A Comparative Study to Assess The Knowledge, Attitude and Practice Regarding Family Planning Methods Among Married Women Residing in Selected Rural and Urban Areas of Bagalkot District

 

Mrs. Shilpa. N. Kugali¹, Mr. Praveen S. Pateel*²

^1,2Dept of Community Health Nursing, Shri B. V. V. Sangha’s, Sajjalashree Institute of Nursing Sciences, Navanagar – Bagalkot Karnataka.

 

ABSTRACT:

A descriptive survey approach with comparative design was used to assess the knowledge, attitude and practice regarding family planning methods among rural and urban married women at reproductive age. Simple random sampling was used to select the study area and Purposive sampling technique was used to select the sample. The study included a sample of 60 married women 30-rural and 30 urban women at reproductive age. Assessment of  the levels of knowledge regarding family planning methods among rural and urban women reveals that, Most of rural people (54%) had poor knowledge, (13%) of them had average knowledge, (33%) of them had very poor knowledge and none of them were having very good and good knowledge. Where as in urban area majority (53%) of the women had very good knowledge, (27%) of them had good knowledge, (20%) of them had average knowledge and there were no women who had poor and very poor knowledge regarding family planning methods. Assessment of levels of practice regarding family planning methods among rural and urban women  reveals that, Most of rural women (60%) had never practiced, (20%) of them had rarely practiced, (13%) of them had sometime practiced and only  (7%) of them had occasionally practiced. Where as in urban women (33%) had always practiced, (50%) of them had occasionally practiced, (17%) of them had sometime practiced and none of them were rarely and never practiced. Assessment of levels of attitude regarding family planning methods among rural and urban women  reveals that, Most of rural women (60%) had disagreed attitude, (13%) of them had strongly disagreed attitude, (20%) of them had uncertain attitude and only  (7%) of them had agreed attitude. Where as in urban women (50%) had strongly agree attitude, (40%) of them had agreed attitude, (10%) of them had uncertain attitude and none of them were having strongly disagree and disagreed attitude. Findings regarding correlation between Knowledge, Attitude and Practice regarding family planning methods among rural and urban married women at reproductive age was positive correlation.

 

 

INTRODUCTION:

Every morning the population clock shows that in spite of all our efforts the population is not decreasing. It appears as if it is standing still is happening really? Why are we failing? Are people not aware of the facts about contraception? If they are aware why are they not practicing the contraceptive they prefer¹. India will be the most populous country in the next few years. Population explosion has been India’s major problem since independence, and is a major obstacle to the overall progress of the nation. Adaptation of FAMILY PLANNING METHODS is one of the best solutions to tackle this problem².

 

Our India nation is facing many problems due to effects of overpopulation such as poverty, unemployment, environment pollution, nutritional problems and deleterious effects on the health of the human life, mainly mother and children of the socioeconomic enlistment of the family. If the population continues to run out of control and grow unchecked, it will negatively damage the world for the coming generation and we cannot afford to do so. The alarming population growth is creating increasing pressure on infrastructure economy, environment and availability of health care services.³

 

The family welfare programme in India seeks to promote responsible parenthood with two children as the norm, through the voluntary choice of a family planning method best suited to the acceptor. In India we can see patriarchal family. Husband will be the decision maker. Male dominance is there, but now we can observe slight shift in female education.⁴  

 

The total population in India was last recorded at 1217.0 million people in 2012. The population of India represents 17.99% of world’s total population which means that “One person in every 6 people on this planet is a resident of India.⁵

 

NEED FOR THE STUDY:

India’s population has been increasing steadily since 1921. The 1991 census placed India’s population at 843.3 million. During the period 1981-1991, the net increase was about 162.9 million. Though India is only two fifth the size of USA here population is more than triple of that country. India is the second most populous country in the world, next only to china, and seventh in land area. With only 2.4 percent of the world’s population. India’s population is currently increasing at the rate of 15 million per year⁶.

