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Effects of Family Planning on Women's Health in Rural Pakistan
1. USAGE OF FAMILY PLANNING PRACTICES AND ITS
EFFECTS ON WOMEN HEALTH:
(A STUDY OF RURAL VICINITIES IN KHANEWAL, PAKISTAN)
Supervised By
Dr. TEHMINA SATTAR
By
SOBIA RIAZ
ROLL NO
32
DEPARTMENT OF SOCIOLOGY
BAHAUDDIN ZAKARIYA UNIVERSITY, MULTAN
PAKISTAN
2. INTRODUCTION
Background
Family planning is the planning of when to have children and the use of birth
control and other techniques to implement these plans and other techniques commonly
used including sexual education, prevention and management of sexually transmitted
infections, preconception counseling and management and infertility management.
According to the WHO, Family planning allows individuals and couples to anticipate and
attain their desired number of children and the spacing and timing of their births. It is
achieved through use of contraceptive methods and the treatment of involuntary
infertility. Women's ability to space and limit their pregnancies has direct impact on their
health and well-being as well as on the outcome of each pregnancy. (Tortolero, 2005)
3. The Importance of Family Planning
Promoting the uptake of contraceptives and family planning is important, first of
all, since 20 percent of all married women have an unmet need for family planning. This
implies that they either wish to space the birth of the next child (9%), or to stop having
children all together (11%), but are not using any form of contraception (Cleland, 2014).
Family planning can contribute to women empowerment as it enables them to exercise
free and informed choice. At the same time, family planning can result in direct health
benefits. The rapid succession of pregnancies of many Pakistani women involves
significant health risks for both mother and child. If contraceptive use would increase, the
number of unintended pregnancies and unsafe abortions, an important cause of
maternal mortality, could be reduced (World Health Organization, & Unicef. 2014).
4. Key Facts of Family Planning
◦ 214 million women of reproductive age in developing countries who want to avoid
pregnancy are not using a modern contraceptive method.
◦ Some family planning methods, such as condoms, help prevent the transmission of HIV
and other sexually transmitted infections.
◦ Family planning / contraception reduces the need for abortion, especially unsafe
abortion.
◦ Family planning reinforces people’s rights to determine the number and spacing of
their children.
◦ By preventing unintended pregnancy, family planning /contraception prevents deaths
of mothers and children.
◦ Family planning allows people to attain their desired number of children and determine
the spacing of pregnancies. It is achieved through use of contraceptive methods and
the treatment of infertility (this fact sheet focuses on contraception).
5. Effects of family planning
◦ Benefits of family planning / contraception
Promotion of family planning and ensuring access to preferred contraceptive methods
for women and couples is essential to securing the well-being and autonomy of women,
while supporting the health and development of communities. (World Health
Organization 2014)
6. Preventing Pregnancy-Related
Health Risks in Women
A woman’s ability to choose if and when to become pregnant has a direct
impact on her health and well-being. Family planning allows spacing of pregnancies
and can delay pregnancies in young women at increased risk of health problems and
death from early childbearing. It prevents unintended pregnancies, including those of
older women who face increased risks related to pregnancy. Family planning enables
women who wish to limit the size of their families to do so. Evidence suggests that women
who have more than 4 children are at increased risk of maternal mortality. By reducing
rates of unintended pregnancies, family planning also reduces the need for unsafe
abortion. (Moos, 2008)
7. Reducing infant mortality
Family planning can prevent closely spaced and ill-timed pregnancies and
births, which contribute to some of the world’s highest infant mortality rates. Infants of
mothers who die as a result of giving birth also have a greater risk of death and poor
health. (World Health Organization 2014)
8. Helping to prevent HIV/AIDS
Family planning reduces the risk of unintended pregnancies among women
living with HIV, resulting in fewer infected babies and orphans. In addition, male and
female condoms provide dual protection against unintended pregnancies and against
STIs including HIV. (Halperin, 2009)
9. Empowering people and enhancing
education
Family planning enables people to make informed choices about their sexual
and reproductive health. Family planning represents an opportunity for women to pursue
additional education and participate in public life, including paid employment in non-
family organizations. Additionally, having smaller families allows parents to invest more in
each child. Children with fewer siblings tend to stay in school longer than those with
many siblings. (Malhotra, 2002)
10. Reducing Adolescent Pregnancies
Pregnant adolescents are more likely to have preterm or low birth-weight
babies. Babies born to adolescents have higher rates of neonatal mortality. Many
adolescent girls who become pregnant have to leave school. This has long-term
implications for them as individuals, their families and communities. (Thaithae, 2011).
11. Slowing Population Growth
Family planning is key to slowing unsustainable population growth and the
resulting negative impacts on the economy, environment, and national and regional
development efforts. (World Health Organization 2014)
12. Who Provides Family Planning /
Contraceptives?
