In order to study contraceptive use, knowledge, and fertility intentions a study was conducted in Wayanad, Kerala by a team of experts from Amrita Hospital. The sample size was 2500 women in the reproductive age group of 15-49 years. The women who were represented in the study are mainly from Paniya, Kurichiyar, Adiya, Kattunaicken. The contraceptive use was only 26.4% compared to the state average of 53%. Knowledge about contraceptive use was poor among more than half of the women( 53%) . This was closely aligned with the knowledge of emergency contraception and educational levels, with higher educational levels having better knowledge. Women who had higher level of education were 2 times more likely to have better knowledge. The knowledge of emergency contraceptive use was also found to be very poor and this was closely related to poor knowledge of contraceptives in general. Those who desired more than two children had lower knowledge of contraceptives.

aid Dr. Aswathy S, Professor, Department of Community Medicine, Amrita Hospital, Kochi, who conducted the study: “Initially, only about 41.2% (1027/2495) reported having heard of contraceptives and on further probing this increased to 50.3% (1256/2495).

She added: “The key findings are that contraceptive use is lower than the general population at 26.4%. However, the family size is not commensurately high which may be due to the use of traditional methods of contraception. Of those who have used contraception 63.8% had used permanent methods. Among those who had not used a contraceptive worry about side effects and partner not wanting to use a method were the main reasons cited. The use of contraceptives was two times higher among the Paniya group compared to Kattunaicken, a particularly vulnerable tribal group and other groups. Those who were more vulnerable such as staying in a kutcha house were less likely to use contraceptives.”

This study specifically highlights the need for improving education and increasing awareness on contraceptives among the various indigenous groups in Kerala. Said Dr. Aswathy S: “At the implementation level more changes are necessary. Despite the numerous schemes and support such as Tribal Health promoter, Oorumithram (friend of the village) there is a huge gap in understanding the tribal persons belonging to different groups. A more culturally sensitive and respectful approach is necessary. Universal access to family planning services, aligned with Sustainable Development Goals, data from the study suggests that we are far from achieving this goal when it comes to tribal communities”