 

A little over a billion people reside in 25 states and 6 union territories of India. If population grows in this rate then India will be the most populous country in another few years. Population explosion has been India’s major problem since independence. It is a major obstacle to the overall progress of the nation. The adaption of family planning method is one of the best solutions to tackle this problem⁷.

 

Now a days at least 200 million women want to use safe and effective family planning but are unable to do so because they lack the access to information and services or there is a lack of support of their husbands and community and more than 50 million of 190 million who become pregnant each year have abortions and many of these are performed under unsafe conditions⁸.

The women remain one of the most underserved segments of Indian population, an alarmed number of women who want to space or limit their families currently don’t have access to or can’t afford or use appropriate means of family planning. The low use of spacing method is reflected in early child bearing and short birth intervals and where ever the services exist there the women are constrained from the use of family planning methods by cultural mores or pressure to rebuild the population⁹.

 

The total population in India was last recorded at 1217.0 million people in 2012. The population of India represents 17.99% of world’s total population which means that “One person in every 6 people on this planet is a resident of India.¹⁰

 

A study was conducted on effective intervention strategies backed with efficient counseling, motivation and efficient services would increase the knowledge of family planning in women at Thane, Maharashtra. Sample size was 3072 married women by a survey to discover the knowledge, perception, attitude and contraception practice of women. The result revealed that 53.7% had positive views about their role in family planning while 66.2% stressed the need to improve the acceptance of women methods by providing knowledge and information through sources such as radio, television and 30% emphasized the need to improve the quality and availability of services. ¹¹

 

With above mentioned data and discussion with experts, the Investigator understood that women have insufficient knowledge and indifferent attitude towards family planning. So investigator felt that it is prudent to assess the Knowledge, Attitude and Practice of women regarding family planning. Hence the investigator felt the need to take up the study.

 

OBJECTIVES OF THE STUDY:

1.        To assess the knowledge, attitude and practice regarding family planning methods among married women residing in selected rural and urban areas of bagalkot district.

2.        To compare the knowledge, attitude and practice regarding family planning methods among married women residing in selected rural and urban areas of bagalkot district.

3.        To find out the co-relation between the knowledge, attitude and practice regarding family planning methods among married women residing in selected rural and urban areas of bagalkot district.

4.        To determine the association between the knowledge, attitude and practice regarding family planning methods among married women residing in selected rural and urban areas with selected socio demographic variables.

 

OPERATIONAL DEFINITIONS:

Assess: In this study the term assess refers to observe or to evaluate level of knowledge, attitude and practice regarding family planning methods among married women residing in selected rural and urban areas.

 

Knowledge:

In this study the term knowledge refers to the correct responses received from the rural and urban married women regarding family planning methods.

 

Attitude:

In this study it refers to the way of thinking or responding regarding family planning methods among married women residing in selected rural and urban areas.

 

Practice:

In this study it refers to the adopting family planning methods among married women residing in selected rural and urban areas.

 

Family Planning Methods:

In this study it refers to the different methods used by the couples to prevent pregnancy. It includes both temporary and permanent family planning methods

Ø Temporary family planning methods includes:-Natural methods, barrier methods and hormonal methods.

Ø Permanent family planning methods includes:-Vasectomy and Tubectomy.

 

Married Women:

In this study it refers to the women who are married, who is in age group between 18 to 45yrs and who is able to produce off springs on sexual intercourse and residing in rural and urban areas of bagalkot district.

 

Rural Married Women:

In this study it refers to the women who are married residing in shirur (rural area) of bagalkot district, who is in age group between 18 to 45yrs and who is able to produce off springs on sexual intercourse. Shirur is a rural area located away from 20kms from Bagalkot City having a Primary Health Centre.

 

 

Urban Married Women:

In this study it refers to the women who are married residing in Vidyagiri (urban area) of bagalkot district, who is in age group between 18 to 35yrs and who is able to produce off springs on sexual intercourse. Vidyagiri is an urban area located away from 6 kms from Bagalkot city.

