Prevalence, Awareness, Treatment, and Control of Hypertension in Rural Areas of Davanagere

Objective:

To study the prevalence, awareness, treatment, and control of hypertension in the rural areas of Davanagere.

Type of Study:

Cross-sectional community-based study.

Setting:

Villages belonging to six sectors of the Davanagere Taluk.

Materials and Methods:

General population above 18 years.

Methodology:

A community-based sample was chosen by a multistage sampling technique. Subjects were screened for hypertension by a house-to-house survey. Subjects with systolic blood pressure more than 140 and diastolic blood pressure more than 90 mm of Hg, on hypertensive treatment, and history of hypertension were classified as hypertensives. The data thus obtained was compiled and analyzed.

Results:

The prevalence rate of hypertension in the study population was 18.3% (95% CI, 16.7-19.9%). Prevalence of hypertension was more in males 19.1% (95% CI, 16.7-21.5%) than in females 17.5% (95% CI, 14.9-20.1%); 11.6%, 5.6%, and 1.2% of the total subjects had Grade I, Grade II, and Grade III, respectively. Only 33.8% of them were aware of their hypertensive status. Hypertensives of 32.1% were on treatment, and 12.5% adequately controlled their BP. About 6.9% of the total hypertensives had severe hypertension.

Statistical Analysis:

Proportions, One way Analysis of Variance, Chi-square test.     

General Morbidity Prevalence in the Delhi Slums

Research Question:

What is the sickness prevalence in the slums of a metropolitan city?

Objectives:

To estimate the morbidity prevalence with reference to a socio-economic and demographic perspective of the slum population of Delhi.

Study Design:

A cross-sectional study was conducted and data were collected by a two-stage random sampling method. In the first stage, slum locations were selected and in the second stage households were selected.

Participants:

Data were collected from 1049 households consisting of 5358 individuals'' information.

Results:

The overall morbidity prevalence is 15.4%. It is 14.7 and 16.3% for males and females, respectively but the differences are not statistically significant. The reported higher morbidity prevalence and the illiteracy status are significantly associated. Diseases of the respiratory system appear to be very high among slum dwellers.

Conclusion:

From this study, it can be concluded that the number of years of staying in the slum area, presence of a separate kitchen, type of house, it being Pucca or Kuccha, types of toilet pits or open defecation are the important environmental factors for the reports of higher morbidity patterns from the slum area.     

A Study of Dysmenorrhea During Menstruation in Adolescent Girls

Research question:

What is the prevalence of dysmenorrhea severity and its associated symptoms among adolescent girls?

Objectives:

(1) To study the prevalence of dysmenorrhea in high school adolescent girls of Gwalior. (2) To study the evidence of severity of the problem with associated symptoms and general health status.

Study design:

An explorative survey technique with a correlational approach.

Setting and Participants:

Nine hundred and seventy adolescent girls of age 15 to 20 years, studying in the higher secondary schools (Pre-University Colleges) of Gwalior.

Statistical analysis:

Percentages, Chi-square test, and Test-Retest Method.

Results:

The prevalence of dysmenorrhea in adolescent girls was found to be 79.67%. Most of them, 37.96%, suffered regularly from dysmenorrhea severity. The three most common symptoms present on both days, that is, day before and first day of menstruation were lethargy and tiredness (first), depression (second) and inability to concentrate in work (third), whereas the ranking of these symptoms on the day after the stoppage of menstruation showed depression as the first common symptoms. Negative correlation had found between dysmenorrhea and the General Health Status as measured by the Body surface area.     

Isolated Systolic Hypertension and its Determinants - A Cross-sectional Study in the Adult Population of Lucknow District in North India

Objectives:

1) To determine the prevalence of isolated systolic hypertension (ISH) in the adult population of Lucknow district. 2) To study the determinants of ISH especially the relationship with age.

Materials and Methods:

A community-based cross-sectional study was conducted in four randomly selected areas of Lucknow district. A total of 800 subjects, aged 20 years and above, 400 from urban and 400 from rural area of Lucknow district were included in the study. The statistical tools used for analysis were Pearson''s Chi-square test and multiple logistic regression.

Results:

The prevalence of ISH according to JNC-7 criteria was 4.3%, which was 5.1% in men and 3.6% in women. A significant increase in the prevalence of ISH was seen with an increase in age. Multivariate logistic regression analysis of the determinants showed that age, BMI and smoking were significant independent risk factors of ISH.

