The objectives of this study were to provide information on knowledge, attitude and practice on family planning, to estimate unmet need for contraception and to investigate accessibility and quality of the health services providing contraceptives among a representative sample of women in reproductive age living in Kakching Sub-Division, Manipur State India.

A probabilistic sample of 407 women in reproductive age was selected from the electoral rolls. A total of 406 women (99.8% response rate) were interviewed in their houses by trained health workers. 196 women (48.3%) were interviewed in the Hindu Kakching town, 108 (26.6%) in the Muslim Sora village and 102 (25.1%) in the Hindu Irengband village. Attitude to family planning resulted very positive: almost all the interviewed and slightly fewer husbands were in favour of family planning, almost 90% requested more information about family planning and 83% was in favour of sex education in school.

Challenging active memory on knowledge of contraceptive methods, 72% of women mentioned IUD, 59% sterilisation, 44% the pill, 20% the condom, 15% withdrawal, 12% breast-feeding, 11% natural methods and 1% injections.

Among contraceptive methods ever used and actually in use: IUD, female sterilisation, oral pill and withdrawal were the most frequent reported methods. The prevalence of the use of high efficacy methods among the currently married women was 50% (17% in Sora , 61% in Irengband and 64% in Kakching).

Total unmet need for family planning computed among married women in reproductive age who were not using any contraceptive method at time of the interview resulted 60% (53% concerned limiters and 7% spacers).

The prevalent family planning providers resulted: the Kakching Post Partum Centre (KPPC) (60%), the pharmacy (15%) and private medical doctors (10%).

Even though home visits have been warmly recommended, the interviewed reported they did never receive a home visit related to reproductive health from the KPPC in the previous two years. Seventeen percent of the sample (29% among Muslim and 24% among women aged less than 25 years) was not aware of the available services in KPPC.

In accordance with the National Family Health Survey–2 the study results show an increase in current use of reversible high efficacy contraceptive methods. Nevertheless unmet need for family planning resulted still high in Kakching district and there is a need for considerable improvement in the coverage and quality of family planning services. Information provided in this paper should support policymakers and programme administrators in planning, implementing and evaluating new strategies in order to meet the reproductive health needs of the resident population.

APPENDIX - XI

ESSENTIALITY CERTIFICATES

CERTIFICATE 'A'

(To be  completed in the case of patients who are not admitted to hospital for treatment)

        Certificate granted to Mrs/Mr/Miss ...................................................................... wife/son/daughter of Mr ............................................................................................... Employed in the ........................................................................................................... 

        I, Dr. ................................................................................................................... hereby certify

    a)     That I charged and received Rs ............................. for ..................................... consultation on ..................................... (date to be given) at my consulting room/at the residence of the patient.

    b)    That I charged and received Rs. ........................ for administering ..................... intra-venous/intra-muscular/subcutaneous injections on .................................................. (date to be given) at ........................................... my consulting room/ the residence of the patient;

    c)     That the injections administered were not/were for immunizing or prophylactic purposes;

    d)    That the patient has been under treatment at ........................................ Hospital/ my consulting room and that the under mentioned medicines prescribed by me in this connection were essential for the recovery/prevention of serious deterioration in the condition of the patient. The medicines are not stocked in the ........................................ ........................................... (name of the Hospital) for supply to private patients and do not include proprietary preparations for which cheaper substances of equal therapeutic value are available nor preparations which are primarily foods, toilets or disinfectants.

            Names of Medicines                                                             Price

    1.    ..............................................................             ..............................................

    2.    .............................................................              ..............................................

    3.    ..............................................................             ..............................................

    4.    ..............................................................             ..............................................

    e)    That the patient is/was suffering from ................................................. and is/was under my treatment form .......................................... to .................................

    f)    That the patient is/was not given pre-natal or post-natal treatment.

    g)    That the X-ray, laboratory test, etc., for which an expenditure of Rs. .................. was incurred were necessary and were undertaken on my advice at .............................. ...................................................... (name of hospital or laboratory).

    h)    That I referred the patient to Dr. ................................................................. for specialist consultation and that the necessary approval of the ......................................... (name of the Chief Administrative Officer of the State) as required under the rules was obtained.

    i)    That the patient did not require/required hospitalization.

Dated ................................                            Signature and Designation of the 

                                                                         Medical Officer and hospital/         

                                                                        dispensary to which attended

N.B:- Certificate not applicable should be struck off. Certificate (e) is compulsory and must be filled in by the Medical Officer in all case.

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