FAMILY PLANNING KAP SURVEY

IN MANIPUR STATE
- INDIA

Serena Donati MD*, Sharma

Nabakanta MD?, Emanuela Medda Bsc* and Michele
Grandolfo Bsc*.

* Department of
Epidemiology and Biostatistics, Istituto Superiore di Sanit?, Viale Regina
Elena 299, 00161 Rome, Italy

Corresponding
author

Serena Donati

Department of
Epidemiology and Bistatistics, Istituto Superiore di Sanit?
Viale Regina Elena 299, 00161 Rome, Italy

e-mail serena.donati@iss.it

tel.: + 39 6
49902116

fax: + 39 6
49387069

ABSTRACT

Objective: to provide
information of knowledge, attitude and practice in family planning, to estimate
unmet need for contraception and to investigate accessibility and the quality
of the health services of a representative sample of the female population of
reproductive age resident in Manipur
State, India.

Methods: Three probabilistic

samples of women of reproductive age (n=407) randomly selected from the
electoral rolls of one Hindu town, one Hindu village and one Muslim village
were interviewed in their homes. Univariate and multivariate statistical
analyses were performed using STATA software.
Findings: the prevalence of
current use of high efficacy methods among currently married women is 50% with
wide variations between the three study areas: 17% in the Muslim village, 61%
in the Hindu village and 64% in the Hindu town. Total unmet need for family
planning is 25.6%. Women?s and husband?s low educational level, being Muslim
and living in a rural area are positively associated with contraceptive unmet
need. Most important sources of family planning are: media (43%), health
providers (32%) and friends (16%). The main contraceptives provider is the
Kakching Post Partum Centre (66%), followed by the pharmacy (15%) and private medical
doctors (10%).

Conclusion: despite the

important reduction of the total fertility rate (from 5.2 in 1970-72 to 2.9 in
1996-98) and the  favourable attitudes
regarding family planning, there is a gap between fertility preference and
achievement, and the prevalence of contraception use is still low especially
among Muslim women.

INTRODUCTION

The new National

Population Policy adopted by the Indian Government in 2000 has set as its
immediate objective the task of addressing unmet need for contraception, in
order to achieve the medium term objective, of bringing the total fertility
rate down to replacement level by the year 2010. One of the goals identified
for this purpose, is to achieve universal access to information - counselling
and services for fertility regulation and contraception with a wide range of
choice (1).

State level and

national-level information on fertility and family planning trends have been
provided by India?s
first and second National Family Health Survey (NFHS) conducted in 1992-93 and
1998-99. The total fertility rate in India has declined from 5.2
children per woman in the years 1970-72 to 3.4 in 1992-93 and 2.9 in 96-98.
Contraceptive prevalence was, on average, 41% in 1992-93 and 48% in 1998-99,
with huge variations among states that are still in different stages of
demographic transition and among communities according to religion, literacy
and utilisation of health facilities (2,3).

The State of Manipur is one of the smallest in India (22,327-squared km) with a

total population of over 1,800,000. The annual per capita income is around
$400. According to NFHS-2 in Manipur (4), the percentage of women who are
illiterate is 41% and the percentage of illiterate men is 20%. The study area
is Kakching, a subdivision of Thoubal district, with a resident population of
around 100,000 people. 85% of the resident population is Hindu and 15% is
Muslim.

A Community
Health Centre with an attached Post Partum Centre that offers Essential
Obstetric Care, family planning and medical termination of pregnancy serves
Kakching. It is also served by a good number of private practitioners, both
medical doctors and paramedical staff.

In spite of the
governmental effort, contraceptive prevalence among women in Kakching  is low and there is an
urgent need to
understand better the discrepancy between reproductive preferences and family
planning practices.

The objectives of this study are to

provide information of knowledge, attitude and practice in family planning, to
estimate unmet need for contraception and to investigate accessibility and the
quality of the health services providing contraceptives among three
representative samples of women in reproductive age living in an urban and in a
rural Hindu setting and in a Muslim village of Kakching district.

METHODS

Three
probabilistic samples of women of reproductive age were randomly selected from
the electoral rolls in the three areas under study. 197 women were
systematically selected from the Hindu Kakching town, 102 from Irengband Hindu
village and 108 from Sora Muslim village.

A questionnaire
was designed according to KAP methodology. It was discussed in Kakching with
local experts and community members and was pre-tested in the field.

