Factors inhibiting the use of reversible contraceptive methods in rural south India
Rajaretnam, T.; Deshpande, R.V.
Studies in Family Planning 25(2): 111-121
1994
ISSN/ISBN: 0039-3665 PMID: 8059444 DOI: 10.2307/2138088Document Number: 284813
In 1990 in south India, a study in 45 villages in Belgium and Gulbarga districts of Karnataka state aimed to identify the perceptions and experiences of 35 program personnel about promoting reversible methods of family planning. It also aimed to determine the degree of knowledge about these methods and couples, acceptance of them among 60 community leaders and the knowledge and attitudes of couples (815 married women and 136 of their husbands) towards reversible methods. The contraceptive prevalence rate for all modern family planning methods was 41%, but the rate for all reversible methods was around 2%. The leading modern method was female sterilization. Mean family size was 3.9. Even though district and primary health center program managers approved of promoting reversible methods, they did not do anything to ensure better performance in providing reversible methods in the villages. Their superiors did not provide them any clear direction on how to improve performance of these methods. Health workers and health supervisors were concerned that reversible methods did not receive more emphasis in the program, and that couples were not enthusiastic about using them. Superiors used sterilization methods rather than reversible methods to evaluate subordinates' performance. Most family planning personnel believed that women wanted to achieve their desired family size as soon as possible rather than spacing births. They thought side effects linked to reversible methods and opposition from elders accounted for low use of these methods. The low emphasis on promotion of reversible methods left the couples uninformed about their benefits. These findings showed that demand for reversible methods and the supply of services were low. The researchers recommend a strong commitment to promotion of reversible methods by program managers at all levels, appropriate direction and training for field workers and supervisors to educate and motivate couples to use reversible methods, and adequate services at clinics and in villages.