 

Selected Demographic Variables:

The variables are Age, Educational status, Occupation, Religion, Type of family, Age at marriage, Number of children, Family monthly income, Source of information about family planning methods.

 

Assumptions:

The present study was based on following assumptions.

1.    Educated married women will have more knowledge than illiterate women.

2.    Higher the age, higher will be the knowledge, attitude and practice of family planning methods

3.    Women’s knowledge regarding family planning will enhance fertility reduction rate.

 

Delimitations:

The present study is delimited to

1.    The married women at reproductive age who were willing to participate in the study

2.    The married women at reproductive age who were able to speak and understand Kannada.

3.    The urban and rural women’s who are married and in the age group of 15 to 45yrs

 

Hypotheses:

On the basis of the objectives and review of literature, the following hypothesis were formulated

H₁:There will be significant relationship between knowledge, attitude and practice of rural and urban married women regarding family planning methods.

 

H₂: There will be a strong positive co-relation between knowledge, attitude and practice of rural and urban married women regarding family planning methods.

 

H_3; There will be significant association between knowledge, attitude and practice of rural and urban married women regarding family planning methods with selected demographic variables.

 

Methodology:

Research methodology is a systematic way to solve the research problem. Research methodology involves the systematic procedure by the research starts from the initial identification of the problem to its final conclusion.

 

Research Approach:

The research approach adopted in this present study is Descriptive Study, is considered as appropriate.

 

Research Design:

The research design adopted for the present study was Non Experimental Comparative Design, because it describes the relationship which exists between selected demographic variables.

 

Socio-demographic Variables:

Socio-demographic Variables in this study includes background factors namely Age, Educational status, Occupation, Religion, Type of family, Age at marriage, Number of living children, Family monthly income, Source of information.

 

Study Variables:

Study variables include knowledge, practice and attitude of rural and urban married women at reproductive age.

 

Setting of the Study:

The present study is conducted among married women residing at Bagalkot vidyagiri city (urban) and Shirur village (rural).

 

Population:

1.      Target population is all married women at Bagalkot district.

2.      Accessible population married women residing at Bagalkot vidyagiri city (urban) and Shirur village (rural).

 

Sample and Sampling Technique:

In this study, researcher used Simple Random Sampling Technique for the selection of rural and urban areas. For this purpose areas of Bagalkot City were listed as Old Bagalkot, Vidyagiri and Navanagar. Out of these areas, Vidyagiri was chosen for urban area where as shrirur was chosen for rural area by using Lottery method. And a Purposive Sampling Technique used for the selection of the sample. In this study sample size consist of 60 married women, in that 30 married women in urban area and 30 married women in rural area.

 

Inclusion Criteria:

The study includes the married women at reproductive age, who were;

1.    The married women those who are willing to participate in the study.

2.    The married women those whose age is in the reproductive age of 15-45yrs.

3.    Available at the time of data collection.

4.    Able to speak and understand kannada

 

Exclusion Criteria:

The study excluded the married women at reproductive age, who were not,

1.    A woman’s who are unmarried.

2.    Not able to speak and understand Kannada.

3.    Not  available at the time of data collection

4.    Not willing to participate in the study.

 

Limitations: The study was limited to,

·      The married women at reproductive age of Vidhyagiri and Shirur areas.

·      The married women at reproductive age who were willing to participate in the study

·      The married women at reproductive age who were able to speak and understand Kannada.

 

Method of Data Collection:

The technique used for data collection was structured closed ended interview schedule technique for knowledge assessment where as rating scale was used for assess practice and likert scale for attitude of rural and urban married women regarding family planning methods.

 

Data Collection Procedure:

The investigators obtained prior permission from the principal, ward counsellor, Medical Officer Shirur PHC, research committee, ethical committee and consent from all the participants.

 

Data Collection Instruments:

The investigator uses structured interview schedule with the use of structured closed ended knowledge questionnaire to assess the knowledge and check list will be used to assess the attitude and practice of rural and urban married women regarding family planning methods.

Section I: Includes 9 items related to selected Socio-demographic characteristics of rural and urban married women regarding family planning methods.

