Background: The reason why family planning techniques aren't used is a lack of awareness about the numerous contraceptive options. The current study examined the knowledge of contraceptives among women of reproductive age and was carried out in Himachal Pradesh. Methods: A cross-sectional survey of females in the state of Himachal Pradesh who are of reproductive age was carried out between January 2023 and March 2023 utilizing Google forms. Until 400 replies were received, the google form was distributed to female state residents in the reproductive age range for responses via email and social networking sites like Whatsapp groups, Facebook, Instagram, and Linkedin. We learned about their socio-demographic make-up and their familiarity with contraception. The Epi info v7 programme was used to run the data through the necessary statistical tests. Results: A total of 400 females of reproductive age were participated, maximum 155 (38.75%) were having age between 26-30 years, educated up to Matric & Senior Secondary 158(39.5%), Hindu 379(94.75%) and unemployed/housewife 323(80.75%). In the present study 13.75% (55) females had very good knowledge (16-20 marks) towards contraceptives, 67.5% (270) having good knowledge (12-15 marks), 16.5% (66) having fair knowledge (8-11 marks) and 2.25% (9) having poor knowledge (<8 marks). Conclusions: This study found that study participants had a respectable degree of awareness about contraceptive options. To encourage the use of contemporary contraceptive techniques among women, ongoing education and regular communication on the significance of birth control are necessary.
According to the WHO, family planning is a style of thinking and living that people and couples freely adopt in order to promote their health and welfare based on their knowledge, attitude, and responsible choices. Family planning enables people to have the number of children, if any, and the spacing between pregnancies that they wish. It is accomplished by using contraceptive methods and managing infertility. Access to contraceptive knowledge, information, and services is essential for ensuring everyone's health and human rights [1-3].
Due to the relatively low awareness and use of contraceptives, the risk of unwanted pregnancy and unsafe abortions continues to be considerable. Each year, incorrect use of contraceptives or their failure to work as intended results in about one-third of unwanted pregnancies. A lack of knowledge of contraceptive methods, source of supply, cost, or poor accessibility are the barriers that exist in developing countries.4-6
Long-term family planning options are currently offered in health centers, hospitals, and private clinics, while short-term options are accessible at all levels of public and private health institutions. People can learn about contraceptive methods, their advantages and disadvantages, as well as how to use them, from a wide range of sources, including friends and family, the electronic and print media, health professionals and the educational materials they distribute, establishments like schools and colleges, as well as a variety of community resources [7,8].
Despite an increase in the usage of contraceptives around the world, there are still many people who need to utilize contraception [9]. Numerous research have evaluated women's awareness of contraceptives in various regions of India; however, few of these studies have focused on mothers in Himachal Pradesh. Thus, the present study was developed to examine the knowledge towards contraceptives among females of reproductive age group in Himachal Pradesh.
Objectives of the Study
To evaluate the knowledge towards contraceptives among females of reproductive age group in Himachal Pradesh.
Research Approach – Descriptive
Research Design – Cross-sectional survey design
Study Area – Whole state of Himachal Pradesh
Study Duration – between January 2023 and March 2023
Study Population
All reproductive age group females who were staying in the Himachal Pradesh for 12 months or more.
Sample Size
A good number of 400 reproductive age group females, assuming 50% have adequate knowledge regarding contraceptives, 5% absolute error, 95% confidence level, and 5% non-response rate.
Study Tool
A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding contraceptives was created. The questionnaire was initially pre-tested on a small number of females to identify any difficulty in understanding by the respondents.
Description of Tool
Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.
Questionnaire
The questionnaire contains 20 structured contraceptives knowledge related questions having three options (yes, no, don’t know). The participants have to choose right one. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as
>80% (16-20) = very good
60-79% (12-15) =Good
41-59% (8-11) =Fair
<40% (< 8) =poor
Validity of tool - by the experts in this field
Data Collection
Data was collected under the guidance of supervisors. The google form questionnaire was circulated among reproductive age group female residents of the state for responses using online modes like e-mail and social media platforms like WhatsApp groups, Facebook, Instagram and LinkedIn till the 400 responses were collected.
Data Analysis
Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage.
Ethical Considerations
Participants’ confidentiality and anonymity was maintained.
Present study was developed to evaluate the knowledge towards contraceptives among reproductive age group females of Himachal Pradesh. A total of 400 females were participated, maximum 155 (38.75%) were having age between 26-30 years, educated up to Matric & Senior Secondary 158(39.5%), Hindu 379 (94.75%) and unemployed/housewife 323 (80.75%).
