oking habit (including cigarettes, pipe, snuff, chewing tobacco or other), use of cesarean section, preparation for delivery (including saved money, arranged transportation, found blood donor, contacted health worker, bought safe delivery kit, prepared food and clothes), use of special safe delivery kit, total pregnancies and use of iron/folic acid tablet were included in the ‘practice’ cluster.
Within ‘knowledge’ variables, women who had heard about family planning was significantly associated with PC status (χ2 = 117.67, p = <.001). As expected, 76.9% of women who said that they have heard about family planning from radio, TV or newspaper received PC, in comparison to 60.1% in women who said that they have not heard about family planning from none of the sources. Similarly, whether or not the women had knowledge about where to get an abortion was strongly associated with PC status (χ2 = 185.68, p = <.001). 80.2% of women who were aware of place to have abortion have received PC compared to 64.1% of women who did not know about the place to get an abortion. Furthermore, the proportion of women who reported having received PC was the lowest (57%) when the respondents had no knowledge of where to get an abortion.
In terms of ‘attitude’, both women’s desire for more children (χ2 = 74,45, p = <.001), and women wanting the last child (χ2 = 105.48, p = <.001) were significantly associated with PC utilization. Surprisingly, the proportion of women who reported having received PC was higher (83.6%) among women who desired more children after more than two years than those who wanted within two years (67%). The proportion of women who have received PC was the lowest (55.6%) among women who wanted more children but were unsure about the timing. Contrary to our expectation, women who wanted their last child ‘later’ (81.3%) had higher proportion to have received PC than women who wanted their last child ‘then’ (74.4%), whereas, the proportion of having received PC among women who did not want last child was 58.9%.
Similarly, in the ‘practice’ variables group, total number of pregnancies (t(4182)=17.6, p=<.001) was significantly associated with PC status of women. Women whether or not smoked (χ2 = 228.25, p = <.001) had strong relationship with the status of PC. The proportion of PC status was much higher among women who did not smoke (77.5%) compared to women who smoked (51.3%). Also, use of caesarean section (χ2 = 33.183, p = <.001) to deliver child was strongly associated with PC status. Interestingly, 96.4% of women who used C-section during delivery reported receiving PC in comparison to 71.6% in women who did not use C-section.
Likewise, preparation for delivery (χ2 = 268.95, p = <.001) for example, saved money, arranged transportation, contacted health worker, found blood donor, bought safe delivery kit and clothes and prepared food, was significantly associated with PC status of women. The majority (83.3%) of women who made preparation for delivery did receive P, whereas only 60.3% of women who did not make preparation received PC. Finally, both the variables, ‘special safe delivery kit used’ (χ2 = 194.3, p = <.001) and ‘iron/folic acid tabled used’(χ2 =252.96, p = <.001), showed significant relationship with the PC status. 62.1% of mothers reported to have received PC who did not use special safe delivery, in comparison to 93.6% of women who did not use special safe delivery kit. Similarly, the proportion of use of PC was much higher among women who used iron/folic acid tablet during pregnancy (94.2%) than women who did not use (66.7%).
Of all health indicators in Nepal, maternal mortality reveals the greatest gap between rich and poor, women residing in rural and urban areas and uneducated and educated women. Previous studies have shown that interventions to increase utilization of PC significantly help to reduce this gap of maternal death. A countrywide analysis of 2006 NDHS data showed that perceived barriers to utilization of PC, such as access to MHS, knowledge about PC, family barrier, transportation and the distance 