Conclusions:

Given the risk of cardiovascular disease associated with ISH, the findings of this study emphasize the need for further research to document the impact of modifiable risk factors of ISH and the effect of hypertension screening and specific health promotion in bringing down the burden of ISH and related cardiovascular morbidity.     

Prevalence of Ischemic Heart Disease Among Urban Population of Siliguri, West Bengal

Objectives:

To determine the prevalence of ischemic heart disease and the associated risk factors among the urban population of Siliguri.

Materials and Methods:

A cross-sectional survey of a random sample of the population aged ≥40 years old in the Municipal Corporation area of Siliguri. Study variables were age, sex, occupation, addiction, food habit, physical activity, body mass index, blood pressure, and electrocardiogram change.

Results:

Out of 250 individuals who took part in this study, 29 (11.6%) had ischemic heart disease (IHD) and 118 (47.2%) had hypertension. Males had a higher (13.5%) prevalence of IHD than females (9.4%). About 5% of the patients had asymptomatic IHD. IHD among the study population is significantly associated with hypertension and smoking.     

Community-based Randomized Controlled Trial of Non-pharmacological Interventions in Prevention and Control of Hypertension among Young Adults

Context:

Hypertension is a major chronic lifestyle disease. Several non-pharmacological interventions are effective in bringing down the blood pressure (BP). This study focuses on the effectiveness of such interventions among young adults.

Aims:

To measure the efficacy of physical exercise, reduction in salt intake, and yoga, in lowering BP among young (20-25) pre-hypertensives and hypertensives, and to compare their relative efficacies.

Settings and Design:

The study was done in the urban service area of JIPMER. Pre-hypertensives and hypertensives, identified from previous studies, constituted the universe. The participants were randomized into one control and three interventional groups.

Materials and Methods:

A total of 113 subjects: 30, 28, 28 and 27 in four groups respectively participated for eight weeks: control (I), physical exercise (II) - brisk walking for 50-60 minutes, four days/week, salt intake reduction (III) - to at least half of their previous intake, and practice of yoga (IV) - for 30-45 minutes/day on at least five days/week.

Statistical Analysis Used:

Efficacy was assessed using paired t test and ANOVA with Games Howell post hoc test. An intention to treat analysis was also performed.

Results:

A total of 102 participants (29, 27, 25 and 21 in groups I, II, III and IV) completed the study. All three intervention groups showed a significant reduction in BP (SBP/DBP: 5.3/6.0 in group II, 2.6/3.7 in III, and 2.0/2.6 mm Hg in IV respectively). There was no significant change (SBP/DBP: 0.2/0.5 mmHg) of BP in control group (I). Physical exercise was most effective (considered individually); salt intake reduction and yoga were also effective.

Conclusions:

Physical exercise, salt intake reduction, and yoga are effective non-pharmacological interventions in significantly reducing BP among young hypertensives and pre-hypertensives. These can therefore be positively recommended for hypertensives. There is also a case to deploy these interventions in the general population.     

Effect of Prenatal Exposure to Kitchen Fuel on Birth Weight

Background:

Maternal exposure to kitchen fuel smoke may lead to impaired fetal growth.

Objective:

To study the effect of exposure to various kitchen fuels on birth weight.

Methodology:

Study type: Retrospective analytical. Study setting: Hospital based.

Study Subjects:

Mothers and their newborns.

Inclusion Criteria:

Mothers registered in first trimester with minimum 3 visits, non-anemic, full-term, and singleton delivery.

Exclusion Criteria:

History of Pregnancy Induced Hypertension (PIH), Diabetes Mellitus (DM), tobacco chewers or mishri users. Sample size: 328 mothers and their new-borne. Study period: Six months. Study tools: Chi-square, Z-test, ANOVA, and binary logistic regression.

Results:

Effect of confounders on birth weight was tested and found to be non-significant. Mean ± SD of birth weight was 2.669 ± 0.442 in Liquid Petroleium Gas (LPG) users (n = 178), 2.465 ± 0.465 in wood users (n = 94), 2.557 ± 0.603 in LPG + wood users (n = 27) and 2.617 ± 0.470 in kerosene users (n = 29). Infants born to wood users had lowest birth weight and averagely 204 g lighter than LPG users (F = 4.056, P < 0.01). Percentage of newborns with low birth weight (LBW) in wood users was 44.68% which was significantly higher than in LPG users (24.16%), LPG + wood users (40.74%) and in kerosene users (34.48%) (Chi-square = 12.926, P < 0.01). As duration of exposure to wood fuel increases there is significant decline in birth weight (F = 3.825, P < 0.05). By using logistic regression type of fuel is only best predictor.

