Choice of postpartum contraception and its socio-demographic and cultural determinants

Background: Postpartum contraception is essential for avoidance of unwanted pregnancy and for adequate spacing between two pregnancies. There are many socio demographic and cultural factors that influence the choice of contraception in rural community in India. Third trimester of pregnancy is ideal time for counselling the women regarding breast feeding and contraception. The objective of the present study was to find out the choice of postpartum contraception among antenatal women and the socio demographic and cultural determinants that influence this choice.Methods: Six hundred pregnant women were interviewed regarding their choice of postpartum contraception during their antenatal visit in third trimester of pregnancy, using a pre-validated and pre-tested brief questionnaire. The choices were compiled and analysed to draw conclusions.Results: Postpartum sterilization was choice of 30% of multiparous women. Primi-parous women either opted for barrier contraception like condom (10%), intrauterine contraception (9%) or oral steroidal pills (8%). The progesterone injectable contraceptives and centchroman each were chosen by 2% respondents. There was strong influence of education, parity, sex of the living children on the choice of contraception. It was observed that 40% of women did not want to use hormonal pills and intrauterine contraceptives due to strong age old misbelieves associated with them.Conclusions: Women in rural area prefer permanent method of contraception in the form of tubectomy operation after having desired number of children. There is insufficient spacing between pregnancies due to either non-use of contraception or inconsistent use of temporary method of contraception. More than 50% women are dependent on the husband regarding the choice and practice of contraception. The level of education of woman, age at marriage, socio economic class, desired sex combination of children are strong determinants of choice of contraception

Perception of Tuberculosis Treatment in Tribal area of Akole Block of Ahmednagar, Maharashtra

Introduction: The family’s knowledge and perception of any disease are essential conditions to formulate effective health policies to combat the disease. The tribal populations of India are likely to live discrete hard to reach geographic areas with their common cultural and socio-religious beliefs which are quite different from the general population. The present study was aimed to evaluate attitude with regards to the treatment of tuberculosis among the tribal community in Akole block of Ahmednagar District, Maharashtra. Methods: This was a qualitative cross-sectional study conducted in the tribal community. The study participants were subjected to a well-structured questionnaire which contained questions about the demographics and attitude of the patients concerning tuberculosis. Results: Twenty patients were included in the study, of which 12 (60%) were males while 8 (40%) were females. Majority of study participants opined that the treatment of tuberculosis should be free (19, 95%), agreed that they should disclose their illness to other people (17, 85%), were scared (12, 60%). Only 6 participants felt of being discriminated in the community. It was regarded by most of the participants that pregnant women won’t be affected by tuberculosis (15, 85%). Most of the study participants approached Private practitioner (11, 55%) and Public health care centre (8, 40%) initially, but preferred treatment from Governmental facility (18, 90%) upon the private facility (2, 10%). Conclusion: There has been a change in attitude and treatment-seeking behaviour of people of Tribal community with regards to tuberculosis. The community needs to be educated with regards to tuberculosis to alleviate fear and eliminate misconceptions. Control of TB in tribal areas continues to face some significant challenges

Role of peri-partum counselling in improving choice of postpartum contraception

Background: The choice of a contraceptive method is a complex decision. Health care providers have an important role in providing information and supporting patients' decision making about contraceptive choices through counselling. Non-use of contraceptive methods, use of less effective methods, and incorrect and inconsistent use of methods underlie the high frequency of unintended pregnancy. Prospective cross-sectional study was undertaken to study the role of peri-partum counselling in improving choice of postpartum contraception at Pravara Rural Hospital Loni, Ahmednagar, Maharashtra, India.Methods: Four hundred and fifty women in third trimester of pregnancy were individually counselled about the postpartum contraception, using educational material and pamphlets. The choice of postpartum contraception before and after the counselling was noted.Results: Among primi gravidas, the most favored choices for postpartum contraception before counselling were condom (25%) and lactational amenorrhea method (12%). In the same group of women, the post counselling choices were PPIUCD (45%), condom (17%) and interval IUCD (7%). Among multi-gravida, the most favored choices for postpartum contraception before counselling were postpartum tubal ligation (26%), condom (20%) and lactational amenorrhea method or calendar method (17%). In the same group of women, the post counselling choices were postpartum tubal ligation (32%) PPIUCD (12%), condom (8%).Conclusions: The study supports the usefulness of good quality counselling both with respect to the interpersonal relationship between the patient and the provider and quality of information that is provided during counselling. Postpartum intrauterine contraceptive device (PPIUCD), a long acting reversible contraceptive, will fulfil the felt need of postpartum contraception in near future

Perception of Tuberculosis Treatment in Tribal area of Akole Block of Ahmednagar, Maharashtra

Introduction: The family’s knowledge and perception of any disease are essential conditions to formulate effective health policies to combat the disease. The tribal populations of India are likely to live discrete hard to reach geographic areas with their common cultural and socio-religious beliefs which are quite different from the general population. The present study was aimed to evaluate attitude with regards to the treatment of tuberculosis among the tribal community in Akole block of Ahmednagar District, Maharashtra. Methods: This was a qualitative cross-sectional study conducted in the tribal community. The study participants were subjected to a well-structured questionnaire which contained questions about the demographics and attitude of the patients concerning tuberculosis. Results: Twenty patients were included in the study, of which 12 (60%) were males while 8 (40%) were females. Majority of study participants opined that the treatment of tuberculosis should be free (19, 95%), agreed that they should disclose their illness to other people (17, 85%), were scared (12, 60%). Only 6 participants felt of being discriminated in the community. It was regarded by most of the participants that pregnant women won’t be affected by tuberculosis (15, 85%). Most of the study participants approached Private practitioner (11, 55%) and Public health care centre (8, 40%) initially, but preferred treatment from Governmental facility (18, 90%) upon the private facility (2, 10%). Conclusion: There has been a change in attitude and treatment-seeking behaviour of people of Tribal community with regards to tuberculosis. The community needs to be educated with regards to tuberculosis to alleviate fear and eliminate misconceptions. Control of TB in tribal areas continues to face some significant challenges