Perceptions of family planning among married women aged 18 to 49 years and healthcare providers in Raipur, India: A qualitative study

Abstract Background: India surpassed China in becoming the World’s most populous country. Family Planning(FP) is in important aspect of controlling population. Although many programmes have been implemented to promote FP, it remains a public health problem because beliefs, attitudes and practices affect acceptance of FP methods. This study aims to explore the factors affecting unmet need for FP by using qualitative study method. Methods: This study was conducted in Urban Field Practice Area (UFPA) of All India Institute of Medical Sciences (AIIMS), Raipur during February 2022 to August 2022. Four Focussed Group Discussion(FGDs) among married women aged 18–49 years, one FDG among ASHAs, two In-depth Interviews(IDIs) with RMA and SN were conducted respectively. The participants were selected purposively and interviewed using open-ended topic guides. Thematic analysis was done for the detailed notes taken during the interviews. Results: Factors facilitating contraceptive usage were ASHAs delivering contraceptives, adequate contraceptive stock, provider’s counselling, husband’s positive attitude, woman’s education. Potential barriers to contraceptive usage were lack of compliance, lack of autonomy, husband’s and familial perception about terminal methods like vasectomy, perceived side-effects, myths, disbelief in government system, unpleasant attitude of healthcare workers(HCW), disruption of contraceptive services including sterilization during Covid-19 pandemic. Scope of improvement suggested by the participants were need for more contraceptive information, individualized contraceptive advice, family counselling, community re-enforcement, improve counselling sessions. Conclusion: The majority of women desired to have a small family and but they could not appreciate the need for FP. The barriers related to socio-cultural believes, contraceptive myths (especially vasectomy) and healthcare system needs special attention. Resource management, family’s counselling, tailor made contraceptive advice and proper counselling sessions could improve contraceptive uptake.