Decline in contraceptive use- is the health care provider to blame, too?


  • Adiba Akhtar Khalil CMH, Risalpur.
  • Munawar Jannat Rana CMH, Peshawar.
  • Umbreen Akram CMH, Guranwala.
  • Sumaira Khan CMH, Rawalpindi.
  • Joodi Kizilwarda Akhtar Shifa International Hospital, Islamabad.
  • Shahzadi Neelam QHAMC Teaching Hospital and Nowshera Medical College, Nowshera.



Contraception, Health Care Provider, Patient Directed Counseling


Objective: To assess what impact does primary physician counseling have on contraceptive uptake. Study Design: Cross-sectional Comparative study. Setting: Study was done in three semi – government hospitals in three different cities. Period: April 2022 to May 2022. Material & Methods: Patients in outpatient clinics of the hospitals were given a questionnaire by simple random sampling. It was to assess women for their current use of contraception based on the source of their information about contraception. These groups were compared with each other for their contraception uptake. Associations between education, parity, working status and contraception use was also sought. The sample size was 175 women. Results: Out of 175 participants, 74 (42.3%) were practicing contraception at the time and 53 (30.3%) did not know about contraception. Reasons for not using contraception included side effects 71 (40.6%), Doctor never told them 56 (32%) and husband not willing 50 (28.6%). More women were of parity 4 or less (58 vs 34) and more working women used contraception (16 vs 6). The difference was not statistically significant. Illiterate women used contraceptives less. With education, there was significantly more use (38 vs 10) p < 0.001. Most Women knew about contraception from neighbor/ relatives 57 (32.5%) and 41 (23.4%) did not practice any method. A doctor/health professional was the source in 37 (21.2%), only 12 (6.9%) did not adopt contraception with p = 0.003. There was a strong statistical significance. Conclusion: There was a strong association between the physician counseling and contraceptive use. There is a strong need of regular, persistent contraceptive advice during each antenatal visit to individualize a contraception plan to suit a couple.

Author Biographies

Adiba Akhtar Khalil, CMH, Risalpur.

FCPS, Associate Professor Obs & Gyn, 

Munawar Jannat Rana, CMH, Peshawar.

FCPS, Assistant Professor & HOD Obs & Gyn, 

Umbreen Akram, CMH, Guranwala.

FCPS, Assistant Professor Obs & Gyn, 

Sumaira Khan, CMH, Rawalpindi.

FCPS, Assistant Professor Obs & Gyn, 

Joodi Kizilwarda Akhtar, Shifa International Hospital, Islamabad.

MBBS, House Surgeon, 

Shahzadi Neelam, QHAMC Teaching Hospital and Nowshera Medical College, Nowshera.

FCPS, HOD Obs & Gyn,