feb 11, 2013|
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