Contributing factors unmet need of family planning among multigravida women attending at koshi zonal hospital.

Thesis Report.

ABSTRACT: Nepal Family Health Survey 1996 estimated that the total fertility rate of Nepali Women of reproductive age is 4.6 and contraceptive privilege rate (CPR) is 29 % the total need of Fip is 60% and total F.P. Unmet need is 31% (Spacing 14% and limiting 17%). The purpose of the study was to identify the contributing factors of unmet need of F.P. among multigravidia women also have at least two living children and are currently pregnant attending Koshi Zonal Hospital. The present study employed a descriptive type and was exploratory in nature and was carried out to determine the contributing factors of unmet need of F.P. The contributing factors of unmet need of F.P. were measured by selected socio demographic, cultural factor, Knowledge on Birth spacing of F.P. service available place F.P. contraceptives, when to the use F.P. and utilization of health service such as distance, accessibility availability of F.P. contraceptive and attitude of health workers towards clients. The cultural factors included desire for son, women's involvement on decision making, pressure by families and fear of side effects. The data for the study were collected from 175 mother who came for antenatal and delivery service at the Koshi Zonal Hospital during Shrawan 9Th to Bhadra 32nd in 2056 study period with structured questionnaire. The finding revealed that the majority of respondents have low education level 70% of respondent were illiterate. 35% of respondents had never heard about F.P. and among the knowledge able ones 40.6% were not able to give the correct meaning of family planning 89.1% of respondents had never used the contraceptives till the time of interview . 45% gave the birth to their first baby before the age 20 years. It increase the possibility of too early, too close too many child bearing as it provides longer duration of reproductive period. The main variable of contributing factors of unmet needs of F.P. contraceptives were the desire of 3 children and more and the desire of two sons. Knowledge about family planning is an associated of unmet needs of F.P. the answer about unmet needs of those who had never used F.P. contraceptives were desired for son 3.2% fear of side effects 26.8% , inaccessibility 14.6% and lack of knowledge on contraceptives 24.8%. Similarly the lack of knowledge about where contraceptives are available place is another factor of unmet needs of F.P. 70 and multi and 50% grand multi said that the hospital is the only place where the contraceptives are available and only 28.2% multi and 42.9% grand multi contraceptives are available. 77.6% including both multi and grand multi g=had never attended Health Institution for contraceptives due to various reasons such as lack of knowledge 49.6% not recognizing health personnel 14% , refused by husband 11.9% , fear of side effects 11.1% lack of money to go there 4.4%, desire contraceptives are not available 4.4 percednt and refused by other family members like mi=other in law 3.7% . Among those attending 18.4% said they have faces problems at health institutional like 34.4% replied that no female health workers were available 21.9% reported long waiting time at the health institution,1.6% Health worker not being available at the time wanted. 18% desired contraceptives no being available 6.3% said that the attitude of health professionals is not positive and polite to clients. Decision making is another major factor found behind the unmet needs of F>P. Decision on F.p. was fond to be made by husband 54% and only 26.4% of decisions were made by both partners, 5.7% said that the decisions were made by husbands 54% and only 26.4% decision were made by both partners, 5.7% said that the decisions are made by other family members abd only 2.9% of women said that they made decision themselves. Regarding the questions "Would you like to use F.P. contraceptive in future " 91.4% of women said that they will use F.P. contraceptives and 8.6% said they will not use them. Among the willing groups 78% want to use female voluntary surgical contraception (Tubectomy ) 13.8% wanted to use Norplant and 8.1% wanted to use injection Depoprovera. So desired methods should be there to reduce the unmet needs and ot increase the contraceptive privilege rate.

Eng.