Needs, beliefs and barriers for contraceptive use among women in a low resource setting in Tamil Nadu: a qualitative study

Background: The decline in fertility rate based on the National Health Profile is attributed to the choice of permanent sterilisation as the preferred method of contraception among Indian women. The uptake of spacing methods has declined over the years in many parts of India related to low awareness about options other than sterilisation. Hence understanding the needs, beliefs and barriers of women regarding contraceptive use can identify the factors behind their choice of contraceptive methods. This study aims to explore the needs, beliefs and barriers of women in using different methods of contraception in a low-resource area of urban Vellore, Tamil Nadu.Methods: A qualitative study was conducted in three underserved areas of urban Vellore served by the secondary care hospital of a private academic institution. A descriptive qualitative method was chosen. Focus group discussion was carried out among study participants. Thematic analysis was used to analyse data.Results: The need for contraceptive use was felt after completing the families determining the type of method chosen. Fear of impending side-effects of commonly available spacing methods of contraception limited their use. The results highlight the forceful use of intra-uterine device among study participants reflecting the incentive-based family planning services implemented in most Indian states.Conclusions: Our study reinforces that neither the availability of contraceptives nor forceful implementation of policies will increase the utilisation of contraceptives. There is a need for community-based education on the indications, types and side-effects of reversible methods of contraception

Determinants of quality of life among people with epilepsy attending a secondary care rural hospita in south India

Context: Epilepsy is associated with profound physical, psychological, and social consequences. Aims : To assess the quality of life (QOL) among people with epilepsy attending the outpatient department of a secondary care hospital and to determine the various social and demographic factors affecting it. Materials and Methods: The QOL of 100 people with epilepsy attending the outpatient department of a community-based secondary care hospital was assessed using the WHOQOL-BREF (WHOQOL: World Health Organization QOL) questionnaire. Univariate analysis and logistic regression was done to determine the factors associated with poor QOL. Results: The QOL scores for all the domains ranged between 15.7 and 74.55 with a mean score of 51.49 [standard deviation (SD) 12.3]. The mean scores in the physical, psychological, social, and environmental domains were 55.7, 37.92, 57.75, and 50.56, respectively. Age more than 30 years [odds ratio (OR): 4.33, 95% confidence interval (CI): 1.73-10.82], female gender (OR: 2.90, 95% CI: 1.16-7.28), and currently married (OR: 3.82, 95% CI: 1.21-12.11) were the factors significantly associated with lower QOL scores. Conclusions: The QOL among people with epilepsy was lower in the psychological domain. Age more than 30 years, female gender, and being married were identified as the factors associated with poor QOL scores among people with seizure disorders