Knowledge, attitudes and practice survey of family planning among South Asian immigrant women in Oslo, Norway



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Knowledge, attitudes and practice survey of family planning among South Asian immigrant women in Oslo, Norway


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This research was conducted in partial fulfillment of the Masters of Philosophy degree in International Community Health at the department of General Practice and Community Medicine, Faculty of Medicine, University Of Oslo.

Dr. Asma Abedin

Supervisor: Prof. Dr. Babill Stray-Pedersen


DEDICATION

To my parents, children and to my beloved one, for being my greatest critic, for sharing my frustration and for caring me and our children during my work on this thesis.

Acknowledgement

I would like to give my heartfelt thanks to the 309 women who answered the questionnaires - for their participation and interest in the survey. This study could not possible without their participation. I am ever grateful to them.


Prof. Babill Stray-Pedersen, my supervisor, has played an enormous role in helping me to achieve this goal. She is the source of inspiration and encouragement for me. During the study period, whenever I faced difficulties, she answered and made issues of concern easy with her valuable comments and advice. I feel immensely proud to express my gratitude for her continuous contribution.
Anne-Birth Vegge Arlt, leader of the Søndre Nordstrand health clinic for family, children and youth - I gratefully acknowledge her cooperation. She and her employees were of vital importance for my fieldwork.
Special thanks are given to the research assistants and staff of the Grønland, Bjørndal, Prinsdal, Klemetsrud and Holmlia health centres.

It is a pleasure to thank, Kalaivani Thanabalan, Syed Israt Haque, Navneet Kaur, Tony Ban Singh, Nazma Kareem,Tayibah Sheikh, Uzma Khan, Era Fatema, Dr. Asaduzzaman, Rohan, and Sabbir Khan - all of whom made this thesis possible, opened up to me, gave me access to immigrant communities and prompted me to conduct the survey.


I owe thanks to Lien Deip for her enormous and indispensable support in statistics. She is great for me.
I would like to express my sincere thanks and regards to Hildegunn Bomnes, director of Stiftelsen Amathea, for her valuable guidance with fruitful and insightful comments, suggestions and support at various stages of my field work.

I would like to thanks ansatte of Stiftelsen Amathea especially Berit Helde for her supports during my field work.


I want to thank all of the wonderful classmates, especially Neupane who have given me valuable support during the frustrations and prosperities of this course. I am especially grateful to Christina Brux, whose comments in improving my English language and warm friendship have helped me to finish this writing.
I would like to express cordial thanks to Prof. Johanne Sundby and Prof. Akhtar Hossain who inspired me to work with immigrant women.
Special thanks also to Line Low, Ragnhild Beyrer and Vibeke Christie, for always being helpful. Their passionate support and care during my course of study will be memorable. I would like to thanks the IT and other support staff at Fredrik Holst’s Hus for their kindness during the master’s course.
Finally, I would like to give sincere thanks to Stiftelsen Amathea and the Norwegian Directorate for Health and Social Affairs for financial support to do this project.
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Acknowledgement

3




Clarification of terms and abbreviation

9




Abstract

11



Introduction

12




    1. Background

12




    1. Literature review

13




    1. Rational for study

15



Objective of the study

18




    1. General objective

18




    1. Specific objective

18



Research methodology

19




    1. Study design

19




    1. Study population

19




    1. Sample size

20




    1. Data Collection procedure

21




    1. Data collection tool

22




      1. Demographic

23




      1. Knowledge

23




      1. Attitude

25




      1. Practice

26




      1. Service for family planning

27




    1. Data management

27




    1. Data analysis and statistics

28




    1. Missing data

29



Ethical consideration

31



Result

31




    1. Demographic characteristics of South Asian immigrant women







Knowledge of family planning

33




    1. Descriptive result for knowledge

34




      1. Association between knowledge of family planning and marital status

34




      1. Association between knowledge of family planning and immigration status

36




      1. Association between knowledge of modern contraceptives and demographics

37




      1. Association between knowledge of emergency contraceptives and demographics

38




      1. Association between knowledge of Chlamydia, STI’s and demographics

39




      1. Association between source of family planning information and demographics

40




      1. Association between received sex education at school and demographics

42




Attitude towards family planning

42




    1. Descriptive results for attitude towards family planning

42




      1. Attitude towards family formation among South Asian immigrant married women (n=228)

43




      1. Attitude towards modern contraceptives among South Asian immigrant married women (n=228)

45




      1. Attitude towards family planning discussion among South Asian immigrant married couples

46




      1. Attitude towards family planning discussions among South Asian immigrant women’s society from where they originate (n=228)

47




      1. Attitude towards FP information among unmarried South Asian immigrant women (n=81)

48




      1. Preferable source for FP information among unmarried women

49




Practice of family planning

49




    1. Descriptive result of practice of family planning

49




      1. Fertility background

51




      1. Association between contraceptive use and demographics and knowledge, attitude of family planning and number of children reported by South Asian immigrant women (n=228)

52




      1. Reason for not using contraceptives

52




      1. History of requesting induced abortion and reason for termination of pregnancy among South Asian immigrant married women

53




Family planning service

53




    1. Preferred to talk or ask about family planning information by South Asian immigrant women

53




    1. Outcome

55




      1. Logistic regression analysis to estimate the ORs and 95% CIs for significant predictors of family planning knowledge among South Asian immigrant women

57




      1. Logistic regression analysis to estimate the ORs and 95% CIs for significant predictors of contraceptive use among South Asian immigrant women






Discussion

59




    1. Summary of important findings

59




    1. Discussion of result

61




    1. Methodological consideration

65




    1. Recommendation

67



Conclusions

68




Reference

69




Appendices

74




Annexure 1. Informed consent form for unmarried women

74




Annexure 2. Informed consent form for married women

75




Annexure 3. Questionnaire for married women

76




Annexure 4. Questionnaire for unmarried women

83




Annexure 5. Ethical clearance letter from REK

86




Annexure 6. Map of Oslo districts

87

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