 

Section II: Includes 30 items seeking the knowledge of rural and urban married women regarding family planning methods.

 

Section-III: Includes 10 items to assess the attitude of rural and urban married women regarding family planning methods.

 

Section-IV: Includes14 items to assess the practice of rural and urban married women regarding family planning methods.

 

A scoring system is developed for the items. Knowledge score is scored for each correct answer in structured closed ended interview schedule is assigned a score of ‘one’ and wrong answer a score ‘zero’. The total score of section B is 30. A scoring system is developed for the items. Practice score is scored for each answer in Rating scale is assigned score in 5 scale that is 1, 2, 3, 4, 5. The total score of section C is 70. A scoring system is developed for the items. Attitude score is scored for each answer in Likert scale is assigned score in 5 scale that is 1, 2, 3, 4, 5. The total score of section C is 50.

 

Plan of Data Analysis:

The data obtained was analyzed in terms of achieving the objectives of the study using descriptive and inferential statistics.

·      Organization of data in master sheet.

·      Frequency and percentage distribution was used for analysis of socio-demographic characteristics.

·      Calculation of mean, standard deviation of knowledge, practice and attitude score.

·      Application of ‘T`- test to find the comparison of knowledge, practice and attitude between rural and urban married women in reproductive age.

·      Application of Karl Pearson’s and Spearman’s Brown prophecy co-efficient of correlation to find out correlation between knowledge and attitude of rural and urban people regarding epilepsy.

·      Application of chi-square test to find the association between socio -demographic variables with knowledge, practice and attitude scores

 

Major Findings:

To begin with, data was entered in a master sheet for tabulation and statistical processing. The findings were presented under the following headings.

 

Section -I: Frequency and percentage distribution of socio-demographic characteristics of the sample residing in selected rural and urban areas of bagalkot district.

 

Description of samples with their socio demographic variables.

 

 

Fig 1.Percentage Distribution of Women According to their Age Group

 

Fig 2. Percentage Distribution of Women According to their Education Status

 

Fig 3. Percentage Distribution of Women According to their Occupation

 

Fig 4. Percentage Distribution of Women According to their eligion

 

Fig 5. Percentage Distribution of Women According to their Type of family

 

Fig 6. Percentage Distribution of Women According to their Age at marriage

 

Fig 7. Percentage Distribution of Women According to their No. of living children

 

Fig 8. Percentage Distribution of Women According to their Family Income

 

Fig 9. Percentage Distribution of Women According to their Source of Information

 

Section -II:

Mean and standard deviation of Knowledge, Attitude and Practice regarding family planning methods among married women residing in selected rural and urban areas of bagalkot district In order to find out the level of knowledge of women, five range categories were used. Categorization on the basis of level of knowledge is as fallows.

 

[A] Table-1 Level of Knowledge of Rural and Urban Women Regarding Family Planning Methods

Categorization of the women on the basis of the level of knowledge was done as follows: scores 25-30 Very good knowledge level, scores 19-24 good knowledge level, scores 13-18 Average knowledge level, scores 7-12 poor knowledge level, scores 0-6 very poor knowledge level N=30

 

Level of knowledge	Rural		Urban
	F	%	F	%
Very Good	0	0	16	53
Good	0	0	8	27
Average	4	13	6	20
Poor	16	54	0	0
Very Poor	10	33	0	0
Total	30	100	30	100

 

B] Table-2 Level Of Practice of Rural And Urban Women Regarding Family Planning Methods

Categorization of the women on the basis of the level of practice was done as follows: scores 70-57 Always, scores 43-56 Occasionally, scores 29-42 Sometime, 12-28 Rarely and scores 0-14 Never practice. N=30

 

Level of Practice	Rural		Urban
	F	%	F	%
Always	0	0	10	33
Occasionally	2	7	15	50
Sometimes	4	13	5	17
Rarely	6	20	0	0
Never	18	60	0	0
Total	30	100	30	100

C] Table-3 Levels Of Attitude of Rural And Urban Women Regarding Family Planning Methods