Questions were
closed and precoded and average time for administration was 20-30 minutes.

The District
Authority issued a formal authorisation for fieldwork and data collection. A
fieldwork plan was prepared with the collaboration of the Department of Family
Welfare of the Government of Manipur, the Medical Officer of Post Partum
Kakching Centre (PPKC) and the local Medical
College. Maps of the
study areas allowed a segmentation procedure in assigning selected areas to
each interviewer.
A total of 8
field workers (Anganwadi workers) and 2 supervisors were locally appointed.
They attended a two days training course on home visits and questionnaire
administration procedures and received a written interviewer?s manual. After
the administration of the questionnaire the field workers informed the women
about family planning methods and about available health facilities in the
district.

Data collection
was performed during the month of February 2001.

Questionnaires
were locally coded and data were entered using EPI INFO 6.0.

Data analysis was

performed in the Epidemiological Unit of the National Health Institute in Rome Italy
using STATA software.

The definition of
unmet need adopted in this study is the same as that introduced by Westoff and
Ochoa in 1993 (5) with the exception of the ?mistimed and/or unwanted last
births among currently amenorrhoic women?, because our survey did not
investigate this issue.

 
 

RESULTS

Of the 407 women of

reproductive age selected for the survey 406 (99.8%) were interviewed.

Table 1 shows the

socio-demographic characteristics of the sample according to the three areas
under study.  196 women (48.3%) were
interviewed in Kakching town, 108 (26.6%) in Sora village and 102 (25.1%) in
Irengband village.

73% of the entire sample is

Hindu and lives in Kakching town and in Irengband village. Sora village is
inhabited only by Muslims and represents 27% of the total sample.

The mean age for the total

sample is 33.6 years and 36.8 years for the husbands. In the three areas under
study, mean age is respectively 34.7 years in Kakching, 31.6 years in Sora and
33.4 years in Irengband. The mean age value of husbands living in Sora village
is 41 years compared to 35 years in Kakching and Irengband.

The achieved educational

level was lower among women (45.8% is illiterate) compared to husbands (23.3%),
and among Muslims (68.5% is illiterate) compared to Hindus both living in
rural  (56.9%) and urban areas (27.6%).

Eighty-one percent of the

women are married and 15% single. More than 80 per cent of the women reported
that they are housewives. Among Muslim women the percentage of housewives rises
to 92%.

Attitude to family planning

was very positive (tab. 2). Almost 90% of the women believed that there is a
need for more information about family planning and 83% were in favour of sex
education in school.

Ninety-three percent of
Hindu women living in Kakching, 79% of those living in Irengband village, and
32% of the Muslim women, reported that they discuss the choice of a
contraceptive method with their husbands.

Asked about their intention

of using family planning methods in the future, 
44% in Kakching, 49% in Irengband and 26% in Sora answered
affirmatively, 22, 15 and 28% negatively and 34, 36 and 47% reported they don?t
know if they will use a contraceptive in the future. The highest percentage of
women intending to use family planning methods in the future are the 31-40
years age group, the women with primary or higher educational level and Hindus
compared to Muslims.

Asked to actively remember

the known contraceptive methods, 72% of the sample mentioned IUD, 59% sterilisation,
44% the pill, 20% the condom, 15% withdrawal, 12% breast-feeding, 11% natural
methods and 1% injections.

Table 3 shows the

contraceptive methods that would be recommended to a friend, ever used and
actually in use. 42% of the sample would recommend  a friend to use IUD, 19% female
sterilisation
and 14% the pill. Among methods ever used and actually in use: IUD, female
sterilisation, oral pill and withdrawal are the most frequent reported
contraceptives.
The
prevalence of current use of high efficacy methods among currently married
women is 50% with wide variations between the three study areas: 17% in Sora
village, 64% in Kakching and 61% in Irengband.

Use of pill and IUD was

higher among women with secondary or university degree while female sterilisation
was more frequent among the illiterate, and among women with primary degree.
Female sterilisation prevalence increases with age and reaches 23% among women
older than 40 years.

The overwhelming majority

(95%) of current users reported they are satisfied with their choice. Among the
78 women who ever changed contraceptive method, the most important reasons are
side effects (45%) and husband?s opposition (30%) especially among Muslims
(48%) and illiterate (44%) women.

Table 4 shows a logistic regression

model of the risk of not having used any contraceptive method.

