Journal of Medical and Clinical Nursing Studies

Knowledge, Attitude, and Practice Towards Family Planning Among Married Women in ALTI City, AL-Gezira State, Sudan, March-2023

Farah Abdelgalil Elsiddig Dafalla

Faculty of Medicine, University of Gezira, Susan - Gazira state - Wad Medani, Marengan, Sudan

Corresponding author
Farah Abdelgalil Elsiddig Dafalla, Faculty of Medicine, University of Gezira, Susan - Gazira state - Wad Medani, Marengan, Sudan.

ABSTRACT
Background: Researches have shown highest awareness but low utilization of contraceptives making the situation a serious challenge. Most of women in reproductive age group know little or have incorrect information about family planning methods. Even when they know the name of some of the contraceptives, they do not know where to get them or how to use it. These women have negative attitude about family planning, whereas some have heard false and misleading information, the current study aimed in assessing the knowledge, attitude, and practice of family planning among married women in ALTI city.

Justification: Considering the high risk of maternal morbidity and mortality, increased risks of unintended pregnancy, this study aims to explore the knowledge, attitude, and practice (KAP) of family planning (FP) and associated factors among married women living in ALTI city February 2023.

Methods: 45 women were interviewed. Data were collected using a structured and pretested questionnaire, which included study participants socio-demographic characteristics, access to FP services, knowledge, attitude, and practice of FP.

Study Population: This study targeted married women in childbearing age in ALTI city February-2023.

Introduction
Family planning (FP) is defined as a way of thinking and living that is adopted voluntary upon the bases of knowledge, attitude, and responsible decisions by individuals and couples [1]. Family planning refers to a conscious effort by a couple to limit or space the number of children they have with contraceptive methods [2].

Family planning deals with reproductive health of the mother, having adequate birth spacing, avoiding undesired pregnancies and abortions, preventing sexually transmitted diseases and improving the quality of life of mother, foetus and family as a whole [3,4].

The Federal Ministry of Health (FMOH) has undertaken many initiatives to reduce maternal mortality. Among these initiatives, the most important is the provision of family planning at all levels of the healthcare system [5,6]. Currently, short-term modern family planning methods are available at all levels of governmental and private health facilities, while long-term method is being provided in health centres, hospitals and private clinics [6].

Most of reproductive age women know little or incorrect information about family planning methods. Even when they know some names of contraceptives, they dont know where to get them or how to use it. These women have negative attitude about family planning, while some have heard false and misleading information [10,11].

Objectives
General Objective
To assess knowledge, attitude, and practice toward family planning among married women in Alti town February 2023.

Specific objectives:

1. / To assess the Concept of family planning among married women in Alti town.
2. / To asses the attitude of married women toward family planning.
3. / To assess the practice of family planning.
4. / To know does the married women know all the methods of contraceptive.
5. / To assess the knowledge of the complications from this contraception.

Literature Review
Previous Study
Measuring family planning quality and its link with contraceptive use in public facilities in Burkina Faso, Ethiopia, Kenya and Uganda July 2018.

Adolescents and long-acting reversible contraception: lessons from Mexico June 2018. Knowledge and acceptability of long-acting reversible contraception among adolescent women receiving school-based primary care services June 2018.

Whos that girl? A qualitative analysis of adolescent girls views on factors associated with teenage pregnancies in Bolgatanga, Ghana June 2018.

Effects of relationship context on contraceptive use among young women June 2018. Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria June 2018.

Emergency contraception in Albania: A multi-methods qualitative study of awareness, knowledge, attitudes, and practices May 2018.

Postpartum intrauterine device placement: a patient-friendly option May 2018.

ACOG Committee Opinion No. 735: Adolescents and long-acting reversible contraception: implants and intrauterine devices May 2018.

Married womens autonomy and post-delivery modern contraceptive use in the Democratic Republic of Congo April 2018.

Effect of self-administration versus provider-administered injection of subcutaneous depot medroxyprogesterone acetate on continuation rates in Malawi: a randomised controlled trial April 2018.

Factors associated with removal difficulties of etonogestrel-containing contraceptive implants (Nexplanon®) April 2018.