It is important that family planning is widely available and easily accessible
through midwives and other trained health workers to anyone who is sexually active,
including adolescents. Midwives are trained to provide (where authorized) locally
available and culturally acceptable contraceptive methods. Other trained health
workers, for example community health workers, also provide counselling and some
family planning methods, for example pills and condoms. For methods such as
sterilization, women and men need to be referred to a clinician. (Olukoya, 2001)
13. Contraceptive Use
Contraceptive use has increased in many parts of the world, especially in Asia
and Latin America, but continues to be low in sub-Saharan Africa. Globally, use of
modern contraception has risen slightly, from 54% in 1990 to 57.4% in 2015. Regionally, the
proportion of women aged 15–49 reporting use of a modern contraceptive method has
risen minimally or plateaued between 2008 and 2015. In Africa it went from 23.6% to
28.5%, in Asia it has risen slightly from 60.9% to 61.8%, and in Latin America and the
Caribbean it has remained stable at 66.7%. (Ross, 2002)
14. Global Unmet Need for
Contraception
◦ 214 million women of reproductive age in developing countries who want to avoid
pregnancy are not using a modern contraceptive method. Reasons for this include:
◦ limited choice of methods;
◦ limited access to contraception, particularly among young people, poorer segments of
populations, or unmarried people;
◦ fear or experience of side-effects;
◦ cultural or religious opposition;
◦ poor quality of available services;
◦ users and providers bias
◦ Gender-based barriers.
15. WHO Response
WHO is working to promote family planning by producing evidence-based
guidelines on safety and service delivery of contraceptive methods, developing quality
standards and providing pre-qualification of contraceptive commodities, and helping
countries introduce, adapt and implement these tools to meet their needs. (Mohllajee,
2005)
16. Significance of the Study
The rationale of the research will be to identify factors that family planning
among women and children health how these factors effect. To maintain proper
spacing of pregnancies. The widespread adoption of family planning represents one of
the most dramatic changes of the 20th century. Moreover, the outcomes of this study
would provide the DHQ khanewal.
17. Research Question
◦ What is role of financial factors related with family planning practices?
◦ What are the repercussion of family planning practices on women and child health?
◦ What is the role of family planning practices in fluctuating the family size?
◦ What is the role of family planning practices in effecting future fertility intensions of
married females?
18. Objective of the Study
◦ To find out the Role of financial factors related with family planning practices?
◦ To find out the repercussion of family planning practices on women and child health?
◦ To find out the Role of family planning practices in fluctuating the family size?
◦ To illustrate the Role of family planning practices in effecting future fertility intensions of
married females?
19. Hypothesis of The Study
◦ There is a positive relationship between family planning practices and financial factors.
◦ There is a positive relationship between family planning practices and mother health.
◦ There is a positive relationship between family planning practices and Child Health.
20. Literature Review
(Nichter, 1989) In this paper we address a topic crucial to the field of family planning,
yet rarely identified as a subject for research: cultural perceptions of fertility. Data from two
ethnographic contexts will be presented: South Kanara District, Karnataka State, India and
Low Country, Southwest Sri Lanka. A case study which sparked our curiosity in the cultural
perception of fertility will initially be introduced, followed by a general discussion of the
anthropological literature on fertility and conception in India. In most of this literature,
conception is discussed in relation to systems of descent. Moving beyond textual sources, we
will present field data on folk notions of fertility collected in both South India and Sri Lanka
during the course of medical anthropological research. In the Sri Lankan context, attention will
additionally be paid to how health ideology affects family planning behavior; more
specifically, for whom a “safe period” constitutes a popular traditional mode of fertility
control.2 Turning to family planning programs in Sri Lanka, we will suggest that the provision of
fertility cycle education for the 25–35 year old age cohort could result in a more effective
usage of safe period with condoms as a popular means of birth control. While most members
of this group have expressed a marked desire for birth postponement and spacing, they
presently underutilize modern family planning methods.
21. (Duze, 2006) This paper examines the linkages between socioeconomic
characteristics, attitudes, and familial contraceptive use. Past family planning programs
in Nigeria have been mainly directed toward women. However, because northern
Nigeria (and to a slightly lesser extent all of Nigeria) remains a patrilineal society
characterized by early age at marriage for women, men at present continue to
determine familial fertility and contraceptive decisions. Consequently, at least for the
time period relevant for current policy planning purposes, the willingness of husbands to
adopt or allow their spouses to use family planning practices will determine the pace of
fertility reduction in Nigeria. The results suggest that there is high knowledge of
contraceptives, a generally negative attitude towards limiting family size for economic
reasons, and consequently low rates of contraceptive use. Respondents who were
willing to use contraceptives were more willing to use them for child spacing purposes
than explicitly for limiting family size. Path-analytic decompositions of the effects of
predictor variables show that education has the largest direct and total effects on
contraceptive use while specific knowledge of contraceptives has the smallest direct
and total effect (as well as a paradoxical negative direct effect when education is
included in the model). Most importantly, attitudes have the largest direct effect on
contraceptive use with a standardized coefficient value of 781. Thus, since knowledge of
contraceptive is already high among even those respondents who do not use
contraceptives, the attitudes of males are especially important for decisions about
contraceptive use. As a result.
