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Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study
OBJECTIVES: To assess the pattern of contraceptive use and its determinants, knowledge regarding contraceptives including oral contraceptive pills and fertility intentions among tribal women in the reproductive age group. DESIGN: Community-based cross-sectional study. SETTING: Community development...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006194/ https://www.ncbi.nlm.nih.gov/pubmed/35414552 http://dx.doi.org/10.1136/bmjopen-2021-055325 |
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author | Sreedevi, Aswathy Vijayakumar, Krishnapillai Najeeb, Shana Shirin Menon, Vishnu Mathew, Minu Maria Aravindan, Lakshmi Anwar, Rithima Sathish, Syama Nedungadi, Prema Wiwanitkit, Viroj Raman, Raghu |
author_facet | Sreedevi, Aswathy Vijayakumar, Krishnapillai Najeeb, Shana Shirin Menon, Vishnu Mathew, Minu Maria Aravindan, Lakshmi Anwar, Rithima Sathish, Syama Nedungadi, Prema Wiwanitkit, Viroj Raman, Raghu |
author_sort | Sreedevi, Aswathy |
collection | PubMed |
description | OBJECTIVES: To assess the pattern of contraceptive use and its determinants, knowledge regarding contraceptives including oral contraceptive pills and fertility intentions among tribal women in the reproductive age group. DESIGN: Community-based cross-sectional study. SETTING: Community development blocks in a predominantly tribal district of Wayanad in Kerala, India. PARTICIPANTS: Women in the reproductive age group (15–49 years) from the tribal groups in the district numbering 2495. OUTCOME MEASURES: PRIMARY: Prevalence of contraceptive use and its determinants. SECONDARY: Knowledge regarding contraceptives in general, oral contraceptives and fertility intentions. RESULTS: The mean age of the study participants was 30.8 years (SD=9.8) and belonged to various tribal groups such as Paniya (59.2%), Kurichiyar (13.6%) and Adiya (10.9%). Current use of contraceptive was reported by about a fourth, 658 (26.4%) (95% CI 27.9 to 24.9) of women. Following logistic regression, belonging to Paniya tribe (adjusted OR (aOR) 2.67, 95% CI 1.49 to 4.77; p<0.001) and age at menarche >13 years (aOR 1.69, 95% CI 1.14 to 2.52; p<0.009) had significantly higher use of contraceptives whereas social vulnerability as indicated by staying in a kutcha house had a lesser likelihood of use of contraceptive (aOR 0.55, 95% CI 0.31 to 0.95; p<0.03). Oral contraceptive use was low (4.8%) among this population and no abuse was observed. Less than half (47%) of the respondents had an above average knowledge on contraception. Multivariable logistic regression indicated that above average knowledge was 2.2 times more likely with higher education (95% CI 1.2 to 3.9), lesser among those who desired more than two children (aOR 0.59; 95% CI 0.38 to 0.94; p<0.02). Two children per family was the preferred choice for 1060 (42.5%) women. No gender bias in favour of the male child was observed. CONCLUSION: Awareness and use of contraceptives are poor though the fertility is not commensurately high. Along with developing targeted responses to contraceptive use among Indigenous people with indigenous data, awareness also requires attention. Ethnographic studies are also necessary to determine the differences in contraceptive use including traditional methods among the various Indigenous groups. |
format | Online Article Text |
id | pubmed-9006194 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-90061942022-04-15 Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study Sreedevi, Aswathy Vijayakumar, Krishnapillai Najeeb, Shana Shirin Menon, Vishnu Mathew, Minu Maria Aravindan, Lakshmi Anwar, Rithima Sathish, Syama Nedungadi, Prema Wiwanitkit, Viroj Raman, Raghu BMJ Open Public Health OBJECTIVES: To assess the pattern of contraceptive use and its determinants, knowledge regarding contraceptives including oral contraceptive pills and fertility intentions among tribal women in the reproductive age group. DESIGN: Community-based cross-sectional study. SETTING: Community development blocks in a predominantly tribal district of Wayanad in Kerala, India. PARTICIPANTS: Women in the reproductive age group (15–49 years) from the tribal groups in the district numbering 2495. OUTCOME MEASURES: PRIMARY: Prevalence of contraceptive use and its determinants. SECONDARY: Knowledge regarding contraceptives in general, oral contraceptives and fertility intentions. RESULTS: The mean age of the study participants was 30.8 years (SD=9.8) and belonged to various tribal groups such as Paniya (59.2%), Kurichiyar (13.6%) and Adiya (10.9%). Current use of contraceptive was reported by about a fourth, 658 (26.4%) (95% CI 27.9 to 24.9) of women. Following logistic regression, belonging to Paniya tribe (adjusted OR (aOR) 2.67, 95% CI 1.49 to 4.77; p<0.001) and age at menarche >13 years (aOR 1.69, 95% CI 1.14 to 2.52; p<0.009) had significantly higher use of contraceptives whereas social vulnerability as indicated by staying in a kutcha house had a lesser likelihood of use of contraceptive (aOR 0.55, 95% CI 0.31 to 0.95; p<0.03). Oral contraceptive use was low (4.8%) among this population and no abuse was observed. Less than half (47%) of the respondents had an above average knowledge on contraception. Multivariable logistic regression indicated that above average knowledge was 2.2 times more likely with higher education (95% CI 1.2 to 3.9), lesser among those who desired more than two children (aOR 0.59; 95% CI 0.38 to 0.94; p<0.02). Two children per family was the preferred choice for 1060 (42.5%) women. No gender bias in favour of the male child was observed. CONCLUSION: Awareness and use of contraceptives are poor though the fertility is not commensurately high. Along with developing targeted responses to contraceptive use among Indigenous people with indigenous data, awareness also requires attention. Ethnographic studies are also necessary to determine the differences in contraceptive use including traditional methods among the various Indigenous groups. BMJ Publishing Group 2022-04-11 /pmc/articles/PMC9006194/ /pubmed/35414552 http://dx.doi.org/10.1136/bmjopen-2021-055325 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Public Health Sreedevi, Aswathy Vijayakumar, Krishnapillai Najeeb, Shana Shirin Menon, Vishnu Mathew, Minu Maria Aravindan, Lakshmi Anwar, Rithima Sathish, Syama Nedungadi, Prema Wiwanitkit, Viroj Raman, Raghu Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study |
title | Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study |
title_full | Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study |
title_fullStr | Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study |
title_full_unstemmed | Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study |
title_short | Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study |
title_sort | pattern of contraceptive use, determinants and fertility intentions among tribal women in kerala, india: a cross-sectional study |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006194/ https://www.ncbi.nlm.nih.gov/pubmed/35414552 http://dx.doi.org/10.1136/bmjopen-2021-055325 |
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