final decision in home about fertility

Majority of the respondents their husbands had a final decision in their homes on fertility 23(52%) and lastly http://www.inosr.net/inosr-experimental-sciences/

7(16%) respondents, final decision was madebyboth.

Fig 3: Number of modern contraceptive methods known

Number of modern contraceptives known

Majority of the respondents knew more 3 contraceptive methods 20(45%) and lastly 4(9%) knewonlyonecontraceptive http://www.inosr.net/inosr-experimental-sciences/

Fig. 4; Column graph : Type of modern contraceptives methods known. n=44

Majority of the respondents knew oral pills 15(34%) and least known methods were 4(9%) diaphragmandfemalesterilization4(9%)respectively

Source of information on modern contraceptives

Majority of the respondents, source of informationwasbyhealthfacility22(50%) and 6(14%) respondents got their information from radios which was the leastsourceofinformation. http://www.inosr.net/inosr-experimental-sciences/

Fig. 6;Pie charts: Distribution of respondents by information related to attitude towards modern contraceptives

Discussed family planning with husband

Majority of the respondents never discussed family planning methods with their husbands 32(72%), 6(14%) discussed with their husbands once or twice and 6(14%) discussed family planning methodswiththeirhusbandsmoreoften

Practice towards modern contraceptives among women attending Bwera family planning clinic. n=44

Fig. 7; Column graph: Family planning methods in use

When interviewed, majority of the respondents used injectable 20(45%) and least used family planning method by respondentswastubligation0(0%). http://www.inosr.net/inosr-experimental-sciences/

Fig.8; Bar graph: Reasons for contraceptive use

Majority of the respondents used family planning methods for birth spacing 32(73), and 0(0%) respondents used family planning methods because they completedtheirfamilies.

Discussion

The study included 44 respondents of which all of them were women of reproductive age attending family planning clinic at Bwera general hospital in kasese district. Majority of the respondents that participated were in the age group of 36-45 , 25(57%), classification according to the level of education 20,(45%) attended secondary school,morethanhalf oftherespondents who participated 25,(57%) were from Anglican religion or protestant and marital status , three quarters of the respondents who participated 35(80%) weremarriedandmostoftheparticipants , three quarters were from the Bakonzo tribe 28(64%) and this is more than ½ of the participants, and according to occupation , majority of the participants werecivilservants20(45%).

Socio demographic variables

Socio demographic variables are among factors influencing the individuals decision on contraception and fertility

This is in line with studies done by [8,9, 10] and majority of the participants aged between 36-45 ,25 (57%). Since marriage and child bearing in rural Africa starts early.Thissimilarstudywasdoneby[11]. This observation indicates sizeable number of participants was in the age in which they could have already several number of children and could need them tohavecontraceptivesforchildlimiting. Results in table1: also indicate that good literacy level for the study population and hence more likely possessing good ability to understand message in health promotion materials (i.e , posters , brochures), including those involving family planning .This is in line with studies done by [12]. About 34% of the sampled population had primary education and 45% of women of reproductive age had secondary education.

Religious affliation; To some extent reflecting existence variations in religious affiliations/ideology in a study population and hence possibly differences in beliefs and practices towardsmoderncontraceptives. Thisisin linewithstudiesdoneby[13,14,15].

Simillarly although majority of the study participants were Bakonzo, however a considerable proportion of them (40%) http://www.inosr.net/inosr-experimental-sciences/ were coming from other tribes and hence possibly existence of culutural differences in a study population which may in turn influence their beliefs and practices towards modern contraceptives and this is in line with studies done by [16,17,13,14,15,16,17]

Information related to fertility

These observation reflect preferences for higher number of children by noticeable proportion of families in a study population, a situation which may hinder uptake of modern contraceptives and hence lowered pace for reducing fertility in the area. Preference for higher number of children by African rural families was also reported in other parts of Africa [18; 19,20,21,22,23,24,25,26,27]

Although a considerable proportion of respondents preferred higher numbers of children (5 and more), proportion of respondents that preferred low (0-2) to medium(3-4)numberofchildrenwasalso substantial. However studies have indicated that lack or low decision autonomyby women on family matters in a house hold could be a barrier for achieving a desirednumberof children in alifetime.