22.
23. Stages
◦ Stage 1: Through the use of simple random sampling will be selected one THQ hospital.
◦ Stage 2: Through the use of simple random sampling will be selected one RHC.
◦ Stage 3: Through the use of simple random sampling will be select the area of one lady
health worker who has 1500 population because 4 lady health worker attach one RHC
Haveli Koranga.
◦ Stage 4: then will be Appling the formula of Morgan & Yameen to will be selected the
sample size.
24. Research Methodology
In this chapter of research methodology is defined as the scientific methods or
procedures used for the collection of data and information. This present study of
quantitative research involves the use of quantitative data, to understand and explain
social phenomena, quantities researchers can be found in many disciplines and fields,
using a variety of approaches. Methods and techniques. Quantitative data sources
include observation and participant observation (fieldwork), interviews and
questionnaires, documents and texts, and the researcher's impressions and reactions. ."
The objectives of this chapter is to explain the tools, Techniques and operationalization of
the key concept used in the study. Various tools and techniques employed for the
collection, analysis and interpretation of the data.
25. Universe
Universe of our study will be whole District khanawal. Khanawal one DHQ 4 THQ 9
RHC and 87 BHUS. Will be selected RHC havaile kouranga as it covers larger population
and deals are sectors of community. For example families and upper middle, middle
middle, lower middle class.
27. Target Population
Will be Selected a rural area of khanawal covered by RHC havaile Kouranga as
it has members of all communities low income middle upper class educated and none
educated our target will be 250 females of child baring age from OPD patients of RHC
havili Koranga and via home vitisits this area.
28. Sampling Frame
Sampling frame will be listed of families and couples of child bearing which will
provide my district authorities after permission total population of the areas was 1500 was
child bearing age and randomly selected 250 people of child bearing age.
29. Sampling Size Technique
The research requires sampling keeping in view point that a sample is a part of
population representing the whole. What is of utmost importance in that sample should
be unbiased selected universe of rural area district Khanewal teshil Kabirwala. A sample
of 250 respondents were selected through convenient sampling.
30. Tools for Data Collection
The research technique adopted for the problem under study will be
questionnaire method. A questionnaire schedule as research instrument will be used
developed for the purpose of collection data. Questionnaire refers to number of
questions formulated according to the requirements and relevance to the research
being conducted. It will planned that questionnaire schedule are to be filled in by the
researcher during face-to-face contents. Questionnaire schedule will be formulated on
the basis of information drawn from the review of the relevant literature and knowledge
of the indicator designed for the concepts used in the hypothesis. The questionnaire
schedule will be constructed to facilitate the respondents having lower educational level
and helpful to the gather relevant in questionnaire schedule will be preferred for data
collection because of the following main reasons.
31. References
◦ Alkema, L., Kantorova, V., Menozzi, C., & Biddlecom, A. (2013). National, regional, and global rates and trends in contraceptive prevalence
and unmet need for family planning between 1990 and 2015: a systematic and comprehensive analysis. The Lancet, 381(9878), 1642-1652.
◦ Cleland, J., Harbison, S., & Shah, I. H. (2014). Unmet need for contraception: issues and challenges. Studies in family planning, 45(2), 105-122.
◦ Dey, S. (2014). A study on family planning acceptance among slum dwellers in Shillong, Meghalaya. Indian Journal of Community Health, 26(1),
111-114.
◦ Duze, M. C., & Mohammed, I. Z. (2006). Male knowledge, attitude, and family planning practices in Northern Nigeria. African Journal of
Reproductive Health, 10(3), 53-65.
◦ Gupta, N., Katende, C., & Bessinger, R. (2003). Associations of mass media exposure with family planning attitudes and practices in
Uganda. Studies in family planning, 34(1), 19-31.
◦ Halperin, D. T., Stover, J., & Reynolds, H. W. (2009). Benefits and costs of expanding access to family planning programs to women living with
HIV. Aids, 23, S123-S130.
◦ Malhotra, A., Schuler, S. R., & Boender, C. (2002, June). Measuring women’s empowerment as a variable in international development.
In background paper prepared for the World Bank Workshop on Poverty and Gender: New Perspectives (Vol. 28).
◦ Mohllajee, A. P., Curtis, K. M., Flanagan, R. G., Rinehart, W., Gaffield, M. L., & Peterson, H. B. (2005). Keeping up with evidence: a new system for
WHO’s evidence-based family planning guidance. American journal of preventive medicine, 28(5), 483-490.
◦ Moos, M. K., Dunlop, A. L., Jack, B. W., Nelson, L., Coonrod, D. V., Long, R., ... & Gardiner, P. M. (2008). Healthier women, healthier reproductive
outcomes: recommendations for the routine care of all women of reproductive age. American journal of obstetrics and gynecology, 199(6),
S280-S289.