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Muralidhar K, Nishimura H, Coursey K, Krupp K, Jaykrishna P, Srinivas V, Madhivanan P. Knowledge and practice of family planning among pregnant tribal women in Southern India: an observational study. Contracept Reprod Med 2024; 9:2. [PMID: 38217011 PMCID: PMC10785510 DOI: 10.1186/s40834-023-00259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 11/28/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND There are over 700 Scheduled Tribes (ST) living in 30 Indian states. As with other indigenous groups across the world, Indian ST have some of the poorest infant and child health outcomes of any communities in India. A child born to an ST family is 19% more likely to die in the first month of life and has a 45 percent risk of dying in their first year compared with other Indian populations. Research suggests that early conception, high fertility, and low use of family planning methods are large contributors to these disparities. METHODS A cross sectional survey in Kannada was conducted among 303 pregnant tribal women in Mysore, India after obtaining informed consent. Univariate and multivariable analyses were carried out to determine the demographic and psychosocial factors associated with knowledge of contraceptive methods using Stata 14.0. RESULTS There was widespread knowledge about female sterilization, while only 39.3% of women reported hearing about one or more forms of temporary contraception, and 36.3% knew where to get them. The largest proportion of women had heard about copper-T (33.0%), followed by oral contraceptive pills (23.8%), condoms (11.9%), and injectables (4.6%). Only 2.7% of women reported ever using any form of temporary contraception. Results from the multivariable logistic regression indicated that knowledge of at least one form of temporary contraception was linked to higher age (adjusted odds ratio[AOR]: 1.09; 95% CI: 1.02, 1.17), greater number of years of marriage (AOR: 0.90; 95% CI: 0.85, 0.96), and last birth in a government facility (AOR: 3.67; 95% CI: 1.99, 6.82). CONCLUSIONS The study revealed poor knowledge and utilization of temporary contraceptive methods among a tribal population in rural Mysore, India. Interventions aiming to increase knowledge of contraceptive options are important for birth spacing in this population and should target younger women and those without contact with government health facilities.
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Affiliation(s)
- Kiranmayee Muralidhar
- Public Health Research Institute of India, Mysore, Karnataka, India.
- JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
| | - Holly Nishimura
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kate Coursey
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Karl Krupp
- Public Health Research Institute of India, Mysore, Karnataka, India
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245209, Tucson, Arizona, 85724-5209, USA
| | | | - Vijaya Srinivas
- Public Health Research Institute of India, Mysore, Karnataka, India
| | - Purnima Madhivanan
- Public Health Research Institute of India, Mysore, Karnataka, India
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, P.O. Box 245209, Tucson, Arizona, 85724-5209, USA
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Villalobos A, Estrada F, Hubert C, Torres-Ibarra L, Rodríguez A, Romero I, Schiavon R, Campero L. Sexual and reproductive health among adolescents in vulnerable contexts in Mexico: Needs, knowledge, and rights. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002396. [PMID: 37910453 PMCID: PMC10619806 DOI: 10.1371/journal.pgph.0002396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023]
Abstract
Ensuring sexual and reproductive health, and rights for adolescents entails the prevention of early pregnancies, which are widely recognized as a public health problem. Based on the ecological model for early pregnancy, this article identifies the healthcare requirements for preventing unintended adolescent pregnancies in predominantly indigenous communities in Chiapas, Mexico. Using a convergent parallel mixed-methods study design, we surveyed adolescents (12-15 years old) and health personnel, organized focus groups with adolescents and their parents, and conducted in-depth interviews at the individual, family, school and community levels. Results showed that adolescents recognized their right to receive sexuality education (64.5%) as well as information on contraceptive methods (53.0%), with indigenous language speakers and individuals living in overcrowded households less likely to know about these rights. Parents of adolescents knew little about contraception and pregnancy. School teachers lacked necessary tools for offering comprehensive sexuality education. A traditional, patriarchal perspective predominated among participants, fostering gender inequalities. In conclusion, it is essential to implement multifocal strategies under a human-rights, intercultural, and health-equity approach. Special attention should be directed to the spheres in which adolescents interact, and efforts should focus on improving knowledge, empowering adolescents, and enhancing their access to sexual and reproductive health resources.