Categorization of the women on the basis of the level of practice was done as follows: scores 41-50 Strongly Agree, scores 31-40 Agree, scores 21-30 Uncertain, 11-20 Strongly Disagree and scores 1-10 Disagree practice. N=30

 

Level of Attitude	Rural		Urban
	F	%	F	%
Strongly Agree	0	0	15	50
Agree	2	7	12	40
Uncertain	6	20	3	10
Strongly Disagree	4	13	0	0
Disagree	18	60	0	0
Total	30	100	30	100

 

D] Table-4 Area wise mean, SD and mean percentage of knowledge scores of Rural and Urban women regarding family planning N = 30

Knowledge area	Max score	Rural		Urban
		Mean	SD	Mean	SD
General concepts of family planning methods	4	1.43	0.56	3.03	0.80
Types of family planning methods	6	2	0.88	1.96	0.92
Condom	3	1.15	0.36	2.43	0.72
Diaphragm	3	1.04	0.21	2.46	0.57
Copper-T	3	1.08	0.28	2.23	0.89
Oral pills	3	1.04	0.20	2.4	0.81
Safe period	3	1	0	2.4	0.81
Permanent methods	5	1.52	0.72	3.53	1.43
Total	30	9.26	3.21	20.71	6.23

 

E] Table-5 Area wise mean, SD and mean percentage of practice scores of Rural and Urban women regarding family planning methods N = 30

Practice area	Max score	Rural	Urban
		Mean	SD	Mean	SD
Permanent family planning methods	2	9.86	0.34	10	0
Natural Method	2	4.46	1.13	9	0.83
Hormonal Method	2	5.4	1.97	8.9	0.92
Emergency Method	2	8	1.96	12.1	16.4
Barrier Method	2	6.73	8.37	9.16	0.83
Chemical Method	2	4.23	1.30	8.93	0.73
Mechanical Method	2	4.1	1.21	8.93	0.73
Total	14	42.78	16.31	67.02	20.46

 

Section-III:

To compare the knowledge, attitude and practice regarding family planning methods among married women residing in selected rural and urban areas of bagalkot district.

 

Table-6 Comparison of Knowledge Level of rural and urban women N = 30

Table Value	T-Test	Mean	SD	SE
2.05	14.98	16	5.83	1.06

Table-7 Comparison of Practice Level of rural and urban women N = 30

Table Value	T-Test	Mean	SD	SE
2.05	4.50	27	3.28	0.59

 

Hence H₁ stated:  There will be significant relationship between knowledge, attitude and practice of rural and urban married women regarding family planning methods is accepted.

 

Table-8 Comparison Attitude Level of rural and urban women N = 30

Table Value	T-Test	Mean	SD	SE
2.05	6.07	26	2.34	0.42

 

Hence H₁ stated:  There will be significant relationship between knowledge, attitude and practice of rural and urban married women regarding family planning methods is accepted.

 

Section -IV

·      Correlation between the knowledge regarding family planning methods and attitude regarding family planning methods residing in selected rural and urban areas of bagalkot district.

·      Correlation between the knowledge regarding family planning methods and practice regarding family planning methods residing in selected rural and urban areas of bagalkot district.

·      Correlation between the Attitude regarding family planning methods and practice regarding family planning methods residing in selected rural and urban areas of bagalkot district

 

Table -9: correlation between knowledge, attitude and practice regarding family planning methods of rural and urban married women at reproductive age

Correlation	Rural Value	Urban Value
Correlation between knowledge and practice	0.02	0.52
Correlation between knowledge and attitude	0.47	0.68
Correlation between attitude and practice	0.06	0.72

 

Hence H₂ stated: There will be a strong positive co-relation between knowledge, attitude and practice of rural and urban married women regarding family planning methods is accepted.

 

Section -V:

·      Association between knowledge regarding family planning methods and selected demographic variables residing in selected rural and urban areas of bagalkot district.