This is similar to the studies done by [23,24,25,26,27,28,29,30,31,32,33,34]. In this regard , when respondents asked on whom has final decision on fertility in family (i.e when to have next birth and number ofchildreninafamily), majority of them indicated that final decision to be done by husbands, a situation which might negatively influence womens’ decision on contraception and their dreams on wanted number of children inlifetimeinastudypopulation.

Knowledge of women towards contraceptives methods

Good knowledge and positive attitude towards an intervention or anew practice by a target groups are among the key determinants for adoption

[27,28,29,35,36,37]. In this study, there wasaninterestonascertainingknowledge of women of reproductive age in study population on modern contraceptives. When asked if theyare aware of modern contraceptives, overwhelming majority indicatedto be aware of the methods 95% and over 45% knew at least three methods. The most commonly known methods were pills, followedbyinjection, Norplant and IUD. This observation supports earlier findings in otherparts of Uganda and Africa in which it was noted that most women were aware of modern contraceptives despite low adoption rate [30,31,32,33,38,39,40,41,42,43,44,45,46,4 7,48,49,50].

Similar views among study participants was also noted in a study by [34] in Ethiopia. Main source of information on modern contraceptives were Health facilities such as hospitals and health centres

Attitude of women toward family planning methods

According to the table of results above, participants had positive attitude towards modern contraceptives. However despite positive attitude of modern contraceptives by a considerable proportion of women in a study population, its use can be limited by negative attitude of husbands towards modern contraceptives as it has been observedinotherstudiesinotherpartsof Africa[35,36,37,38,40,41,42,43,44,45,46,4 7,48,49,50]. Results from the table indicate that 66% of the participants shows that their husbands disapproves modern contraceptives and this is almost 2/3 of the total participants and 72% never discuss modern family planning with their husbands. A situation which may hinder uptake of modern contraceptives by women in a study population

Practice of women towards family planning methods

In practice women show to use the modern contraceptive methods and according to the results in column graph 1resultsin thea study,most participants haveoptedtheuseofinjectablesfollowed by oral pills and most participants in this study showed up to have used Barrier methods at first coitus especially male condoms followed by oral pills and this showspreferenceofthesemethodsdueto the side effects of other family planning methods. However according to table 11, most participant reasons for not using http://www.inosr.net/inosr-experimental-sciences/ family planning methods is partner opposition and a situation which may limit or hinder uptake of family planning by women in the study population, [39] andaccordingtothestudythepercentage ofuseaveragely25%inthestudywhichis less far away from the national target of 60% [30], indicating more effortis needed to increase contraceptive use in the study population.

Conclusion

Knowledge of modern contraceptive is high in a study population. Substantial proportion of women had positive attitude towards modern contraceptives and hence more room for increasing modern contraceptive use in population, though negative attitude of husbands towardsmoderncontraceptiveandlackof spousal communication on family planning could be a limitation. Likely hood of being current users of modern contraceptives by a woman increased increased with increase in the level of education , having higher number of living children , spousal communication on modern contraceptives i.e frequently talking/discussing family planning methods among spouse), women participation in decision making regarding fertility in a family , husbands approval of family planning methods especially the modern contraceptives and having positive attitude towards modern contraceptives or family planning methods. For example thinking of benefits of family planning methods out weighingnegativeeffects.

Recommendations

Based on findings of this study, to en hence contraceptive use by women of reproductive age in a study population, it is recommended that education to the community on importance of having smallerfamiliesshouldbeintensified. Furthermore, campaigns to empower women such as emphasis on their education,encouraginggender balanceby changing community attitude towards position status of women in a house hold and in a society as a whole should be strengthened. This would improve their participation in house hold decisions including those related to fertility and contraceptiveuse.

Campaigns to raise awareness on importance of modern contraceptives or family planning methods among males (husbands) should be emphasized and should go along with those involving women. This could be through involvement of males in family planning programmes. More education/counseling services to women on how to handle/deal with side effects associated with various moderncontraceptives.

Campaigns against myths and beliefs that negatively affect use of modern contraceptives in the study should be initiated.

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