Unintended Pregnancies among Married Women in Sindh Pakistan: Role of Lady Health Workers

Background: Unintended pregnancies, which pose substantial risks to both mothers and children, account for 24% of all pregnancies in Pakistan. Door to door visits and service provision by lady health workers (LHWs) may be related to the reduction of such pregnancies, particularly in rural areas. This study aimed to determine the association of knowledge about Lady Health Visitors (LHWs) and door to door visits by LHWs with unintended pregnancies among rural women.Methods: We conducted a community-based, nested case-control study of 800 pregnant women, identified from the database of an active surveillance mechanism, which registers and follows all pregnant women in the catchment area. Women who were enrolled during the first trimester and reported their pregnancy to be unintended were selected as cases from the database (n=200). Women whose pregnancies were intended served as controls (n=600). Logistic regression was used for analysis.Results: Knowledge about LHWs and door to door visits by LHWs had no significant association with unintended pregnancies OR=1.11(95%CI: 0.74-1.66) and OR=1.03 (95%CI: 0.67-1.58) respectively. Other factors associated with unintended pregnancy were higher knowledge and use of family planning, maternal age, having at least one son, spousal opposition to family planning and limited spousal education.Conclusion: Results suggest that Family planning strategies need to target old aged women and address the role of men in addition to improving coverage and quality of Family planning services