In the present study 13.75% (55) females had very good knowledge (16-20 marks) towards contraceptives, 67.5% (270) having good knowledge (12-15 marks), 16.5% (66) having fair knowledge (8-11 marks) and 2.25% (9) having poor knowledge (<8 marks).
We conducted this survey to assess participants' knowledge of birth control methods because, as far as we are aware, there aren't many studies on contraception knowledge in Himachal Pradesh.
The prevalence of unintended pregnancies, risky induced abortions, and STIs, as well as their occurrence and related problems, will decrease with increased knowledge about and proper use of contraceptives. Low contraceptive awareness may prevent women from starting or continuing their contraception, which may be a significant and modifiable cause of unwanted pregnancy. Effective contraception assists mothers and their children on a health and social level by lowering
Table 1: Socio demographic characteristics of the participants
| Frequency | Percent | |
| Age Group | ||
| <20 | 22 | 5.5 |
| 21-25 | 124 | 31 |
| 26-30 | 155 | 38.75 |
| 31-35 | 38 | 9.5 |
| >35 | 61 | 15.25 |
| Education | ||
| No education | 18 | 4.5 |
| Primary (1–8 yrs) | 42 | 10.5 |
| Matric & Senior Secondary | 158 | 39.5 |
| Graduate | 152 | 38 |
| Post graduates | 30 | 7.5 |
| Religion | ||
| Hindu | 379 | 94.75 |
| Muslim/others | 21 | 5.25 |
| Employed | ||
| No (Housewife/others) | 323 | 80.75 |
| Yes | 77 | 19.25 |
Table 2: Responses of The Participants to Various Statements
| S.No. | Statements | frequency of correct response | Response |
| Contraception is a man-made way of preventing pregnancy. | 344 | 86 | |
| Condom, Contraceptive pills, Intrauterine devices, implants and injections are few examples of Contraception. | 330 | 82.5 | |
| Contraceptives prevent the fertilization of egg and sperm, reducing the risk of an unexpected pregnancy. | 217 | 54.25 | |
| Condoms can prevent both a pregnancy and the transmission of sexually transmitted infections, including HIV. | 293 | 73.25 | |
| Barriers Contraceptive methods are available for both males and females. | 222 | 55.5 | |
| Contraceptive devices such as the loop or Copper-T are placed in the uterus to prevent pregnancy | 129 | 32.25 | |
| Surgical method are performed either in male (vasectomy)or female (tubectomy). | 334 | 83.5 | |
| Permanent contraception, sometimes called sterilisation, prevents all future pregnancies. | 349 | 87.25 | |
| Breastfeeding as a form of natural contraception | 236 | 59 | |
| Short-acting hormonal methods include birth control pills, as well as the vaginal ring, skin patch and contraceptive injection (Depo-Provera). | 259 | 64.75 | |
| This skin patch is worn on the lower abdomen, buttocks, or upper body | 104 | 26 | |
| The Depo Provera injection is an injection you get every three months. | 193 | 48.25 | |
| Long-acting hormonal methods include the copper IUD, the hormonal IUD and the contraceptive implant | 255 | 63.75 | |
| Long-acting reversible contraception (LARC) are the most effective types of contraception | 222 | 55.5 | |
| Spermicide or vaginal gel are nonhormonal options for birth control. | 107 | 26.75 | |
| The emergency contraceptive pill (ECP) can be taken up to three days after unprotected sex. | 215 | 53.75 | |
| ECP (emergency contraceptive pill) is 98% effective. | 206 | 51.5 | |
| The copper IUD can be inserted up to five days after unprotected sex, and is more than 99% effective at preventing pregnancy. | 182 | 45.5 | |
| Fertility awareness is learning the signs of fertility in your menstrual cycle to help you plan or avoid a pregnancy. | 104 | 26 | |
| The implant is a single, thin rod that is inserted under the skin of a women’s upper arm. | 106 | 26.5 |
Figure 1: Knowledge towards contraceptives among study participants
Table-3: NFHS-5 data on contraceptives in Himachal Pradesh
| Sr.no | Indicator | NFHS-5 2019-20 | NFHS-4 2015-16 |
| Current Use of Family Planning Methods (currently married women age 15–49 years) | |||
| a) | Any method (%) | 74.2 | 57.0 |
| b) | Any modern method (%) | 63.4 | 52.1 |
| Total unmet need for Family Planning (%) | 7.9 | 15.7 | |
| Unmet need for spacing (%) | 2.8 | 4.8 |
unplanned pregnancies and abortions and facilitating family planning/spacing of births. But this study disclosed an acceptable level of knowledge with respect to birth control methods among study participants [4-6].