 

 

Table-10: Association Between Knowledge Regarding Family Planning Methods and Selected Demographic Variables Residing In Selected Rural Areas of Bagalkot District.

 

Hence stated: H₃:  There will be significant association between knowledge, attitude and practice of rural married women regarding family planning methods with selected demographic variables is accepted for age at marriage and source of information with knowledge of rural women regarding family planning methods and rejected for other demographic variables such as age, religion, education, occupation, and monthly family income, type of the family, number of living children.(Table.10).

 

Table-11: Association between knowledge regarding family planning methods and selected demographic variables residing in selected urban areas of bagalkot district

Hence stated: H₃:  There will be significant association between knowledge, attitude and practice of urban married women regarding family planning methods with selected demographic variables is rejected. (Table 11)

 

Table-12: Association between practice regarding family planning methods and selected demographic variables residing in selected rural areas of bagalkot district.

 

Hence stated: H₃:  There will be significant association between knowledge, attitude and practice of rural married women regarding family planning methods with selected demographic variables is accepted for education with practice of rural women regarding family planning methods and rejected for other demographic variables such as age, religion, occupation, and monthly family income, type of the family, no. of living children. (Table 12)

 

Table-13: Association between practice regarding family planning methods and selected demographic variables residing in selected urban areas of bagalkot district.

Hence stated: H₃:  There will be significant association between knowledge, attitude and practice of urban married women regarding family planning methods with selected demographic variables is rejected..(Table 13).

 

Table-14: Association between attitude regarding family planning methods and selected demographic variables residing in selected rural areas of bagalkot district

 

Hence stated: H₃:  There will be significant association between knowledge, attitude and practice of rural married women regarding family planning methods with selected demographic variables is accepted for No. of living children and family monthly income with attitude of rural women regarding family planning methods and rejected for other demographic variables such as age, religion, occupation and type of the family. (Table 14)

 

 

Table-15: Association between attitude regarding family planning methods and selected demographic variables residing in selected urban areas of bagalkot district

 

 

 

Hence stated: H₃:  There will be significant association between knowledge, attitude and practice of urban married women regarding family planning methods with selected demographic variables is rejected. (Table 15)

 

CONCLUSION:

By this investigators concluded that there was a strong positive correlation between Knowledge, attitude and practice regarding family planning methods among rural and urban married women at reproductive age.

 

ACKNOWLEDGEMENT:

We take this opportunity to express our gratitude to the people who helped, encouraged, guided, and pushed us on to this accomplishment. Our heartfelt thanks to Prof. Deelip S. Natekar, Principal and Head of the Department of Community Health Nursing, Shri. B.V.V. Sangha’s Sajjalashree Institute of Nursing Sciences, Navanagar, Bagalkot.

 

REFERENCE:

1.     K. Park Text Book of Preventive and Social Medicine 17^th edition ed.jabalpur:2003 Nov.p.451.

2.     www.health.com/health/gallery/motherhood.modernmom.com

3.     www.Reference/types of family planning methods/knowpeel.ca/bc preg/methods.html

4.     www.infochange in India.org/Population/Statistics/Population Growth in India

5.     Bhattacharya SK, Ram R, Goswami D, Guptta UD, Bhattacharya K, et al. Study of Unmet need for family planning among women of reproductive age group attending immunization clinic in medical college of Kolkata, Indian Journal of Community Medicine April- June 2006

6.     WHO report on family Planning Methods and Knowledge, Attitude and Practice

7.     Govt. Of India, Ministry of Health and Family Welfare, New delhi, Annual Report1999-2000

8.     International Journal of OBG Nursing. Vol-I/ Issue-I/2014

9.     Victoria A, Velkoff, Arjun. Women’s health in India, Adlakha International Programme center. Dec-1998

10.   Mukherjee. M, improving women health, health action april-2012;4-7

11.   Kumar NP, Knowledge and use of contraceptives among married Adolescent Women in India- 2009.

 

 

 

Received on 18.07.2017          Modified on 12.09.2017

Accepted on 29.10.2017          © A&V Publications all right reserved