FAMILY PLANNING AND ITS KNOWLEDGE, ATTITUDE, PRACTICE (KAP) AND BARRIERS AMONG TEA COMMUNITY, ASSAM: MIXED METHOD RESEARCH STUDY

Abstract

Background: Family planning is an essential component of reproductive health that contributes to maternal and child health improvement, prevention of unintended pregnancies, and women’s empowerment. Although India has achieved significant progress in family planning services, marginalized communities such as tea garden populations continue to experience challenges due to low literacy, socioeconomic disadvantages, limited access to healthcare services, and sociocultural barriers. The present study aimed to assess the knowledge, attitude, practice (KAP), and barriers related to family planning among women of reproductive age in the tea community of Assam. Methods: An evaluative research approach with an exploratory sequential mixed-method research design was adopted. The study was conducted among women aged 15–49 years residing in selected tea estates of four districts of Assam, namely Golaghat, Nagaon, Kamrup, and Dibrugarh. A total of 300 women were selected for the quantitative phase using a random sampling technique, and 20 women were purposively selected for the qualitative phase. Data were collected using three tools: a demographic proforma, a structured KAP questionnaire on family planning, and a semi-structured questionnaire to explore barriers related to family planning practices. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were analyzed using thematic analysis. Results: The findings revealed that 82.7% of women had heard about family planning; however, only 33.3% were aware of available family planning services in their community. Knowledge regarding contraceptive methods varied, with condoms (100%), oral contraceptive pills (80%), sterilization (80%), and intrauterine devices (74%) being the most commonly known methods, whereas awareness regarding injectable contraceptives (6.7%) and emergency contraception (31%) was limited. Overall, 59% of women had inadequate knowledge, 32.3% had moderate knowledge, and only 8.7% had adequate knowledge regarding family planning. Regarding attitude, 60% of women demonstrated a favourable attitude, while 40% had an unfavourable attitude. Despite awareness and positive attitudes, 75% of women reported poor family planning practices. Qualitative findings revealed major barriers including inadequate knowledge, family influence, accessibility issues, affordability concerns, financial burden, and health-related reasons affecting contraceptive decision-making. Conclusion: The study highlights a significant gap between awareness, attitude, and actual practice of family planning among women in the tea community of Assam. Although many women expressed acceptance of family planning, inadequate knowledge, socioeconomic constraints, limited-service awareness, and family-related influences continue to affect contraceptive utilization. Strengthening reproductive health education, improving accessibility of family planning services, enhancing counselling by healthcare workers, and involving family members and men in reproductive decision-making are essential strategies to improve family planning practices among this vulnerable population.