Conclusion:

Cooking with wood fuel is a significant risk-factor for LBW, which is modifiable.     

Study on Prevalence of lodine Deficiency Disorder and Salt Consumption Patterns in Jammu Region

Research Question:

What is the situation of iodine deficiency disorder (IDD) and salt consumption in Jammu region?

Hypothesis:

The prevalence of IDD has decreased markedly as a result of medical as well as socio-economic factors.

Objective:

To assess the magnitude of IDD in Jammu region and also assess the salt consumption patterns in the region.

Design:

Cross-sectional study.

Setting:

Primary schools in both urban and rural areas.

Study Tools:

Clinical examination of study population for goiter, laboratory assessment of casual urine sample for urinary iodine estimation of I₂ content of salt samples collected from sub-samples of study population.

Participants:

School children in the age group of 6-12 years were selected for study using WHO 30-cluster methodology, urine samples were collected from 15% of selected children and salt samples from 5% of sub-sample.

Ethical Concern:

No ethical issues were involved.

Results:

An overall goiter prevalence of 11.98% was observed in the region. Females had a prevalence of 16.1% and males 10.1%. The median urinary iodine excretion in the region was 96.5 μg/l (range: 29.0-190.0 μg/l). Forty-nine percent of subjects had biochemical iodine deficiency with 6.7% having moderate and 42.53% mild iodine deficiency. In Jammu region, 74.47% of households consume powdered salt with 98.17% powdered salt samples having an I₂ content of greater than 15 ppm.

Conclusion:

Iodine deficiency remains a public health problem in the region, though the region seems to be in a state of nutritional transition from iodine deficiency to iodine sufficiency.     

Association of Obesity with Hypertension Amongst School-Age Children Belonging to Lower Income Group and Middle Income Group in National Capital Territory of Delhi

Background and Objectives:

Hypertension is one of the most common diseases world-wide and the prevalence in school-aged children appears to be increasing perhaps as a result of increased prevalence of obesity. Thus, the present study was planned to establish an association between body mass index (BMI) and waist circumference (WC) with hypertension amongst school children in the age group of 5-16 years belonging to lower income group (LIG) and middle income group (MIG) in National Capital Territory of Delhi.

Subjects and Methods:

Population proportionate to size methodology was adopted to select 30 clusters/schools in each LIG and MIG category. About 170 children from each school were selected randomly with the help of random number tables. Anthropometric measurements of weight, height and WC and blood pressure measurements were taken by using the standard methodology.

Results and Interpretation:

t0 he prevalence of high systolic blood pressure (SBP) in LIG and MIG school population was 3.8 and 4.4% with high WC and BMI are more likely to have hypertension.

Subjects and Methods:

Population proportionate to size methodology was adopted to select 30 clusters/schools in each LIG and MIG category. About 170 children from each school were selected randomly with the help of random number tables. Anthropometric measurements of weight, height and WC and blood pressure measurements were taken by using the standard methodology.

Results and Interpretation:

t0 he prevalence of high systolic blood pressure (SBP) in LIG and MIG school population was 3.8 and 4.4% with high WC and BMI are more likely to have hypertension.     

A Study of Morbidity Pattern in Street Sweepers: A Cross-sectional Study

Background:

Street sweepers play an important role in maintaining the health and hygiene within the cities. This job exposes the street sweepers to a variety of risk factors such as dust, toxins and diesel exhaust pollution, which make them vulnerable to develop certain occupational diseases. Therefore, it was thought necessary to study the morbidity profile in this occupational group.

Objectives:

To study the prevalence of morbidities among street sweepers and comparison group.

Study Design:

A cross-sectional study with a comparison group.

Study Setting:

Nagpur Municipal Corporation, Nagpur.

Subjects:

The study included two groups: (1) A study group comprising 273 street sweepers. (2) A comparison group comprising 142 class IV workers working in the office buildings of Nagpur Municipal Corporation, Nagpur.

Materials and Methods:

A pretested proforma was used to record the necessary information such as clinical history, sociodemographic factors, findings of clinical examination and investigations performed.

