|
Sign In to gain access to subscriptions and/or personal tools.
|
Contraceptive Services of the District Health System in Tribal and Rural Areas of Visakhapatnam District, Andhra Pradesh
G.R. Varma
G.R. Varma is Assistant Professor, Department of Social Work, MR (PG) College, Vizianagaram 531 205, Andhra Pradesh.
B.V. Babu
B.V. Babu is Deputy Director, Division of Epidemiology, Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar 751 023, Orissa. E-mail: babubontha{at}gmail.com
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.
References
- Anderson, R.M. (1995). Revisiting the behavioural model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10 .[Medline]
[Order article via Infotrieve]
- Bang, R.A., A.T. Bang, M. Baitule, Y. Choudhary, S. Sarmukkadam and O. Tale (1989). High prevalence of gynaecological diseases in rural Indian women . Lancet, 1(8629), 85–88 .[CrossRef][Medline]
[Order article via Infotrieve]
- Becker, G. (1960). An economic analysis of fertility. In: Demographic and Economic Change in Developed Countries (pp. 209–31). Princeton, NJ: Princeton University Press .
- Becker, G. (1976). The economic approach to human behaviour. Chicago: University of Chicago Press .
- Caldwell, J. (1986). Routes to low mortality in poor countries . Population and Development Review, 12(2), 171–220 .
- Census of India (2001). Census of India, Provisional Tables. New Delhi: Government of India .
- Cleland, J. and C. Wilson (1987). Demand theories of the fertility transition: An iconoclastic view . Population Studies, 41(1), 5–30 .[Medline]
[Order article via Infotrieve]
- Coale, A.J. (1973). Age composition in the absence of mortality and in other odd circumferences . Demography, 10(4), 537–42 .[CrossRef][Medline]
[Order article via Infotrieve]
- Easterlin, R. (1975). An economic framework for fertility analysis . Studies in Family Planning, 6(3), 54–63 .[CrossRef][Medline]
[Order article via Infotrieve]
- Easterlin, R. and E. Crimmins (1985). The fertility revolution: A demand supply analysis. Chicago: University of Chicago Press .
- Government of Andhra Pradesh (1997). Andhra Pradesh state population policy: A statement and a strategy. Hyderabad: Department of Family Welfare .
- Gupte, M. (1994). Women's experience with family planning . Health Millions, 2(3), 33–36 .[Medline]
[Order article via Infotrieve]
- Hudelson, P. (1994). Qualitative research for health programmes (No. WHO/MNH/PSF/94.3 Rev. 1). Geneva: World Health Organisation .
- Indian Council of Medical Research (ICMR) (1982). Collaborative study on sequelae of tubal sterilization. New Delhi: ICMR .
- International Institute for Population Sciences (IIPS) (2000). National family health survey (NFHS-2) 1998–99 India. Mumbai: IIPS .
- Lengeler, C., H. Mashinda, D. de Savigny, P. Kilima, D. Morona and M. Tanner (1991). The value of questionnaires aimed at key informants, and distributed through an existing administrative system, for rapid and cost-effective health assessment . World Health Statistics Quarterly, 44(3), 150–59 .[Medline]
[Order article via Infotrieve]
- Ministry of Health and Family Welfare (1998). Family welfare programme in India: year book, 1996–97. New Delhi: Department of Family Welfare .
- Monteith, R.S., S. Richard, C.W. Warren, E. Stanziala, R.L. Unzna and M.W. Obelre (1987). Use of maternal and child health services and immunization coverage in Panama and Guatemala . Bulletin of the Pan American Health Organization, 21(1), 1–15 .[Medline]
[Order article via Infotrieve]
- Mosley, W.H. and I. Sirageldin (1987). The effect of family planning on improving efficiency and effectiveness of health services . Paper presented at the International Conference on Better Health for Women and Children through Family Planning, Nairobi, Kenya, 5–9 October.
- Padmadas, S.S., I. Hutter and F. Willekens (2004). Compression of women/s reproductive spans in Andhra Pradesh, India . International Family Planning Perspectives, 30(1): 12–19 .[CrossRef]
- Pelto, P.J. and G.H. Pelto (1978). Anthropological Research: The Structure of Enquiry. Cambridge: Cambridge University Press .
- Retherford, R.D. and B.M. Ramesh (1996). Family and contraceptive use in Tamil Nadu, Andhra Pradesh and Uttar Pradesh . National Family Health Survey Bulletin, 3: 1–4 .[Medline]
[Order article via Infotrieve]
- Simmons, G.B. (1992). Supply and demand, not supply vs. demand: Appropriate theory for the study of efforts of family planning programmes on fertility. In J.F. Phillips and J.A. Ross (eds), Family planning programmes and fertility (pp. 59–77). Oxford: Clarendon Press .
- Spradley, J.P. (1979). The ethnographic interview. New York: Holt, Rinehart and Winston .
- Srinivasan, K. and S.K. Mohanty (2004). Health care utilization by source and levels of deprivation in major states of India: Findings from NFHS-2 . Demography India, 33(2): 107–26 .
- Taylor, H.C. and B. Berelson (1971). Comprehensive family planning based on maternal/child health services: A feasibility study for a world program . Studies in Family Planning, 2(2), 22–54 .[CrossRef]
- Taylor, C.E., R.S. Sarma, R.L. Parker, W.A. Reinke and R. Faruquee (1983). Child and maternal health services in rural India: The Narangwal experiment. In C.E. Taylor, R.S. Sarma, R.L. Parker, W.A. Reinke and R. Faruquee (eds), Integrated family planning and healthcare (Vol. 2, pp. 33–56). Baltimore, MD: Johns Hopkins University Press (a World Bank Research Publication) .
- Warren, C.W., R.S. Monteith, J.T. Johnson, R. Santiso, F. Guerra and M.W. Oberle (1987). Use of maternal–child health services and contraception in Guatemala and Panama . Journal of Biosocial Science, 19(2), 229–43 .[Medline]
[Order article via Infotrieve]
- Wilopo, S.A. and W.H. Mosley (1992). The relationship of child survival intervention programmes to the practice of contraception: a case study in Indonesia. Baltimore, MD: Johns Hopkins University School of Hygiene and Public Health .
- Winikoff, B. (1988). Women's health: An alternative perspective for choosing interventions . Studies in Family Planning, 19(4), 197–214 .[CrossRef][Medline]
[Order article via Infotrieve]
- World Bank (1996). Improving women's health in India. Washington, DC: World Bank .
Journal of Health Management, Vol. 9, No. 3,
399-419 (2007)
DOI: 10.1177/097206340700900306

CiteULike Complore Connotea Del.icio.us Digg Reddit Technorati Twitter What's this?
|
|