Date of Award

Winter 8-1-2018

Document Type

Thesis

Degree Name

M.Sc. Nursing

Department

Department of Community Health Nursing

First Advisor

Mrs. Ansuya

Second Advisor

Mr. Vinish

Abstract

ABSTRACT A descriptive study to assess the knowledge, attitude, utilization of contraceptives and barriers for non-utilization among the married women residing in the selected slums of Udupi district” was conducted by Mrs. Sowmya in partial fulfillment of the requirement for the degree of Master of Science in Nursing at Manipal College of Nursing, Manipal, MAHE. The objectives of the study were to assess the knowledge on contraceptives among married women residing in the slums, to determine the attitude of married women towards contraceptives, to find the utilization of contraceptives by the married women residing in the slums, to assess the barriers for non-utilization of contraceptives among married women, to find the association between knowledge on contraceptives and selected demographic variable, to find the association between attitude towards contraceptives and selected demographic variable, to find the relationship between knowledge and attitude towards contraceptives. The conceptual frame work of the study is based on the Andersen and Newman framework of health service utilization. The research approach used in the study was survey approach. Research design used was descriptive survey design. The sample of the study was 323 married women in the reproductive age group residing in the selected slums of Udupi district. Slums for the study were selected by simple random sampling technique and subjects were selected by purposive sampling technique. Abstract Manipal College of Nursing, MAHE, Manipal vii The data collection instrument used for the study were demographic proforma, knowledge questionnaire on contraceptives, attitude scale towards contraceptives, questionnaire on utilization of contraceptives, dichotomous questionnaire on barrier for non utilization of contraceptives. To ensure Content validity, the instruments were submitted to seven experts. The instruments were pretested among 5 married women residing in the slum and reliability was established by interviewing 20 married women. Reliability of the knowledge questionnaire was 0.77, attitude scale was 0.79 and barriers for non-utilization were 0.98. Pilot study was conducted among 30 married women in Nittur slum and the study was found feasible. Administrative permission obtained from Institutional Research Committee, MCON Manipal, Head of institution, MCON Manipal, Institutional Ethical committee KH, Manipal- 749/2017, CTRI registration- CTRI/2018/01/011572, District Health Officer, Informed written consent of participants. The data were collected from 23rd December 2017 to January 18th 2018. The data were collected through interview method by using structured questionnaire from 323 subjects. The data on barriers for non-utilization was collected from the married women those who are not using any contraceptives. After explaining subject information sheet and getting informed consent, the data was collected by the participants through interview method. The data were analyzed using SPSS version 16. Out of 323 participants 129 (39.9%) of women were in the age group of 25-31 years, majority 308 (95.4%) belongs to Hindu religion, 159(49.32%) had a primary education, 154 (47.7%) husbands had primary education. Majority 176(54.5%) women were unskilled worker, 315(97.5%) of husbands were unskilled workers, 162 (47.5%) women had monthly family income Abstract Manipal College of Nursing, MAHE, Manipal viii >15000 rupees. Majority 126 (39.0%) women duration of marriage is 6-10 years, 110(34.1%) of women had two children, 190(58.8%) of women belonged to nuclear family. Most of them 286(88.5%) of women had previous information about contraceptives, the main source of information were doctors and nurses. Majority 193(59.8%) of women had average knowledge, 122(37.5%) had poor knowledge, only 9(2.7%) of women had good knowledge on contraceptives. Out of 321 (99.4%) of women had positive attitude towards contraceptives, 2(0.6%) had negative attitude towards contraceptives. Among 323 married women 198(61.3%) are not using any type of contraceptives. Only 125(38.7%) women are using one or the other method of contraceptives, 92(73.6%) of the women adopted Tubectomy, 18(14.4) of adopted copper T, 10(8%) of them are using condom, 5(4.0%) of them are using injectable contraceptive. Out of 125 married women using contraceptives one was experienced irregular menstrual cycle. Out of 323 married women 10(3.1%) were used contraceptives in the past, out of 10 women 6 of them were used copper T, 2 of them were used contraceptive pills, one of them used injectable contraceptives, one of them used condom. Out of 10 women 6(60%) of women experienced side effects such as vaginal bleeding 3(50%), weight gain 1(16.7%), irregular menstrual cycle 2(33.3%). Among 198 samples, Majority 61.3% of women were not using contraceptive and leading barrier accounting for low non-use of contraceptives were fear of side effects (65.2%), followed by desire for girl/ boy child (31.3%), husbands’ disapproval (25.8%), lack of knowledge about contraceptive methods (25.3%), and lack of personal interest to use contraceptives (23.2%). discomfort for contraceptive use, 23(11.6%) of women had discomfort to use contraceptives. Abstract Manipal College of Nursing, MAHE, Manipal ix There was association found between number of living children and attitude towards contraceptives (χ2 =9.205 p=0.008). There was no association found between knowledge and selected demographic variables. There was a positive correlation between knowledge and attitude which is statistically significant (ρ=0.256, p=0.001). It infers that knowledge has influence on their attitude towards contraceptives. The study population was limited to 5 selected slums of Udupi district. Hence the study findings cannot be generalized. However, this study has implications to nursing practice, research, education and administration. The prevalence of contraceptive use in this study was low. Education, encouragement of health education programs and involvement of the spouse and in-laws might promote contraceptive utilization in slum dwellers.

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