Sreedevi A, Vijayakumar K, Najeeb SS, Menon V, Mathew MM, Aravindan L, Anwar R, Sathish S, Nedungadi P, Wiwanitkit V, Raman R. Pattern of contraceptive use, determinants and fertility intentions among tribal women in Kerala, India: a cross-sectional study.
BMJ Open 2022;
12:e055325. [PMID:
35414552 PMCID:
PMC9006194 DOI:
10.1136/bmjopen-2021-055325]
[Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
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.
Collapse