Pronatalist Policies and its Role in Pattern of Contraceptive Methods among Women in Reproductive Age in Sanandaj City, 2016

In response to rapid fertility reduction over the recent decades in Iran, pronatalist policies was introduced in 2014 and significant changes has occurred in the family planning programs in the country, while it is not clear enough what influences these policies have had on pattern of using contraceptive methods. This study was performed with aim to determine the role of pronatalist policies in the pattern of using contraceptive methods, as well as the attitudes of women towards changes in the access, quality, cost and advocacy of contraceptive methods after introduction of these polices. This descriptive-analytic and comparison study is a population-based survey which was conducted among 454 married women aged 15-49 years in Sanandaj in 2016. Data collection was performed using a researcher-made questionnaire. Last contraception used (n=454) was compared to corresponding method used in the Demographic Health Survey of Kordestan (n=260) in 2010. The women’s attitude towards changes in the provision, quality and cost of contraceptive methods were evaluated and the factors associated to the women’s attitude were also assessed using t-test and Chi-square test. P<0.05 was considered statistically significant. Over the period of 2010-2016, the prevalence of modern methods was reduced from 81.2% to 64.7%, while the prevalence of withdrawal method increased from 19% to 36%. A reduction was shown in the prevalence of women's tubal ligation (from 24.4% to 4%). The prevalence of using IUD and condom was clearly increased from 19% to 26.3% and from 11% to 15.1%, respectively. In 2016 survey, a reduction was reported in the access, quality, and advocacy and informing of contraceptive methods and the cost of providing contraceptive methods had increased compared to two years ago from the viewpoints of women at reproductive age. Women from lower socio-economic status were more concerned of rising cost and reduced quality of contraceptive methods. The pattern of contraceptive methods has been changed from safe to unsafe methods. Adverse health consequences of restriction of family planning due to new population policies will be greater for vulnerable groups of the society that needs more attention by health policymakers and appropriate interventions.