Results and Conclusions:

The important morbidities detected among street sweepers were the following: anemia (20.5%), hypertension (9.5%), upper respiratory tract infections (URTI) (7.3%) and chronic bronchitis (5.9%). In the comparison group, important morbidities detected were the following: anemia (20.4%), hypertension (11.3%), hyperacidity (9.9%), URTI (7.0%) and refractive error (7.0%). Chronic bronchitis was detected in two subjects (1.4%) of the comparison group. The prevalence of chronic bronchitis was significantly high among street sweepers than that of subjects of the comparison group. Therefore, it is recommended that further studies with a larger sample size be undertaken to identify the factors responsible for higher prevalence of chronic bronchitis among the street sweepers.     

Non-pharmacological Interventions in Hypertension: A Community-based Cross-over Randomized Controlled Trial

Background:

Hypertension is the most prevalent non-communicable disease causing significant morbidity/mortality through cardiovascular, cerebrovascular, and renal complications.

Objectives:

This community-based study tested the efficacy of non-pharmacological interventions in preventing/controlling hypertension.

Materials and Methods:

This is a cross-over randomized controlled trial (RCT) of the earlier RCT (2007) of non-pharmacological interventions in hypertension, conducted in the urban service area of our Institute. The subjects, prehypertensive and hypertensive young adults (98 subjects: 25, 23, 25, 25 in four groups) were randomly allotted into a group that he/she had not belonged to in the earlier RCT: Control (New Group I), Physical Exercise (NG II)-brisk walking for 50 to 60 minutes, three to four days/week, Salt Intake Reduction (NG III) to at least half of their previous intake, Yoga (NG IV) for 30 to 45 minutes/day, five days/week. Blood pressure was measured before and after eight weeks of intervention. Analysis was by ANOVA with a Games-Howell post hoc test.

Results:

Ninety-four participants (25, 23, 21, 25) completed the study. All three intervention groups showed significant reduction in BP (SBP/DBP mmHg: 5.3/6.0 in NG II, 2.5/2.0 in NG III, and 2.3/2.4 in NG IV, respectively), while the Control Group showed no significant difference. Persistence of significant reduction in BP in the three intervention groups after cross-over confirmed the biological plausibility of these non-pharmacological interventions. This study reconfirmed that physical exercise was more effective than Salt Reduction or Yoga. Salt Reduction, and Yoga were equally effective.

Conclusion:

Physical exercise, salt intake reduction, and yoga are effective non-pharmacological methods for reducing blood pressure in young pre-hypertensive and hypertensive adults.     

Diabetes and Hypertension in Urban Bhutanese Men and Women

Background:

Bhutan is a mountainous country with 31% urban population. There is no information on prevalence of diabetes and hypertension in Bhutan yet. This was the first study of its kind conducted in the capital city.

Objective:

To determine prevalence of diabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and hypertension in urban Bhutanese population aged 25 to 74 years.

Materials and Methods:

Stratified two-stage sampling was adopted to include 2474 respondents (Males: 1132, Females: 1342) equally distributed among different age and sex groups. A questionnaire containing demographic, educational and social details and history of diabetes and hypertension was administered on the sampled population the previous evening and blood pressure measured the next morning in nearby camp where fasting blood samples were collected and an oral glucose tolerance test done.

Results:

Age and sex standardized prevalence of diabetes, IGT and IFG were 8.2.0, 21.6 and 4%, respectively. Only 66.5% of the population had normal blood sugar. Prevalence of diabetes and IGT increased progressively with increasing age. Prevalence of hypertension was 26% (Males: 28.3%, Females: 23.2%). It was observed that 54.1% of diabetes population had hypertension.

Conclusion:

The study shows that not only is prevalence of diabetes and hypertension high in the urban Bhutanese but also there is a high diagnosis and treatment gap in these disorders.     

Evaluation of Primary Immunization Coverage of Infants Under Universal Immunization Programme in an Urban Area of Bangalore City Using Cluster Sampling and Lot Quality Assurance Sampling Techniques

Research Question:

Is LQAS technique better than cluster sampling technique in terms of resources to evaluate the immunization coverage in an urban area?

Objective:

To assess and compare the lot quality assurance sampling against cluster sampling in the evaluation of primary immunization coverage.

Study Design:

Population-based cross-sectional study.

Study Setting:

Areas under Mathikere Urban Health Center.

Study Subjects:

Children aged 12 months to 23 months.

