Educational level and family planning among Pakistani women: a prospective explorative knowledge, attitude and practice study

Worldwide organisations such as the United Nations recognise that autonomy in decision-making regarding reproductive health issues is considered as a human right [1]. It has been recognized as key to women’s health, having positive impact on her family, community and country. In developing countries, women’s autonomy is affected by socio-demographic, religious and cultural influences. The most prevalent influences being lack of education and living in a (traditionally or presently) male-dominated society [2]; [3]; [4]; [5]. The latter is illustrated by results from a study published in 2001, where Pakistani women indicated that the main reasons for not using contraceptives was the concern that their use would conflict their husband’s wishes and that it would go against social and cultural custom [6]. Furthermore, there is evidence to support that often males will have the final say in family planning, despite more engagement with health authorities and support organisations by females [4]. In Pakistan, family planning and related support was introduced on a national scale in 1994 to improve maternal and child health. In parallel, Lady Health Workers have been introduced to visit women who may not be able to visit central health centers for cultural or religious reasons [7]. Despite the longstanding presence of these national initiatives, in the past their effectiveness has come under scrutiny [8]. There is an unmet need to describe and evaluate the current situation around the role that Pakistani women have in family planning and contraception decisions, and to explore if level of education influences said role. References: [1] United Nations Population Fund, http://www.unfpa.org/family-planning (last accessed 18 January 2018) [2] J. Cleland, S. Bernstein, A. Ezeh, A. Faundes, A. Glasier, J. Innis Family planning: the unfinished agenda, Lancet, 368 (2006), pp. 1810–1827 [3] M.S. Wazir, B.T. Shaikh, A. Ahmed National program for family planning and primary health care Pakistan: a SWOT analysis, Reprod Health, 10 (2013), p. 60 https://doi.org/10.1186/1742-4755-10-60 [4] N. Sultana, H. Nazli, S.J. Malik, S. Kazi Determinants of female time allocation in selected districts of rural pakistan [with Comments], Pakistan Develop. Rev., 33 (4) (1994), pp. 1141–1153 [5] K. Yadav, B. Singh, K. Goswami Agreement and concordance regarding reproductive intentions and contraception between husbands and wives in rural Ballabgarh, India, Ind. J. Commun. Med.: Off. Publicat. Ind. Associat. Prevent. Soc. Med., 35 (1) (2010), p. 19 [6] J.B. Casterline, Z.A. Satar, M. Haque Obstacles to contraceptive use in Pakistan: a study in Punjab, Studies Family Plann., 32 (2001), pp. 95–110 [7] Z. Mumtaz, S. Salway, C. Nykiforuk, A. Bhatti, A. Ataullahjan, B. Ayyalasomayajula The role of social geography on Lady Health Workers’ mobility and effectiveness in Pakistan, Soc. Sci. Med., 91 (2013), pp. 48–57 [8] J. Shelton, L. Bradshaw, B. Hussain, et al. Putting unmet need to the test: community-based distribution of family planning in Pakistan, Internat. Family Plann. Perspect., 25 (1999), pp. 191–195.