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Affiliation(s)
- Aremis Villalobos
- Center for Population Health Research, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | | | - Celia Hubert
- Center for Population Health Research, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Leticia Torres-Ibarra
- Center for Population Health Research, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Alejandro Rodríguez
- Center for Population Health Research, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | - Irma Romero
- Center for Population Health Research, National Institute of Public Health, Cuernavaca Morelos, Mexico
| | | | - Lourdes Campero
- Center for Population Health Research, National Institute of Public Health, Cuernavaca Morelos, Mexico
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Sreedevi A, George LS, Varughese SA, Najeeb SS, Aravindan L, Anvar R, Georgy S, Menon VB, Sathish S, Nedungadi P. Menstrual practices, fertility intentions and decision-making regarding family planning by women belonging to various indigenous groups of Wayanad- A qualitative study. J Family Med Prim Care 2023; 12:1214-1221. [PMID: 37636171 PMCID: PMC10451590 DOI: 10.4103/jfmpc.jfmpc_1799_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 03/05/2023] [Accepted: 03/27/2023] [Indexed: 08/29/2023] Open
Abstract
Background Among the different social groups in India, the tribes are the most vulnerable and socioeconomically deprived. The tribal population is distinct from the general population in terms of their unique cultural, traditional, and reproductive health practices. Therefore, the aim of the study was to conduct an exploratory analysis of the menstrual practices, fertility intentions and decision-making regarding family planning among various indigenous tribal women of Kerala. Methods A qualitative study was conducted among the tribal women of Wayanad district using the grounded theory approach. Using purposive sampling 16 in-depth interviews, 6 key informant interviews and 2 focus group discussion (FGD) s were conducted. Interview guides were developed for in-depth interviews, key-informant interviews, and focus group discussion through extensive formative research with literature reviews and taking expert opinions. The interviews were conducted among women of reproductive age and their spouses hailing from Paniya and Kurichiya tribal groups in Kalpetta and Mananthavady areas of Wayanad district. Key informant interviews were also conducted among doctors, pharmacists, and community health workers. Results The key findings of this study were the identification of a web of cultural practices pertaining to menstruation among persons of tribal origin. Unique traditional practices such as "Valayamapura" and "Thirandukalyanam" were reported and most of the women were keen to carry it forward. Fertility desires among couples were found to be not significantly influenced by any gender bias. Decision-making regarding family size were found to be on a mutual agreement between the spouses. The tribal women were aware of modern spacing methods, but preferred natural methods of contraception for temporary use and tubectomy as the permanent method. Non-contraceptive use of oral contraceptive pills (OCP) was prevalent, and the majority took it occasionally for postponement of menstruation to attend various social events. Conclusion Menstruation-related myths and practices are prevalent and require educational interventions. More focus needs to be given to male sterilization as the permanent method of contraception. The study underscores the need to address gender inequalities and attitudes among tribal populations and to increase efforts to promote higher education among the tribes for busting cultural myths and practices.
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Affiliation(s)
- Aswathy Sreedevi
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Leyanna S. George
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Steffi A. Varughese
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Shana S. Najeeb
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Lakshmi Aravindan
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Rithima Anvar
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Sneha Georgy
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Vishnu B. Menon
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Syama Sathish
- Department of Community Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
| | - Prema Nedungadi
- Director, AmritaCREATE, Amrita Vishwa Vidyapeetham, Cochin, Kerala, India
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Mahobia A, Choudhari SG. Social Security Measures of Reproductive Health Among Adolescents in India: A Narrative Review. Cureus 2022; 14:e28546. [PMID: 36185839 PMCID: PMC9517583 DOI: 10.7759/cureus.28546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 08/29/2022] [Indexed: 11/05/2022] Open
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