According to NFHS 5 statistics on family planning methods in Himachal Pradesh, there was an increase in the percentage of methods that are now used and decrease in unmet need for Family Planning as compared to NFHS-4 [8] (Table-3).
The government of India has started Mission Parivar Vikas as part of the Family Planning Programe in order to greatly expand access to contraceptives and family planning services. New contraceptives such injectable contraceptives, centchroman, and progesterone-only pills (POP) have been added to the current selection. Condom, OCP, and ECP packaging has now been enhanced and revised in an effort to affect consumer demand for these goods. A comprehensive media effort has been developed to increase demand for contraceptives [9-11].
Limitations of The Study
Due to the limited sample size and cross-sectional character of the current investigation, it was challenging to generalize the results. In order to identify obstacles to promoting adequate information and practices concerning contraceptives among females, future research should concentrate on bigger sample sizes and qualitative investigations such as focus group interviews. More research is required to understand the factors that contribute to family planning non-use and how to address them.
This study found that study participants had a respectable degree of awareness about contraceptive options. Knowledge creates an attitude, and attitude and behavior work together to shape behavior. To encourage the use of contemporary contraceptive techniques among women, ongoing education and regular communication on the significance of birth control are necessary. This will inform them, support the adoption of various new practices, and enable them to recommend the most effective family planning options.
The results of this study will aid in the development of programmes that can enhance understanding of women and the services offered by the healthcare system, as well as programmes that can lessen the negative effects of contraception and the prevalence of unplanned births.
WHO. “Family planning/contraception.” https:// www. who. int/ news-room/ fact-sheets/ detail/ family-planning-contraception. Accessed 8 Apr. 2023.
WHO. “High rates of unintended pregnancies linked to gaps in family planning services: New WHO study.” https:// www. who. int/ news/ item/ 25-10-2019-high-rates- of- unintended- pregnancies- linked- to- gaps- in-family-planning-services-new-who-study. Accessed 8 Apr. 2023.
Wani, R. T., et al. “Knowledge, attitude, and practice of family planning services among healthcare workers in Kashmir – a cross-sectional study.” Journal of Family Medicine and Primary Care, vol. 8, no. 4, Apr. 2019, pp. 1319–1325.
Kasa, A. Semachew et al. “Knowledge, attitude and practice towards family planning among reproductive age women in a resource limited setting of Northwest Ethiopia.” BMC Research Notes, vol. 11, 2018, pp. 577–81.
Guttmacher Institute. “Contraceptive failure rates in the developing world.” https:// www. guttmacher. org/ report/ contraceptive- failure- rates- in- developing- world. Accessed 9 Apr. 2023.
Tsui, A. O., et al. “Family planning and the burden of unintended pregnancies.” Epidemiologic Reviews, vol. 32, no. 1, 2010, pp. 152–74.
Ahirwar, R. K., et al. “A study to assess the socio-demographic factor and knowledge, attitude, and practice of family planning methods in Lohpeeta migrants tribe located in Shivpuri central India.” Journal of Family Medicine and Primary Care, vol. 10, no. 3, Mar. 2021, pp. 1308–1312.
NFHS-5. Himachal Pradesh factsheet. https:// www. im4change. org/ docs/ Himachal%20Pradesh%20NFHS-5%20Factsheet.pdf. Accessed 11 Apr. 2023.
Ministry of Health and Family Welfare, Government of India. “Initiatives under the family planning programme.” https://pib.gov.in/newsite/PrintRelease.aspx?relid=159064. Accessed 12 Apr. 2023.
Schrumpf, L. A., et al. “Side effect concerns and their impact on women's uptake of modern family planning methods in rural Ghana: A mixed methods study.” BMC Women’s Health, vol. 20, no. 1, Mar. 2020, p. 57.
Institute for Health Metrics and Evaluation. “160 million women worldwide have unmet contraception needs, new study reveals.” https:// www. healthdata. org/ news-release/ lancet- 160- million-women- worldwide- have-unmet-contraception-needs-new-study-reveals. Accessed 13 Apr. 2023.
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