Primary, secondary or higher

educational levels, as well as having two or three or more children  increase the prevalence of
contraceptive
usage. The model shows an increased risk for the women living in the Sora
Muslim village.

Figure 1 refers to the

component of unmet need for family planning computed among currently married
women of reproductive age who were not using any contraceptive method at time
of the interview. Total unmet need was 25.6%: 22.2% concerned limiters and 3.4%
spacers.

Risk factors for

contraception total unmet need are: woman?s low educational level (OR=2.96,
C.I. 95%=1.39-6.41) and husband?s low educational level (OR= 2.15, C.I. 95% =
1.19-3.91), living in the Sora Muslim village (OR=7.86, C.I. 95% = 3.51-17.81)
and in the Hindu Irengband village 
(OR=1.79, C.I. 95%= 0.91-3.51) compared to the Hindu Kakching town, not
discussing the choice of a contraceptive method with the husband (OR= 7.36,
C.I. 95%= 3.52-15.52) and, although not statistically significant, being older
than 40 years, having had 4 or more children 
and not knowing the fertile period of the cycle.

Most important sources of

information on family planning were: media (43%), health providers (32%) and friends
(16%).

The main provider of family

planning (66%) was the Kakching Post Partum Centre (KPPC) especially among less
educated women and among women living in Irengband. About 15% of women said
they get their contraceptives from the pharmacy (25% in Kakching, and 30%
among  the highly educated) and 10% from
private medical doctors.

Knowledge and trust in the

health staff are the most frequent reasons behind provider?s choice. Over 75%
of the sample judged positively the following aspects: availability of
contraceptive methods, experienced reception and respect of their privacy and
choices, and technical and relational ability of the staff. Cleanness of the
health centres is the only aspect that rated a very low score (51% of the
sample reported it as bad).

17% of the sample ignores

the available health services offered in the KPPC. Women younger than 25 years
and those older than 40 years, as well as Muslims were at higher risk of
ignoring the available services.

Table 5 shows the available

health services in KPPC known. Immunisation, family planning and antenatal care
are the most frequently mentioned services.
99.8% of the sample reported
they  never received a home visit related
to reproductive health from the KPPC in the previous two years.

DISCUSSION

Socio-demographic
characteristics of the entire sample reflect those reported in the preliminary
report for Manipur
State of the NFHS-2
conducted in 1998-99 (4). The similarity of the two samples in terms of
socio-demographic characteristics supports the validity of the sampling
procedures of this study.

Lack of knowledge of
contraceptive methods can be a major obstacle to their use. In this survey the
percentage of contraceptive methods known by the women was lower compared to
the NFHS ?2 report, probably because women were asked to actively remember
which family planning methods they knew (active memory) while in the NFSH-2
survey they were asked whether they had heard of each of the mentioned methods
(recall memory). In both surveys IUD was the most widely known and ever used
method, followed by female sterilisation which is the most frequent method
among current users.

According to the  NFHS?2 survey in Manipur State

(4), among currently married women, 57% had ever used and 39% were currently
using a method of contraception. IUD was the most popular among ever users
(23%), and female sterilisation among current users (14%).
In our sample, the
prevalence of ever use of contraceptives was 60% and the prevalence who actual
use was 50%, with percentages of IUD (22%) and female sterilisation (14%)
similar to NFHS-2. On the contrary, NFHS?1 estimates were 47% for ever users
and 35% for current users, thus there has been an increase in  current use among the three
surveys.

The largest differentials in

current use, as shown in the logistic regression model reported in tab.5, are
due to woman?s age with a peak for the age class 36-40 years, to woman?s
educational level, and to the number of living children (current use increases
with the increase of family size).

As reported by other studies

(6,7) in this survey education is a key factor influencing contraceptive use.
Ever use of contraceptives among currently married women increases with
education, from 49% among illiterate to 65% among women with primary degree and
to 79% among women with secondary or higher degree. While use of modern methods
tends to increase with education, female sterilisation declines sharply with
educational level.

As found in the NFHS-2

survey (3) and other studies (8,9,10) Muslims have lower use rates (17%) than
Hindus (62%)  even after controlling for
education. 

