Exploring women’s knowledge, attitudes and practices about family planning in a rural area of Timor-Leste

Introduction: Family Planning (FP) has been recognised as an important public health intervention for reducing the reproductive health burdens occurring among women. Timor-Leste has been reported as having the highest rate of maternal mortality (557 per 100,000 live births) and fertility rate (4.2 per women childbirth) among the other Southeast Asian countries. Family planning has been justified as systems which provide support to reproductive women or couples to achieve positive goals; to prevent pregnancy, and the control and planning of the spacing, and number of child births. FP initiatives are aimed at reducing poverty, improving maternal and child health, and decreasing maternal fertility and mortality rate in Timor-Leste. However, poor use or a lack of family planning in Timor-Leste contributes to unmet FP needs, with higher rates of maternal mortality and fertility rate in the country, with only 24% of married women using FP. Aim of research: The aim of this study was to explore rural women’s knowledge, attitude and practice in relation to utilisation of family planning in Timor-Leste. Methodology: Using a qualitative descriptive approach, the study sought to identify the different factors which may influence women’s perceptions and experience regarding decision making related to family planning. The study conducted three focus group discussions with 25 married women aged between (18 – 45 years) in rural areas of Suai-Covalima district of Timor-Leste. Their data was thematically analysed. Finding and discussion: This study identified that there are positive perceptions in favour of family planning use. However, there was a lack of knowledge about family planning contraception methods. FP had not been fully understood by the women participants and this had contributed to women and their family having misunderstandings about side-effects and impact on infertility. Timorese culture, specifically the patriarchal society, strongly influenced FP decision making. To help empower women education on FP should include men so that future FP decisions are more likely to be shared. Traditionally, Catholic teaching has not favoured modern FP. However, the women in this study were not influence by the Church, which may have been a particularity of this specific group of women. Health literacy was seen as central to improving understanding of FP in terms of its benefits and side-effects. In addition, enhancing health providers’ access to up to date FP information and training will help increase future family planning utilisation