Introduction: All differentials for varying acceptance of family planning methods need to be addressed for healthy population growth. The current study explores the family planning behaviour and role of the community in family planning practices in rural Kerala. Aim: To identify the family planning behaviour, by analysing the contraceptive practices by eligible couples in a selected panchayath and to assess the barriers faced by eligible couples in accepting modern contraceptives. Also to explore the perspectives of service providers about factors affecting family planning behaviour of the rural community. Materials and Methods: The present mixed method study was conducted among eligible couples and family planning service providers in Puthussery, in the Palakkad District of Kerala, India during two months period between August- September 2021. The study comprised two phases: In Phase 1, investigators collected data on sociodemography and family planning practices from the eligible couple survey reports of Family Health Centre (FHC) Puthussery; Phase 2 involved free listing and pile sorting exercise done among family planning service beneficiaries and Key Informant Interviews (KII) with service providers after getting their consents. After phase 1, data was analysed using Epi Info software 7.2.5.0. Phase 2 utilised thematic analysis based on a deductive approach. A hierarchical cluster analysis was completed to get a collective picture of perceived rationales behind a grouping of the barriers. The analysis of free list and pile sort data was undertaken using Anthropac 4.0 software. Results: There were a total of 8035 eligible couples registered to FHC. Majorty belonged to above poverty line families 4821 (60%). In most couples 1857 (23%) female partners’s age ranged between 25-29 years and had attained secondary education 4210 (52%). The modern contraceptive prevalence rate was 5817 (72.4%). Female sterilisation 4598 (57.2%) was mostly preferred followed by condoms 677 (8.4%), intrauterine devices 518 (6.4%), oral contraceptive pills 19 (0.2%) and no scalpel vasectomy 5 (0.06%). All acceptors used conventional modern contraceptives. Barriers to accepting modern contraceptives were lack of awareness, side-effects and complications, Fear and myths, privacy concerns, and non-availability. Social factors centered around gender, other sociocultural factors, social factors affecting health system performance, and factors within the health system influenced contraceptive behaviour according to providers. Conclusion: Several social, cultural, and systemic determinants shaped the female-oriented and modern contraceptive-specific family planning behaviour of the rural population. Addressing sociocultural determinants and strengthening the healthcare system are needed for broader acceptance of an expanded basket of choices in family planning. All beneficiary barriers could be addressed by proper one-to-one, couple-based, and group approaches to communication.
Midhukrishna et al. (Tue,) studied this question.
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