Exploring the Individual and Interpersonal Obstructive Factors Affecting Contraceptive Usage among Married Fertile Women in Rural Vicinities of Multan District, Pakistan

Abstract

Family Planning is the most effective tool to reduce maternal morbidity and mortality during pregnancy. Contraceptive usage is the widely accepted method for birth spacing among married women in reproductive age span. In Pakistan, contraceptive prevalence is low in rural areas as compared to urban milieus. For exploring the present research phenomenon, the ethnographic research design was used to determine the subjective meaning-making of participants about the study phenomenon. Informal Discussions (IDs), N=20 In-Depth Interviews (IDIs), and N=6 Focus Group Discussions (FGDs) were conducted in two adjacent villages X and Y of Multan, Pakistan. Interview guide and discussion guide were used to explore the responses of the participants through thematic analysis. The present research results illustrated that the causes behind disinclination for contraceptive usage prevailed at two major levels, i.e. individual and interpersonal. The individual-level obstructive factors comprised of age of the married women, education level of husband, the economic cost of contraceptive usage, and adverse effects of contraceptives on the health of married females. Furthermore, the inter-personal level factors comprehended of husband opposition towards contraception usage, and discussion about contraception usage with husband as an anti-normative act. In conclusion, the orthodox, misogynistic, and gender-biased normative structure snatched the reproductive autonomy of married women. Resultantly, the women changed their fertility preferences and avoided birth spacing through contraceptive usage. Government intervention through social media awareness campaigns, provision of monthly incentives, and facilitation of “health card” could be used to ensure high prevalence of contraceptive usage among married women in the study locale.