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Knowledge, attitude and practice of EC in the State of Kerala
– Dr P Chandrapal, HRRC, JMC, Trivandrum

Kerala is one of the states where health indices are relatively better, current use of contraception is high (64%) and unmet need is only 12% (national 16%). Still there is a need for EC in Kerala. In most families, husbands are away or abroad and need for long-term contraception is minimal. Availability of EC will help prevent unplanned pregnancies and improve the reproductive health of the women. Eighty women coming for MTP were surveyed about their contraceptive knowledge. This table depicts their knowledge matrix.

Table : Contraceptive Knowledge Matrix


Method IUD OCP Saheli Condom Tubectomy Vasectomy Others

Knowledge 96% 90% 15% 92% 99% 98% 9%

efficacy (100%) 30% 24% 4% 24% 28% 28%

Can fail rarely 4% 2% 1% 2% 21% 21%

Can fail often 50% 55% 5% 44% 38% 38%

Correct usage 84% 63% 6% 93% 99% 98%

It reveals that almost 90% women had knowledge about existing contraceptive methods available in NFWP. Above 90% of these clients had knowledge about condoms, tubectomy and vasectomy, 54% were of the opinion that the advantage of condom is for delaying the first child, while 66% said IUD and pills are used for spacing the second child and 97% opined that tubectmy and vasectomy are for limiting their family size. Knowledge about centchroman (Saheli) was poor (12/80) and only 5 knew how it is used.

Emergency Contraception

Out of these 80 clients, nobody had any knowledge about the Emergency Contraception. Very few had heard about some pills that can be used for abortion and some of them had tried some pills for abortion after missing a period. They were not sure when these pills were used and from where the pills had been obtained. After explaining what emergency contraception was, majority of these clients had favourable attitude towards emergency contraception and expressed the indication to opt for EC in future, in case they needed, so that MTP/abortion could be avoided. Whether EC is safe or effective was not known to many. majority had doubts about the efficacy of various contraceptive methods. Opinion was that each couple should know about EC, its methods and dosage, as easy accessibility and availability of EC will attract couples for its use. Majority said that contraception should be made available only to married couples.

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