Unmet need for family

planning is a common phenomenon in developing countries. 25.6% of the
interviewed women in Manipur have an unmet need for family planning, 22.2% for
limiting and 3.4% for spacing. According to the same definitions, NFHS-2
reported a 16 percent of currently married women in India having an unmet need for
family planning. Yet, unmet need varies ranging from 7 percent in Punjab to 36 percent in the
small north-eastern state of
Meghalaya (3). The findings on unmet need for family planning in Manipur from
NFSH-2 (4) are similar (23.6%) to those computed in this study (25.6%). Our
findings could be a slightly underestimate due to the lack of information on ?mistimed
or unwanted pregnancies among the 39-amenorrhoic women of the sample?.

The public medical sector

was the source of contraception for 79% of current users of modern methods in
NFHS-1 (3), for 76% in NFHS-2 (4) and for 66% in this study. The role of the
private sector has consequently increased and reliance on private services is
expected to expand in the future. The international agencies favoured
privatisation and fees for those able to pay. Increasing the role of the
private sector has been part of the explicit policies of many funding agencies
such as the World Bank and USAID (11). Obviously the privatisation of family
planning services will restrict the access of the poor people (12). While the
separation of services according to ability to pay may also pose a challenge
for the quality of services for the poor, even when access is secured.
Moreover, regulation of private services is virtually non-existent and their
interest is determined more by profits than by the desire to fill a need (12).
The enormous increase in the use of sex determination tests in order to abort
female foetuses in India
(13) is an example of the problems associated with the increasing role of the
private sector in service provision.

One of the most important

factors that influence family planning use, is the quality of the health
services, which has been receiving increasing emphasis in the government?s
reproductive and child health care efforts. Quality of care within the Family
Welfare Program was addressed by Koening 
et al (14). They recommend client oriented delivery system in the field
of Family Planning and they denounce that auxiliary nurse midwifes, who should
visit every household within their vicinity to provide family planning services
once every two months, spend limited time with inadequate provision of services
to the population.

An important quality-of-care
indicator that rated very poor was the home visits related to reproductive
health performed by a health practitioner of the KPPC. Out of the total sample,
only one woman received a home visit in the previous two years, although they
were recommended (15). Pro-active offer of health measures through home visits
is one of the best options to reach the resident population, to promote health
and to accredit local health services. It is difficult to create awareness
among people regarding health related issues and door by door visits is one of
the best strategies. That only one household was visited could partly explain
the high percentage of respondents that are not aware of the available services
in KPPC.

In India the family planning programme

has been using mass media for many years to promote contraceptive use. Studies
have confirmed that exposure to mass media messages had a substantial effect on
contraceptive use and on women?s motivation to prevent unwanted fertility (15).

NFHS-2 results indicate that

family planning messages disseminated through the mass media reached 60% of
ever married women in India;
forty-four percent reported having seen a family planning message on
television, and 38% having followed it by radio (3).

In this survey 96% of the

interviewed women reported that TV and radio are good means of providing
information regarding family planning to the population.

CONCLUSIONS

Although this paper shows an

important reduction of the total fertility rate from 5.2 in 1970-72 to 2.9 in
1996-98, it also exposes the failure of health services to meet women?s
reproductive health needs. It indicates a need for effective intervention
strategies, both at the community and the clinical level, backed with efficient
counselling, motivation and provision of services in rural and remote areas.
Although India?s family
planning program is one of the earliest among developing countries, serious
shortcomings in quality of care such as absence of outreach programs and
proactive offer of family planning, restricted choice of methods, limited
information provided to clients, poor technical standards and low levels of
follow-up as well as continuity of care seem to characterise the Indian
practice.

Contraceptive prevalence is
a function of both family planning programmes and socio-economic conditions. We
believe that women?s empowerment policies should guide a gender-aware approach
in national development. The expansion of women?s empowerment, through such
factors as women?s education and economic independence, is central to an
effective resolution of the so-called population problem.

The relation between high

fertility rates and the low decisional power of women has been extensively
discussed in recent decades (16-18). In terms of policy analysis, inter-country
comparisons as well as inter-regional contrasts within a large country like India
showed that women?s empowerment can have a very strong effect in reducing
fertility rate (19,20). Variations within India also show that even cultural
or religious influences on fertility can themselves be swayed.  For example, Kerala, the most
successful
state in India
in reducing fertility has a higher proportion of Muslims compared to the Indian
average. Although cultural and religious influences on the fertility rate, as
found in this survey, cannot be ignored, they are not independent of social and
economic factors and therefore not immutable (9,10,17-20). Although many
religious doctrines have been used to legitimate conflicting opinions on gender
and reproduction, we believe that a population policy taking account of gender
together with better infrastructure and adequate access to high quality health
services could be successful in addressing the causes of persistent poor
reproductive health and the gap between stated fertility preferences and
achieved fertility levels in India as well as in many other developing
countries.

