Perceptions and experiences of men and women towards acceptability and use of contraceptives in underserved areas of Karachi, Pakistan: A Midline Qualitative Assessment of Sukh Initiative, Karachi Pakistan

Abstract

Background: Family planning (FP) is an essential component of Sustainable Development Goals (SDG) and contributes directly to SDG targets 3.7 and 5.6. In Pakistan, contraceptive use has remained stagnant over the past 5 years. This change has been very slow when compared to the FP2020 pledge. The Sukh initiative project was conceived and implemented to alleviate these challenges by providing access to quality contraceptive methods in some underserved areas of Karachi, Pakistan. A qualitative study was conducted to understand the perceptions and experiences of men and women towards acceptability and contraceptive use.Methods: A qualitative study was conducted at ten Sukh stations located in four towns of Karachi. Focus group discussions (FGDs) were conducted with Married Women of Reproductive Age (MWRA) and married men who received FP services through the Sukh initiative. Study participants were purposively sampled for focus group discussions (FGDs). Interview data was manually transcribed and analyzed using thematic analysis.Results: A total of 20 FDGs (Men=10 FGDs; MWRA=10 FGDs) were conducted. Three overarching themes were identified: (I) Appropriateness and means to promote contraceptive use; (II) Equity and Accessibility to contraceptives; and (III) Perspective on available FP services. Generally, both men and women were informed about FP methods but women were more cognizant of FP information. The Door to Door services by community health workers in Sukh initiative areas was largely appreciated both by women and men as it has made the accessibility and availability of the information and services easy. Women suggested that the Sukh initiative should bring some strategies that can help men broaden their perspective towards FP. The study informed that the men feel left out from the FP programs. Therefore, male participants expressed keen interest in initiatives for men in their communities that would cater to their FP needs.Conclusions: This qualitative study provided a unique opportunity to understand the perceptions of men and women towards the phenomena of contraceptive use. The study identified the need for trained and qualified female and male healthcare providers and well-established health facilities alongside door-to-door services.

Drivers of Family Planning Services Utilization in Pakistan: A Literature Survey and Recent Trends in Contraceptive Use

“…Ali & White, 2005;Asif, Pervaiz, Afridi, Abid, & Lassi, 2021;Douthwaite & Ward, 2005;Fikree, Razzak, & Durocher, 2005;Kiani, 2003;Mahmood & Ringheim, 1996;Mubarik, Jameel, & Khalil, 2016;R. Mustafa, Afreen, & Hashmi, 2008;Naqvi, Hashim, Zareen, & Fatima, 2011;Nasir, Tahir, & Zaidi, 2010;Raheel, Karim, Saleem, & Bharwani, 2012;Sajid & Malik, 2010;Saleem et al, 2020;Siddiqui et al, 2020;Stephenson & Hennink, 2004a). According to all of these studies, education plays a vital role in making family planning decisions.…”

“…Studies showed the positive relationship among female's decision-making power and the usage of family planning methods (Douthwaite & Ward, 2005;Fikree et al, 2005;Mahmood & Ringheim, 1996;G. Mustafa et al, 2015;Naqvi et al, 2011;Nasir et al, 2010;Saleem et al, 2020;Stephenson & Hennink, 2004b).…”

“…Families with higher number of living children are more likely to opt family planning methods as compared to the families with smaller family size (S. Ali & White, 2005; S. M. Ali, 1989;Amin, Johar, Mashhadi, & Shams, 2020;Asif & Pervaiz, 2019;Bibi et al, 2008;Feyisetan, 2000; S. U. Khan & Awan, 2011;Mahmood & Ringheim, 1996;Nasir et al, 2010;Raheel et al, 2012;Saleem et al, 2020;Sharan & Valente, 2002;Siddiqui et al, 2020).…”