DOES UNMET NEED OF FAMILY PLANNING DIFFER IN WOMEN OF URBAN AND RURAL AREAS OF CENTRAL INDIA?

BACKGROUND Women with unmet need are those who are fecund and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the next child. The concept of unmet need points to the gap between women's reproductive intentions and their contraceptive behaviour. In this study, an attempt has been made to find out the unmet need of contraception in urban and rural women population and a comparative study to understand the different factors affecting this unmet need of contraception. MATERIALS AND METHODS This study was conducted in Rural & Urban field practice areas under the administrative control of Department of Community Medicine, Indira Gandhi Government Medical College, Nagpur from a period of January 2014 to June 2014. It was a community based cross sectional study. Women were interviewed in a house to house survey from adopted villages of urban and rural health training centres by a pre-tested structured questionnaire. Data was analysed using statistical software Epi Info version 6, year 2009. Total 290 women were enrolled in the study. RESULT The prevalence of unmet need was found to be 43.8% in urban (spacing 57.8%, limiting 42.2%) and 42.3% in rural areas (spacing 70.5%, limiting 29.5%). The commonest reasons for not using contraceptives in urban area were low perceived risk of pregnancy (42.1%) followed by health concerns about harmful effects (35.9%) and in rural area it was lack of awareness of contraceptive methods (44.8%) and non-cooperation from family members (12%). On applying chi square test, the difference was found to be statistically significant (p<0.005). Moreover, our study also revealed the association of determinants like education, duration of marriage and parity with unmet need. Surprisingly, illiterate urban women had high prevalence of unmet need (6.1%) as compared to rural women (2.2%). With increasing duration of marriage and parity, unmet need was found to be decreasing (p<0.001). Overall a trend of completing family and opting for permanent method of contraception instead of using temporary contraceptives was seen in rural areas. CONCLUSION The high unmet need warrants an effective health promotion program to encourage the uptake of contraceptives especially in women of low education and low parity.