Literature Review

Introduction

This chapter discusses the literature review undertaken on knowledge on usage of

contraceptive among women. The purpose of this chapter is to review on relates theory

and research have been developed about the studied topic. In addition, literature review

also useful to identify the definition of concepts and variables already established.

Furthermore, literature review help to examine elements of research used by others,

such as designs, methods, instruments and techniques of data analysis that may prove

useful in the proposed project.

The purpose of the literature review in this study was to obtain information on women

knowledge on utilization of contraceptives. The literature review revealed that

considerable research had been done on the proposed topic but not specifically in the

Hospital Tengku Ampuan Afzan (HTAA) Kuantan, Malaysia hospital.

Definition of Term

Contraception is a way to prevents pregnancy by interfering with the normal process of

ovulation, fertilization, and implantation. There are different kinds of birth control that act

at different points in the process. (Fradley, 1962).

According an article wrote by Kumarasamy, (2012) there are several contraceptive

methods commonly chosen by women in Malaysia as followed:

Pill: Birth control pills must be taken by mouth every day.

Injected: Depo Provera is a hormonal medication that is given by injection every

three months.

Implanted: Norplant is a long-acting hormonal form of birth control that is

implanted under the skin of the upper arm.

Intra Uterine Contraceptive Device (IUCD): A device inserted into the uterus to

prevent conception. The IUCD can be a coil, loop, triangle, or T in shape made of

plastic or metal. An IUCD is inserted into the uterus by a health-care

professional.

In this chapter our group would like to get the evidence that without knowledge among

the pregnant mother the usage of contraceptive will be failure. Therefore next section

will be review of some researches that was conducted most part of the world and the

result will be the evidence showing that the knowledge is relates to the practice on the

usage of contraception. The literature review will be discussed with relates to the three

components, important of contraceptive knowledge, source of knowledge, and women

perception toward contraceptive.

Important of Contraceptive Knowledge

Unplanned pregnancies cold be resulted from wrong perception of some women about

the contraceptive usage. Some of them think that contraceptives to be irrelevant or even

harmful. Unplanned pregnancies could have serious implications to the physical and

psychological.

Knowledge about contraception and different contraceptive is very important to all

women in order to enable them to make informed decisions about their own as well as

their children’s futures.

Moreover, adequate information about contraceptives could help women to realize that

effective utilization of contraceptives can successfully postpone pregnancies until they

have fully recovered and/or are financially capable to have another child.

Source of knowledge

Numerous study has been stressed the important role of systematic and responsible

education in the promotion of good reproductive health. Minimize the risk of unwanted

or unplanned pregnancies and infections with sexually transmitted diseases and

improving the quality of sexual life, relationships and well-being in general are the main

objective of contraception education. In a study conducted by Toutas et al. (2004), the

sources of information about contraceptive among the respondent has been assessed.

They have reported that, each respondent could cite more than one source of

information and gynecologist as their main source of information. TV/radio programs

and newspapers/ magazines are also the sources of information. However, they have

found that the ages of respondent was the factor affected the sources of information.

Influencing factors of Contraception Use

Women age, religious background, wealth, educational level and etc. are the most

influenced individual factors that affected the contraceptive usage. The family planning

program can be improved by studying the effect of women socioeconomic and

demographic characteristics on contraceptive usage. Moreover, looking at the

background of those using contraception and evaluate where they come from is very

important on finding the factors might influence the usage of contraceptive among

woman.

Most studies evaluate socio-economic or socio-demographic determinants with different

health outcomes. In Stephenson et al. (2008), the authors evaluated the outcome

contraception use in South Africa and community level determinants such as expected

gender roles, female autonomy in the community and ratio of men to women with a

primary education. In another study, Stephenson et al. (2007) looked at community and

contextual determinants in SSA and they looked at community level of approval of

family planning, community level of educational attainment, and dominant religion in the

community.

Numerous studies have been done to survey the knowledge among women on

conceptive usage, source of knowledge, and women perception toward contraceptive in

the whole world. Here, we have selected five studies that have been done by the

previous researchers related to our topic.

