Myths and misconceptions about contraceptive methods: an exploratory qualitative study amongst married youth of Karachi

Introduction Youth is emphasized as an important phase of life because it makes up the personality forming years of an individual. According to UNFPA, the age between 15-24 years is considered as youth. Pakistan presently has one of the largest cohorts of young people in its history, with around 36 million people between the ages of 15 and 24 years which has grown rapidly parallel to the total population of the country over the last few decades Currently, the rapid population growth of the country is a major concern as it is leading to increased pressure on social and economic resources. One of the main reasons for high population growth is almost stagnant contraceptive prevalence rate (CPR) of 30% which country is struggling for at least two decades. More worryingly, the CPR among youth is only 17.4 percent. The low CPR amongst youth could be due to myths and misconceptions about family planning methods, which may raise concerns about the side effects and effectiveness of different methods. There are many examples of myths and misconceptions about contraceptives such as injections being responsible for causing cessation of menstruation and cancer of ovaries. The actual fact is that cessation of menstruation is due to high level of the hormones in the blood caused by contraceptive injections and as soon as the levels come down, menstruation resumes. In addition, the injection rather pi otects the women from the cancers of ovaries and uterus. Another aspect of low use of contraceptives is its relation with unwanted pregnancies ending up in unsafe abortions, morbidities and mortality. Though there is not much data about female youth, the overall maternal mortality ratio in Pakistan is 276 per 100000 live births with around 700,000 women per year facing one or more morbidity during pregnancy, childbirth and postpartum period. Many of these women are in the age group of 15-24 years as the mean age of marriage for girls in Pakistan is 17.9 years. Family planning could be one of the interventions helping in saving women\u27s lives through proper spacing between the children. Many of these women are youth. Study Objectives To explore the perceptions regarding myths and misconceptions of contraceptive methods and to understand the effect of these myths and misconceptions on use of contraceptive methods among married youth aged 18-24 years in Karachi. Methodology The study was conducted in the city of Karachi, Pakistan from July to September 2010 in two Union Councils (UC2 and UC3) of Korangi Town. Qualitative exploratory study design was adopted and focus group discussions (FGDs) with the youth and in-depth interviews with FP service providers were conducted to know about perceptions and experiences about low use of family planning methods amongst married youth. Purposive sampling was done for the selection of males and females as participants for FGDs who were 18-24 years old having at least one live child. For the in-depth interviews, family planning service providers were selected in consultation with local Lady Health Workers and those suggested by participants of FGDs. Analysis For analysis purpose, FGDs and in depth interviews were transcribed and translated into English. Content analysis was conducted manually. Coding of data into nodes, sub nodes was done and themes were derived around individual contraceptive methods. Triangulation was done with the responses from the male and female youth and FP service providers. Results The study demonstrated that use of family planning methods amongst married youth was quite low. In addition to the misperceptions about family planning in general, main reasons identified behind it was myths and misconceptions about FP methods among youth. A main misperception among male youth was that family planning is meant for females only. In addition, both males and females misperceived that youth should not use any contraceptive until they have two or three children. The foremost myth was that most of the contraceptive methods cause sterility in both males and females. There were misconceptions against the individual methods of contraception. Some of the myths about condoms were that it causes infections, backache and headache in males. IUCD was perceived to result in putrefaction, perforation and cancer of the uterus and it could also move up in the abdomen and heart. Most of the men and women expressed that injections and OCPs cause excessive weight gain and swelling of body and in breastfeeding women, milk secretion decreases. Similar findings were also validated by vu family planning service providers, that youth of the area are having these perceptions. The myths were more prevalent among FGDs participants with low educational status. Conclusion Our finding suggests that though married youth resident of squatter settlement of Karachi appear to be inclined towards family planning, the actual use of contraceptives is low. The potential reasons behind this are the myths and misconceptions about different contraceptive methods. Major factors contributing to these myths and misconception could be poor education, certain cultural and religious beliefs and apprehensions about the use and side effects of family planning methods. There are some important policy implications like counseling of the couple through peers and well trained family planning service providers to remove these myths and misconceptions from the minds of youth. Moreover friend, families and mothers in law could play a substantial role in removing the misconception