NEPAL (2012): Knowledge and Attitudes of Married Women of Reproductive Age towards IUDs and MA (ROUND II)

Abstract

Background: The purpose of this study is to assess the knowledge and perception of married women of reproductive age (MWRA) towards Intrauterine Contraceptive Device (IUD) and safe Medication Abortion (MA) in 50 Women Health Project (WHP) districts where PSI/Nepal is implementing its activities. Methods: A multi-stage cluster sampling approach was used. The sampling frame consists of two set of areas; 20 districts with IUD service provision and demand generation support to the public sector health facilities and 30 districts with no support to public sector health facilities. Assuming similar proportions for districts, 1234 MWRA were interviewed in areas where PSI is supporting public sector health facilities and 1234 in areas where PSI is not supporting public facilities. The study was conducted during December 2011- January 2012. Results: Despite high knowledge of contraceptive method, knowledge on legality of abortion and safe abortion services is low. Marie Stopes and private facility were more commonly mentioned facilities and TV (38.6%), and radio (33.5%) the major source of information on safe abortion. Almost 38.4% women are currently using a FP method, with 29.3% using modern contraceptive method. Husbands play a vital role in recommending the current FP method (54.3%). The knowledge of IUD was good, though they felt not getting enough information on IUD from health providers. Low social support for IUDs from friends, neighbours and family members was reported. Exposure to FP messages and IUDs messages is low with, radio (38%), and television (27.6%). Conclusions: The program intervention should focus more towards knowledge, awareness, service utilization, and harm reduction on availability of IUCD and safe abortion. PBCC followed by regular outreach activities are important for ensuring private providers giving complete information on MA as well as FP counseling to potential IUCD, and MA clients. Conducting client exit interview surveys in predefined intervals is effective at measuring FP and MA service satisfaction among targeted beneficiaries (MWRAs). Mass media interventions need to be continued. Keywords: attitude; IUCD; knowledge; married women of reproductive age; medical abortion.