Study 1

In order to estimate the knowledge and prevalence of contraception among women

presenting for voluntary termination of pregnancy (MTP) or as septic and incomplete

abortions Reena et al., (2005) have conducted a study at the Department of Obstetrics

and Gynecology, of Gorakhpur Medical College, from August 2002 to July 2003. The

281 women respondents in the study were categorized as those who came seeking

MTP and who came with incomplete or septic abortion following induced abortion. Pre-

designed and pre-tested questionnaire has been used to evaluate the respondent

knowledge toward contraceptive. From their study, 82.2% of respondents have

knowledge about the existence of a contraceptive method, but only 44.2% ever used

one. They also conclude that, awareness does not always lead to the use of

contraceptives. They also suggest that, in order to reduce high fertility rate a lot of

educational and motivational activities and improvement in family planning services are

required to promote the use of contraceptives. As a conclusion from this study having

knowledge on contraception alone will never encourage a person to practice the

contraception.

Study 2

In order to assess the knowledge, attitude regarding family planning and practice

among rural women, Mustafa et al., (2008) have conducted a cross-sectional

observational study at the gynecological outpatient clinic of Fatima Hospital, Baqai

Medical University, from July to December 2005. The 100 women at the ages 15-14,

living with husband and from rural area respondents in the study were categorized

according to age, parity and educational status. They used pre-designed questionnaire

has been used to evaluate the respondent knowledge toward contraceptive and the

result has been analyzed in percentages using descriptive method. From their study,

81% of respondents have knowledge about the family planning methods, but only 53%

ever used contraception. In addition, they also found that in 52 out of 81 women known

about the contraceptive from information provided by the media. They also conclude

that, even with good knowledge about the contraceptive among the women of rural

origin but there was low contraceptive used.

Study 3

In another work by Saluja et al., (2009), a cross-sectional study has been used to

assess the knowledge, attitude regarding family planning and the practice of

contraceptives among eligible couples of rural Haryana at the Agroha village. They

have collected the data from 250 eligible women and men respondents by using

predesigned and pretested questionnaire. From their study, 94.4% of male respondent

known about modern contraceptive and 72% of male respondent known about

traditional contraceptive method. While, 95.6% of women respondent known about

modern contraceptive and only 46.4% females respondent known about traditional

contraceptive. In addition they also found that, media is the most common source of

contraceptive knowledge for all couples (72.0%) followed by discussion with doctors

and other health care workers (42.6%). They also highlight that, knowledge or

awareness does not always lead to the use of contraceptives. They also suggest a lot of

educational and motivational activities and improvement in family planning services are

needed to promote the use of contraceptives and reduce the high fertility rate.

Study 4

Moreover, in order to assess determinants of preferences, knowledge, attitudes, and

practices of modern contraception among women of reproductive age in Woreta town, a

community-based, cross-sectional study has been conducted by Weldegerima and

Denekew (2008) at Woreta town, South Gondar zone, Ethiopia in April 2007. They have

used a multistage sampling procedure to interview 400 women in the study area. Data

was collected by using a pretested structured questionnaire. From their study, they have

found that eighty-nine percent of respondents were aware of modern contraceptives.

They also found that among respondents, 88% knew of at least two contraception

methods, and 12% knew only one contraception method. In addition they also found

that, knowledge of modern contraceptives was highest among married women, who

were 5.7 times more likely than divorced women to report contraceptive knowledge.

Moreover, they also reported that, knowledge of modern contraception method among

Muslims was highest and women with higher levels of education were more likely to

indicate knowledge of modern contraception methods. They have concluded that

accessibility and education about contraceptive among women in the Ethiopia region

need to improve.

Study 5

Furthermore, the level of knowledge of contraception among Chinese women with

unplanned pregnancy has been reported by Ip et al., (2009). Cross-sectional survey

design has been applied in their study. They have collected data from 117 eligible

Chinese females. They have used questionnaires, which included the Chinese version

of the Contraceptive Knowledge Scale. In their report, they have found that the

respondents have demonstrated an above medium level of knowledge. They also

suggest that, future direction in the development of educational programs and

contraceptive promotion strategies appropriate for women with unplanned pregnancy.

Conclusion

The evidence from the above study on contraception shows that most of the

respondents do have knowledge on contraception. However the practice on the use of

contraceptive is low. According to Najafi et al. (2011), in Malaysia, only 30% of the

married women use modern contraceptive methods. Low usage of contraceptive

methods, results in high rates of unwanted pregnancies and its consequence which

includes; psychological problems physical health and unsafe unsafe abortion.

Therefore, it is important to continually monitor the community knowledge about the

contraceptive.

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