Sample Size:

220 in cluster sampling, 76 in lot quality assurance sampling.

Statistical Analysis:

Percentages and Proportions, Chi square Test.

Results:

(1) Using cluster sampling, the percentage of completely immunized, partially immunized and unimmunized children were 84.09%, 14.09% and 1.82%, respectively. With lot quality assurance sampling, it was 92.11%, 6.58% and 1.31%, respectively. (2) Immunization coverage levels as evaluated by cluster sampling technique were not statistically different from the coverage value as obtained by lot quality assurance sampling techniques. Considering the time and resources required, it was found that lot quality assurance sampling is a better technique in evaluating the primary immunization coverage in urban area.     

Managing Hypertension in the Elderly: A Common Chronic Disease with Increasing Age

Background

Hypertension increases with age, affecting approximately 66% of the elderly population (aged ≥65 years). By the year 2030, 1 of 5 Americans will be aged ≥65 years. A number of placebo-controlled clinical trials have demonstrated that blood pressure (BP) control reduces cardiovascular events in elderly patients, even in those aged >80 years. Despite advances in medical care, hypertension control rates remain low, especially in the elderly population.

Objective

The goal of this article is to review the information that addresses hypertension in the elderly and current strategies that can facilitate improvement in the management of this common, chronic, and life-threatening condition, which is often undertreated or inappropriately managed.

Discussion

The goals and strategies of treating hypertension in the elderly population are different from, and more challenging than, those in younger patients. Lifestyle modification is effective in this population, but it is difficult to maintain. Many antihypertensive medications are available, with thiazide diuretics being the preferred first-line treatment. Beta-blockers and alpha-blockers are generally not recommended in this population. A majority of older patients will require 2 or 3 antihypertensive medications to reach BP goal. This article reviews current data on hypertensive treatment in the elderly and summarizes the strategies and challenges healthcare providers face when dealing with this population.

Conclusion

Understanding the strategies and challenges that apply to the management of hypertension in the US elderly population can help providers and payers better address the growing need for improving the management of this condition in the elderly, because their numbers are expected to increase dramatically in the coming decades.Hypertension, defined as systolic blood pressure (BP) ≥140 mm Hg, diastolic BP ≥90 mm Hg, increases with age, affecting more than 50% of patients aged ≥60 years, and approximately 66% of those aged ≥65 years.1–3 It is well known that by 2030, 1 of 5 Americans is expected to be 65 years or older. Hypertension is the number one diagnosis in the ambulatory setting, and is one of the top diagnoses in the nursing home.4 Data from the Framingham Heart Study suggest that patients who are normotensive at age 55 years have a 90% lifetime risk of developing hypertension.5Between 1988–1994 and 2005–2008, the prevalence of hypertension increased among patients aged ≥65 years.6 The use of antihypertensive medications also increased during that period.6 As life expectancy continues to rise, approaching 75 years for men and 80 years for women, the use of antihypertensive medications in the elderly will intensify.6 Approximately 10% of the current US total annual drug expenditure is spent on antihypertensive medications.7 In 2009, the total direct and indirect costs attributable to hypertension in the United States were estimated to be $73.4 billion.8     

Interaction of Sleep Duration and Sleep Quality on Hypertension Prevalence in Adult Chinese Males

Background

Previous studies demonstrated conflicting results about the association of sleep duration and hypertension. Given the potential relationship between sleep quality and hypertension, this study aimed to investigate the interaction of self-reported sleep duration and sleep quality on hypertension prevalence in adult Chinese males.

Methods

We undertook a cross-sectional analysis of 4144 male subjects. Sleep duration were measured by self-reported average sleep time during the past month. Sleep quality was evaluated using the standard Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure level ≥140/90 mm Hg or current antihypertensive treatment. The association between hypertension prevalence, sleep duration, and sleep quality was analyzed using logistic regression after adjusting for basic cardiovascular characteristics.

Results

Sleep duration shorter than 8 hours was found to be associated with increased hypertension, with odds ratios and 95% confidence intervals (CIs) of 1.25 (95% CI, 1.03–1.52) for 7 hours, 1.41 (95% CI, 1.14–1.73) for 6 hours, and 2.38 (95% CI, 1.81–3.11) for <6 hours. Using very good sleep quality as the reference, good, poor, and very poor sleep quality were associated with hypertension, with odds ratios of 1.20 (95% CI, 1.01–1.42), 1.67 (95% CI, 1.32–2.11), and 2.32 (95% CI, 1.67–3.21), respectively. More importantly, further investigation of the association of different combinations of sleep duration and quality in relation to hypertension indicated an additive interaction.

