Introduction
Family planning programs provide a constellation of methods, techniques and services that allow women and couples to regulate their fertility and determine the spacing of pregnancies. This study aims to determine the frequency of contraceptive users among Saudi females, the type of contraceptive methods used, in addition to assessing their knowledge, attitudes, accessibility to contraception, reasons and barriers of their use, in an attempt to place recommendations towards establishment of family planning programs in the Kingdom.
Methodology
This cross-sectional study was conducted among Saudi women attending governmental primary care centers in Riyadh city. Single stage sampling was done to select primary health centers, and participants were selected by simple random sampling. The data collection instrument inquired on socio demographic characteristics, socioeconomic status, knowledge and current use of contraception, types used, in addition to reasons for and barriers against their use.
Results
Out of 550 women, 535 (97.3%) accepted to participate in the study. Ages ranged from 18-50 years, with the majority ≥ 29 years (44.9%). Their mean age was 31.2 years [(SD) ±6.4]. The most common educational level was university and above (46.9%). More than half 73.6% were housewives, 58.9% had been married for ≥9 years and 47.9% had 3-6 children.
Overall, 86.0% of participants had used or were using some forms of contraceptive at the time of the interview. Use of contraceptives was greater between the ages of 30-39 years. The main cause for using contraceptives was child spacing 68.2%. Reasons for not using any?family?planning?method were:?wanting?to?have more children?50.7%,?fear of side effects 32.0%, husbands'?objection 26.7%, medical?reasons?20.0%, newly married 9.3%,?not effective 6.7% or against?religious?belief?2.7%. Oral contraceptives were the most common method (49.8%), followed by the intrauterine device (19.6%). Most participants 66.1% obtained their contraceptive methods from pharmacies, and 16.5% from private clinics.
Over half 287 (53.6%) had a positive opinion about contraceptive methods influence on maternal health. Only 49 (9.2%) disapproved of their use. The major source of information regarding contraception was health care providers 56.1%.?? Among contraceptive users, 64.3% reported side effects. The most common method believed to cause these side effects was oral contraceptives (84.1%).
Around one-third (31.6%) believed that there were barriers against contraceptive use in the Kingdom, the most common was lack of knowledge and awareness (61.0%), socio -cultural factors (59%), and lack of family planning programs (34.9%).
Conclusion
This study shows a high frequency of contraceptive practices 86.0% among Saudi women attending PHCCs in Riyadh. No governmental PHCCs provide any type of contraceptives to married women and no family planning programs are implemented in PHCCs. Lack of family planning programs at PHCCs is one of the most important barriers to contraceptive use in Saudi Arabia. We recommend to increase awareness of couples regarding all aspects of family planning, which can be achieved by activating and implementing antenatal, postnatal, and well-baby clinics at governmental PHCCs. Making contraception accessible at primary care level and more acceptable by involvement of Islamic leaders, health care provider, family member and media in family planning program.