TMSS Medical College Journal

Background: Bangladesh is a small country in Asia with a large population of about 160 million and is ranked the seventh most populous country in the world. Its Total Fertility rate (TFR) per woman is 2.3 while in Asia it is 2.2 Objective: This descriptive type of cross sectional survey was carried out to evaluate the contraceptive practice in married women of rural arcas of Bogra. Methods: The study was done in 300 married women of reproductive age from 15 to 49 years of rural area who attended the Family planning unit of Rafatullah Community Hospital (RCH) attached to TMSS Medical College from July 2014 to June 2015. Result: Out of 300 married women of reproductive age, 200 were practicing some methods of contraception while 100 were not using it. Oral contraceptive pill (OCP) was the commonest method of contraception used by 100 women (50%), followed by condoms 40 (20%), Injectable 20 (10%). Implant 10 (5%), Tubectomy 10 (5%), Traditional methods 10 (5%) (withdrawal, rhythm method) and periodic abstinence 10 (5%) but none was found to use TUCD. The reasons for non user of contraceptives were intention to have more children, pressure from husband, religious believe and worry about the complications of contraceptive use. Among the 200 contraceptive users 160 (80%) experienced different types of side effects such as menstrual irregularities 100 (50%), change or gain in body weight 40 (202%) and other effects 20 (10%). Conclusion: Mass awareness about the benefit of small family, acceptance of “Two child family norm” and use of contraceptive of choice should be encouraged.

Family planning methods are considered to be an important way to control the rapid population growth of Bangladesh with the main focus being women. Of the world population 75% live in the developing countries characterized by high fertility rate, high maternal and infant mortality and low life expectancy'. Female population is about 60.26 million in Bangladesh and married women of reproductive age group constitute 51.7% of total female population and more than 500000 Women dic every year duc to pregnancy related complications in the developing countries®®. Although the average age of marriage is 18 years for female and 27 years for males, the rural females tend to marry even before the age of 16 years resulting in early pregnancy. The fertility rate in the country has declined from 192 births per 1000 women in the 2004 BDHS to 143 births per 1,000 women in the 2014 BDHS and the Contraceptive Prevalance Rate (CPR) (which is the proportion of women of reproductive age and who are using or whose partner are using a contraceptive method at a given point of time) is 62% but in most developed country like USA has 71% for all the methods.** Under the health population and Nutrition Sector Development Program (HPNSDP), Bangladesh aims to increase overall use of contraception to 72% by 2016 (MOHFW, 2011) and if the target is fulfilled, Total Fertility Rate (TFR) will be 2.0 (HPNSDP, target 2016) and Maternal Mortality Rate (MMR) will also reduce. The unmet need for family planning in Bangladesh has decreased from 14% in 2011 to 12% in 2014. The HPNSDP results framework has also set a target to reduce unmet need for family planning services to 9% by 2016 (MOHFW, 2011). In our country, adoption of family planning and uptake of contractive methods remain still low due to social, cultural, religious believe, desire for more children and fear of side effects for contraceptive use. As Bangladesh is a male dominated country, the application of contraceptive methods regarding reproductive decision are being taken by the male and the husband's approval of contraceptive use increase the contraceptive prevalance rate, while disapproval leads to decrease the rate. So, contraceptive practices and awareness largely depend on co-operation of husband, female education and autonomy and also educational status of spouse.