KAP SURVEY REGARDING REPRODUCTIVE HEALTH IN MISSAN MARSHLANDS 2009

Introduction:The needs for reproductive health (RH) care are enormous. However improvement of reproductive health care is feasible. A socially integrated and culturally well-accepted approach is essential for any initiative in the reproductive health care sector.The main objective of this KAP study is to better understand the way Marshlands women perceive their reproductive health and reproductive health needs. Methods:A total of 3726 marshland women of reproductive age (15 to 49 years) have been interviewed. They have been selected through systematic sampling of adult women living in 11 sub-districts in Missan Marshlands. Results: about 70 % of interviewed women were illiterate, 41.6% of their husbands illiterate, 10% were single.On average, women lived at 25 minutes walking distance to the nearest health sub-center and30 minute-one hour by car to the nearest district hospital, about (40-50 Km), 45% of women are currently working, 92% of ever-married women had been pregnant before. The average number of previous pregnancies per married woman was 4.3. The average interval between two deliveries is estimated at 1.5 years. Of the total number of reported deliveries, two third (64%) occurred at home and 36% at a health facility, 81% of home deliveries were attended by TBA. About 66% of the women attended antenatal consultations during their last pregnancy and 65.6% of the women reported to have received a tetanus vaccination at least once during their last pregnancy. Half of study group reported obstacle to antenatal care visits.56% of the last deliveries were assisted by skilled health personnel. One quarter of all home deliveries were attended by skilled personnel, mainly midwives.Among the unskilled attendants, female relatives were most popular (48% of all home deliveries). Traditional Birth Attendants assisted in 17.5% of all reported last home deliveries. More than one third of women were currently using FP method, indicating there is still an unmet FP need, 32.3% did not know about any method to delay or avoid pregnancy. Lack of knowledge can therefore be considered as the most important obstacle to FP services.The oral contraceptive pills seemed most popular among interviewed women (74%). Only 16.4% of the interviewed women have knowledge of any STI. Among the STIs they knew of, HIV / AIDS was the most mentioned (25.8%),25.8% of the women did heard about HIV/AIDS.Nearly 60% of women have vaccinated their children; of those who did not vaccinate their children, 81.9% cited the cause of far distance from PHC services. Vast majority of husbands respected their wives wishes and spent time with them.More than one quarter of women interviewed (27.7%) of women said that their husbands have pushed and shoved them,21.5% mentioned being slapped andtheir arms twisted by their husbands.Most of violated women (85.7%)mentioned that domestic violence began after one year after marriage. Conclusion:most of women lived in marshlands in Missan have little knowledge about their RH. Recommendations: Promotion of education and schooling of girls and women empowerment of women, community health education and a multi-sectoral approach and long-term commitment were recommended