Conclusions

There is an additive interaction of poor sleep quality and short sleep duration on hypertension prevalence. More comprehensive measurement of sleep should be performed in future studies.Key words: sleep duration, sleep quality, hypertension     

Tobacco Use Among Adolescent Students and the Influence of Role Models

Background:

Seventy per cent of premature deaths among adults are due to behavioral patterns that emerge in adolescence, including smoking.

Objective:

The objective was to study the prevalence of tobacco use among adolescent students in South Delhi and its epidemiological correlates.

Materials and Methods:

This was a cross-sectional study.

Setting:

Three schools and two colleges of South Delhi were chosen. There were 550 adolescent students aged 14-19.

Statistical Analysis:

Statistical analysis was done using proportions, the chi-square test, and multivariate logistic regression.

Results:

A total of 88 (16.0%) students reported having ever tried cigarette or bidi smoking. The prevalence of current smoking was 7.1%. Exactly 10% (55) of the students reported having ever used smokeless forms of tobacco. The prevalence of tobacco use overall was found to be 20.9%, and was significantly higher (P=0.016) among the males than the females. Tobacco use was found to be significantly associated with having seen a brother/sister smoke (OR 5.15), best friend smoke (OR 2.92), and belonging to a nuclear family (OR 1.96).

Conclusions:

Tobacco use is still an important risk behavior among adolescent students. This study found a strong association of tobacco use by the adolescents with their having seen various role models ever smoking.     

Risk Behaviors Related to Inter-personal Violence Among School and College-going Adolescents in South Delhi

Background:

Injuries are a major cause of death and disability among the adolescents in the world.

Objective:

To study risk behavior related to interpersonal violence amongst school- and college-going adolescents in South Delhi and its epidemiological correlates.

Study Design:

Cross-sectional study.

Setting:

Three schools and two colleges in South Delhi.

Participants:

Five hundred and fifty adolescents aged 14-19 years.

Statistical Analysis:

Proportions, Chi-square test, multivariate logistic regression.

Results:

Among the study participants, 65 (11.8%) reported having carried a weapon in past 30 days. Seventy-four (13.5%) respondents had threatened or injured someone with a weapon in past 12 months. Almost one in every two boys (49.1%) reported being involved in a physical fight in past 12 months. Involvement in interpersonal violence was found to be significantly more amongst males than females. Adolescents who were working part time were more likely to be ‘at risk’ (67.5%) than those not working (48.5%). In logistic regression analysis, the significant correlates of interpersonal violence were male gender, lower age, number of close friends, having seen role models smoke/drink, and residing in resettlement colonies, slums or villages. The findings regarding violence-related behaviors among adolescents are remarkably similar to those in other countries.     

Unmet Family Planning Need: Differences and Levels of Agreement Between Husband-Wife, Haryana, India

Research question:

Is there agreement between husbands and wives regarding unmet need of family planning?

Hypothesis:

The unmet need of family planning is perceived more by women then their husbands.

Objective:

1) To ascertain the unmet needs of family planning for husbands and wives. 2) To ascertain the level of agreement between husbands and wives regarding unmet needs of family planning.

Design:

A cross-sectional survey

Setting:

Dayalpur village in Intensive field practice area of Comprehensive Rural Health Services project (CRHSP), Ballabgarh, Haryana.

Study Period:

July 2003- June 2005.

Participants

included 200 married couples selected by simple random sampling.

Statistical Analysis:

Level of agreement between husbands and wives was analyzed using Kappa statistics.

Results:

Unmet need for family planning was 11% (22 out of 200) for husbands and 17.5% (35 out of 200) for wives. The difference was seen both in unmet need for spacing (M-3.5% vs. F-6%) as well as limiting family size (M-7.5% vs. F-11.5%). Overall, 93.5% concordance was observed amongst husbands and wives. In all the cases where disagreement was seen (6.5%), wives reported having unmet need for contraception whereas their husbands perceived none. The unadjusted Kappa statistic was 0.73 and prevalence adjusted Kappa was 0.88.

Conclusion:

Unmet need for family planning was significantly higher for wives compared to husbands. Despite high degrees of agreement amongst the couples, the nature of disconcordance reinforces the need for policy makers to take into account the perspective of men.