Influence of age on tolerability, safety and effectiveness of subdermal contraceptive implants April 2018.

Client satisfaction and decision making amongst females visiting family planning clinics in Hyderabad, Pakistan February 2018.

Recommendations for contraception: examining the role of patients age and race February 2018. Developing mHealth messages to promote postmenstrual regulation contraceptive use in Bangladesh: participatory interview study January 2018.

Pill Magic The Economist January 2018.

Factors associated with non-adherence to instructions for using the Nestorone ®/ethinyl estradiol contraceptive vaginal ring January 2018.

Effects of immediate postpartum contraceptive counseling on long-acting reversible contraceptive use in adolescents December 2017.

Knowledge and opinions of postpartum mothers about the lactational amenorrhea method: the Turkish experience December 2017.

Methodology
Descriptive Cross-Sectional Facility Based Study
45 women were interviewed. Data were collected using a structured and pretested questionnaire, which included study participants socio-demographic characteristics, access to FP services, knowledge, attitude, and practice of FP.

Study Population
This study targeted married women in childbearing age in ALTI town February-2023. Study area: Alti rural hospital, Alti city, Gazira state, Sudan

Inclusion and Exclusion Criteria
Inclusion Criteria
1/ married women in childbearing age in ALTI town. Exclusion criteria
1/ All women outside ALTI town. 2/ All unmarried women.
3/ Older women in menopause age. Ethical Approval
Verbal consent from selected samples without mentioning their name for keeping their privacy Sample size and Sample Technique
N= 450    10 % of N =45    N=45

Sample Technique
Quantities Random technique.

KAP Study
I adopted it on old questionnaire and adjusted to my research. Knowledge: 8 questions
80 % if true    : good knowledge
60 % - 79 %    : average knowledge
Less than 60%.     : Poor knowledge

Results
The study showed that the overall proper knowledge, attitude and practice of women towards family planning (FP) was 63%%, 40%, and 41% respectively. Factors associated with the practice of FP were residence, marital status, educational status, age, occupation, and knowledge, and attitude and number of children. In this study, the level of knowledge and attitude towards family planning was relatively low and the level of family planning utilization was quite low in comparison with many studies. Every health worker should teach the community on family planning holistically to increase the awareness so that family planning utilization will be enhanced. Besides, more studies are needed in a thorough investigation of the different reasons affecting the non-utilizing of family planning and how these can be addressed are necessary

Discussion
The results of the present study showed that 63% of study participants had good knowledge, 41% had favourable attitude, and 40% had good practice towards family planning.

It has also found that women who completed primary & secondary education were practicing family planning than those who were uneducated (64% and 20.6%) respectively. This finding was in line with a study done in Jemma, Ethiopia [9]. This might be due to the fact that women who were able to read and write would think in which FP activities are useful to be economically, self- sufficient and more likely to acquire greater confidence and personal control in marital relationships including the discussion of family size and contraceptive use.

This study showed that, age of the study participants had an association with practicing FP. Those reproductive age women is whose age >30 years were practicing family planning better than those do whose age <18 years. This finding was in line with a study done in India [20]. This might be due to the reason that, when age increases mothers awareness; attitude and practice towards family planning may increase. In addition, as age increases the chance of practicing sexual intercourse increases and as a result they would be interested to utilize family planning in one or another way. The current study also showed that knowledge and attitude of reproductive age women were related to FP utilization. Those reproductive age women who had good knowledge were utilized FP better than from those who were less knowledgeable.

Those participants with favourable attitude were practicing better than those who had unfavourable attitude.This is might be because knowledge and attitude for specific activities are the key factors to start behaving and maintaining it continuously.

Conclusion & Recommendation
In conclusion The study showed that married women in ALTI city where amarginalized group in terms of family planning and that their overall capacity for family planning, practices and professional practices were low. Contraception was unpopular among the women of Altay, mainly due to the lack of educational qualifications and awareness of family planning. In addition, there were no family planning initiatives and campaigns in ALTI city. Therefore, strengthening family planning interventions and increasing access to basic health services and education is indispensable to improve maternal and child health.

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