Contraceptive Services of the District Health System in Tribal and Rural Areas of Visakhapatnam District, Andhra Pradesh

Abstract

The present article reports communities’ acceptance of and perceptions on contraceptive services provided by district health system among tribal and rural population of Andhra Pradesh, India. The study has been conducted in two tribal and two rural developmental blocks of Visakhapatnam district. Both quantitative and qualitative data were collected from married women of the age up to 40 years. Around 72 per cent of tribal women and 85 per cent of rural women had used or were currently using contraception. Currently the number of contraception users are higher among rural than tribal areas. The predominant method among both tribal and rural areas is female sterilisation, that is, tubectomy. These results suggest that despite the increased emphasis on contraceptive choice and on spacing methods in government programmes, female sterilisation continues to dominate the method mix, and spacing methods still account for only a negligible amount of contraceptive use. A majority of women received information on family planning from government health staff. Similarly, government institutions are the main source of contraception in both tribal and rural areas. Though, the quality of pre- and post-contraception care among the community is very important, the perceptions of the community on contraception care are not at desirable levels. Also, remarkably higher number of women who have undergone tubectomy (33 per cent of tribal and 45 per cent of rural women) had experienced various problems. These findings emphasise the continuing need to strengthen post-operative care and counselling for sterilisation acceptors. Some of the indicators of contraceptive service outreach are poor among the Scheduled Tribes as well as in rural population. Thus, the centralized top-down planning of healthcare services could not facilitate the tribal and rural people to articulate needs for services.