 
 

REFERENCES

1.     
Ministry of Health and Family Welfare (MOHFW). 2000.
National Population Policy, 2000. New
Delhi: Department of Family Welfare, MOHFW.

2.     
National Family Health Survey. A Final Report of the
National Family Health Survey, 1992-93 Bombay,
India:
International Institute for Population Sciences, 1995.
3.     
National Family Health Survey. A Final Report of the
National Family Health Survey, 1998-99 Bombay,
India:
International Institute for Population Sciences, 2000. www.nfhsindia.org

4.     
National Family Health Survey, 1998-99. Manipur
Preliminary Report TNS MODE Private Limited, New Delhi and International Institute for
Population Sciences, Mumbai June 2000. www.nfhsindia.org

5.     
Westoff F.C. and Ochoa L.H., 1993, Unmet need and
the demand for contraception and family planning, Readings in Population Research
Methodology,
Vol. VII (Chicago:
Social Development Center,
UNFPA).

6.     
Retherford, R.D. and B.M. Ramesh.1996. Fertility and
contraceptive use in Tamil Nadu, Andra Pradesh and Uttar Pradesh, National
Family Health Survey Bulletin No 3. Mumbay: International Institute for
Population Sciences; and Honolulu:
East-West Center.

7.     
Pattanaik BK and Kaur K 1999. A correlative study of
factors associated with contraceptive prevalence differentials in rural Uttar
Pradesh; Journal of Family Welfare: 45(1); 53-7.

8.     
Moulasha K. and Rama Rao. 1999. Religion-specific
differentials in fertility and family planning. Economic and Political Weekly
34 (42&43): 3047-3051.

9.     
Donati S., Hamam R., Medda E. Family planning KAP
survey in Gaza Social Science and Medicine 50 (2000) 841-849

10.  Makhlouf
Obermeyer, C. 1992. Islam, women and politics. Population and Development
Review 18 (1), 33-57.

11.  Koivusalo M. and
Ollila E. Making a Health World: Agencies, Actors & Policies in International
Health. Zed Books, London,
1997

12.  Baru R.V.
Reproductive technologies and the private sector: implications for women?s
health Health for the Millions 1(1): 6-8, 1993.

13.  Booth B.E., Varma

M., and Beri R.S. Fetal sex determination in infants in Punjab, India:
Correlation and implications BMJ 309: 1259-1261, 1994.

14.  Koenig MA, Foo

GH, Joshi K. 2000. Quality of care within the Family Welfare Program; a review
of recent evidence. Stud Fam Plann. 31 (1): 1-18.

15.  Ramesh, B.M.,
S.C. Gulati, and Robert D. Retherford. 1996. Contraceptive use in India. National
Family Health Survey Bulletin No 2. Mumbay: International Institute for
 Population Sciences; and Honolulu:
East-West Center

16.  Sen A. 2001.
Gender equity and the population problem. International Journal of Health
Services, Vol. 31 (3); 469-474.

17.  Hartmann, B.
Reproductive Rights and Wrongs: The Global Politics of Population Control and
Contraceptive Choice. Perennial Library, Harper and Row, New York, 1987

18.  Garcia-Moreno, C.
and Claro A, Challenges from women?s health movement: Women?s rights versus
population control. In Population Policies Reconsidered: Health, Empowerment
and Rights edited by G.Sen, A. Germain, and L.C. Chen, pp. 47-61. Harvard
Series on Population and International Health. Harvard University
Press, Boston,
1994.

19.  Doyal L. The
politics of women?s health: Setting a global agenda. Int. J. Health Serv.
26:47-65, 1996.

20.  Ollila E.,
Koivusalo M., and Hemminki E. International actors and population policies in India, with
special reference to contraceptive policies. Int. J. Health Serv. 30 (1);
87-110, 2000.

