The family planning “know–do” gap among married women of reproductive age in urban Pakistan

OBJECTIVE:To examine the prevalence and predictors of family planning (FP) know-do gaps among married women of reproductive age (MWRA) in low socio-economic urban areas of Karachi, Pakistan.DESIGN:This was a cross-sectional survey of randomly selected 7288 MWRA (16–49 years) to identify predictors of the know-do gap in FP using a logistic regression model.RESULTS:More than one third (35.5%) of MWRA had FP know-do gap, i.e., despite having a knowledge of contraceptives and desire to limit or delay childbearing, they were not using contraceptives. Women were less likely to use FP if they were getting older (25–35 years: OR 1.45, 95% CI 1.09–1.94; >35 years: OR 3.02, 95% CI 1.90–4.80), from certain ethnicities (Sindhi: OR 1.64, 95% CI 1.11–2.42; Saraiki: OR 1.66, 95% CI 1.01–2.71; other minorities: OR 2.37, 95% CI 1.63–3.44); did not receive FP counselling: OR 1.43, 95% CI 1.13–1.80; and had not made a joint decision on FP: OR 1.44, 95% CI 1.06–1.98). Conversely, women were more likely to use contraceptives if they had >10 years of schooling (OR 0.66, 95% CI 0.46–0.94), with each increasing number of a living child (OR 0.68, 95% CI 0.62–0.75) and each increasing number of contraceptive method known (OR 0.93, 95% CI 0.88–0.98).CONCLUSION:The predictors associated with the FP know-do gap among MWRA should be considered when planning future strategies to improve the contraceptive prevalence rate in Pakistan.