 
 

 
 

Table 1 ? Socio-demographic
characteristics by study area
  KAKCHING SORA IRENGBAND

N. of interviews 196 (48.3%) 108 (26.6%) 102 (25.1%)

Religion Hindu Muslim Hindu

Age      

<-25 years 33 (16.8%) 29 (26.9%) 18 (17.6%)

26-30 years 33 (16.8%) 31 (28.7%) 21 (20.6%)

31-35 years 39 (19.9%) 18 (16.6%) 20 (19.6%)

36-40 years 42 (21.4%) 11 (10.2%) 28 (27.5%)

>40 years 49 (25.0%) 19 (17.6%) 15 (14.7%)

Woman education      

None 54 (27.6%) 74 (68.5%) 58 (56.9%)

Primary 36 (18.4%) 28 (25.9%) 34 (33.3%)

Second./university 106 (54.1%) 6 (5.5%) 10 (9.8%)

       
Marital status      

Single 37 (18.8%) 10 (9.2%) 13 (12.7%)

Married 155 (79.1%) 85 (78.7%) 87 (85.3%)

Divorced/widowed 4 (2.0%) 13 (12.0%) 2 (1.9%)

Husband education:      

none      

primary 19 (12.2%) 22 (25.3%) 36 (41.8%)

secondary 37 (23.7%) 50 (57.5%) 36 (41.8%)

university 50 (32.0%) 9 (10.3%) 9 (10.5%)

50 (32.0%) 8 (9.1%) 5 (5.8%)

 
 

Table 2 ? Attitude to family

planning

Variables Yes

  n      
%

Do you think it right for  

a married couple to decide how many children to have according to their
wishes and economic situation?

380 93.8

Are you in favour of

family planning?
397   
Is your husband in favour 98.0
of family planning?

321 95.2
Do you believe that TV and
radio are good means to provide information regarding family planning to the
population?
 

Are you planning to use

any contraceptive method in the future? 388   
95.6

Do you discuss with your

husband the choice of a contraceptive method? 122   
39.0

243  72.5

 
 

Table 3 ? Contraceptive
methods recommended to a friend, ever used and actually in use
  Recommended Ever used Actually in use

IUD 169 (41.6%) 99 (28.6%) 91 (22.4%)

Female sterilisation 78 (19.2%) 51 (14.7%) 51 (12.6%)

Vasectomy 9 (2.2%) 4 (1.2%) 4 (1.0%)

Pill 58 (14.3) 37 (10.7%) 24 (5.9%)

Withdrawal 16 (3.9%) 29 (8.4%) 24 (5.9%)

Condom 7 (1.7%) 16 (4.6%) 3 (0.7%)

Breast feeding 4 (1.0%) 3 (0.9%) 4 (1.0)

Calendar method 2 (0.5%) 10 (2.9%) 3 (0.7%)

Don?t know 63 (15.5%)    

None   138 (39.9%) 202(49.8)

Table 4. Risk of not having

used any contraceptive method (logistic regression)

 
Variables                                 n                                  OR                                          CI 95%

Woman?s
age

1                                              29                                1

26-30                                       64                                0.70                                         0.23-2.16

31-35                                       74                                0.41                                         0.13-1.32

36-40                                       79                                0.32                                         0.10-1.08

>40                                          80                                0.49                                         0.14-1.64

Woman?s
educational level

None                                       167                              1
Primary                                    80                                0.44                                         0.22-0.88

Secondary or more                  79                                0.40                                         0.17-0.93

Number
of children suggested to a friend

1-3                                                      171                                 1

>3                                            155                              0.51                                         0.26-1.01

Residence

Kakching                                 155                              1

Sora                                         85                                12.27                                       5.58-28.96

Irengband                                86                                1.40                                         0.67-2.92

 
Number
of children

0-1                                           35                                1

2-3                                           149                              0.10                                         0.04-0.28

>3                                            142                              0.16                                         0.05-0.50

Figure 1 ? Unmet need for

family planning
 

Currently married women of

reproductive age

Who are not using

contraceptives

N=144

Pregnant women                                 Amenorrhoic
women                          Fecund
women

      N=16                                                   
      N=39                                      N=89

 
Wanted pregnancy      Mistimed
pregnancy   unwanted pregnancy              

            N=2                             N=10                           N=4                            

Desire other
children immediately                              Spacers                        Limiters

N=20                                                   N=1                             N=68

Unmet
need population          Unmet need
population                       Total
unmet need

for
spacing                               for
limiting                             population
             N=11                                       N=72
                                                  N=83

Table 5. According to your

knowledge which are the available services in KPPC?
 You don?t know 17.2%

Ante-natal care 42.9%

Post-natal care 15.3%

Family planning 44.6%

Immunisation 49.0%

Other   2.0%

 
 

 
 

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