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PROFORMA FOR REGISTRATION OF
SUBJECT FOR DISSERTATION
DISSERTATION PROPOSAL
“A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICE
OF PERMANANT FAMILY PLANNING METHODS AMONG
THE ELIGIBLE COUPLES IN SELECTED AREAS OF
TUMKUR.”
SUBMITTED BY:
Mr. TAISON VARKEY
1st YEAR M.Sc. NURSING
COMMUNITY HEALTH NURSING,
SHRIDEVI COLLEGE OF NURSING,
TUMKUR.
(2010-2012)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE,KARNATAKA.
ANNEXURE-II
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
1. NAME OF THE CANDIDATE AND
ADDRESS
Mr. TAISON VARKEY
1st YEAR MSc. NURSING
SHRIDEVI COLLEGE OF NURSING
SIRA ROAD.
TUMKUR
SIRA ROAD.TUMKUR.
2. NAME OF THE INSTITUTION
SHRIDEVI COLLEGE OF NURSING
3. COURSE STUDY AND SUBJECT
1ST YEAR M.Sc. NURSING
COMMUNITY HEALTH NURSING
4. DATE OF ADMISSION TO
COURSE
18-05-2010.
5. TITLE OF THE STUDY
“A STUDY TO ASSESS THE
KNOWLEDGE AND PRACTICE
OF PERMANENT FAMILY
PLANNING METHODS AMONG
THE ELIGIBLE COUPLES IN
SELECTED AREAS OF
TUMKUR.”
[2]
6.BRIEF RESUME OF INTENDED WORK
INTRODUCTION
“Between a man and his wife
nothing ought to rule
but love”
~William Penn
Human development is the ultimate objective of all planning efforts. Planning takes
into account the resources and pathways available for human development and human
resources available for carrying out the developmental Plans. Family planning in India
continues to be synonymous with sterilisation, although government policies strive to
promote reversible methods. Indeed much of the recent fertility decline in India (especially in
the southern states) is attributed to increasing acceptance of sterilisation, particularly female
sterilisation. Family planning evolution and the widespread high use of sterilisation has
several roots.1
India launched the National Family Welfare Programme in 1951 with the objective of
"reducing the birth rate to the extent necessary to stabilise the population at a level consistent
with the requirement of the National economy. The Family Welfare Programme in India is
recognised as a priority area, and is being implemented as a 100% Centrally sponsored
programme. As per Constitution of India, Family Planning is in the Concurrent list.2 The
approach under the programme during the First and Second Five Year Plans was mainly
"Clinical" under which facilities for provision of services were created. However, on the
basis of data brought out by the 1961 census, clinical approach adopted in the first two plans
was replaced by "Extension and Education Approach" which envisaged expansion of services
facilities along with spread of message of small family norm.3
During the early phases of the health and family planning programmes in India,
sterilisation services were introduced only in few Indian states for men especially in large
cities such as Madras and Bombay; the programme initially focused on the distribution of
diaphragm, jelly, vaginal foam tablets and condoms.4 A clinic-oriented approach to family
planning prevailed in the first (1951–56) and the second (1956–61) five-year plans of the
[3]
government of India. The third five-year plan (1961–66) introduced the strategy to promote
different methods. The year 1962–63, when this new approach was first implemented, was
considered as an important landmark in the Indian family planning programme (Srinivasan
1998; Raina 1994). As a part of this initiative, the IUDs introduced in 1965 turned out to be a
failure as a result of side effects and high expulsion rates of the Lippes loop. Meanwhile,
population planners recognized the problems associated with rapidly increasing population
and felt the dire need for an effective population control programme. In response to this,
sterilisation, especially vasectomy, was given due emphasis in the official family planning
programme initiated during the inter-plan period (1966–69). As an effective promotion
strategy, incentive systems were introduced for both clients and providers during this period.5
Recent scientific findings and new understanding about long-acting and permanent
methods of contraception underscore their safety and effectiveness. This has led to new
guidance from the World Health Organization (WHO), as well as continuing strong support
by the US Agency for International Development (USAID) for family planning in general
and for long-acting and permanent methods of contraception in particular. The methods
considered "long-acting" in this context are intrauterine devices (IUDs) and implants;
vasectomy and female sterilization are considered "permanent."6Injectables, such as DepoProvera are considered "short-acting" because their lengths of action are only from 1 to 3
months.WHO's guidance documents are available to inform national policies, guidelines, and
standards for delivery of family planning services, which in turn should help foster wider
access to family planning services.7
Evidence shows that women’s education has a positive association with a wider range
of contraceptive product usage in India,whereby women possessing high levels of education
use both modern and traditional non-terminal methods of birth control. Those with high
levels of education also marry later, although they will have shorter first birth intervals than
uneducated women. Nonetheless, it is unclear whether educated women use these nonterminal method options to prolong subsequent birth intervals or as effective substitutes for
sterilization to compress reproductive spans into a narrower age range in the same manner
that their uneducated counterparts accept sterilizations for the same purpose.8
[4]
6.1.NEED FOR STUDY
The concept of
“available,accessible and affordable”
is central to the successful implementation
of any planned program.
India has a long history of addressing population issues through policy and programs,
which have not been able to yield the desired results. In the world today India ranks second in
population numbers. India is set to overtake China, which at present is most populous
country, very soon. There is an important legal aspect of population phenomena and family
planning, which has not been sufficiently explored so far.9
Indian legal regime could not systematically compile all of its laws bearing on family
planning. The various statutes, administrative guidelines and judicial pronouncements are
often scattered throughout the general body of law. The significance of law to facilitate
family planning lies in helping the State to secure Constitutional guarantee of socio-economic
justice to the people of India.10
The technological advances and improved quality and coverage of health care resulted in a
rapid fall in Crude Death Rate (CDR) from 25.1 in 1951 to 9.8 in 1991. In contrast, the
reduction in Crude Birth Rate (CBR) has been less steep, declining from 40.8 in 1951 to 29.5
in 1991.11 The crrent crude death rate in India as per estimated on 2010 July is 7.53 deaths
per 1,000 population and the average crude death rate for the entire world is estimated to be
8.6 deaths per 1,000 population.12
.As a result, the annual exponential population growth rate has been over 2% in the
last three decades. During the Eighth Plan period the decline in CBR has been steeper than
that in the (CDR) and consequently, the annual population growth rate has been around 1.9%
during 1991-95.The rate of decline in population growth is likely to be further accelerated
during the Ninth Plan period. Though the decline in CBR and CDR has occurred in all States,
the rate of decline in CBR was slower in some States like U.P. and Bihar.12
[5]
Currently, the total number of acceptance of vasectomy in India in the year 2007-08 is
4,791,811 and that of tubectomy is 5,018,693.Although 43.5% of couples in India were
currently and effectively protected by family planning methods,vasectomy accounted for only
3.3% of all sterilizations.Again sterilization was accepted by largely a female population
which constituted 30.3% of all effectively protected couples.Further there was a severe
decline in the acceptance of vasectomy in the past 20 years.13
The eligible couple must be told that child should not be simply the result of a sexual
act, parenthood should be planned. Scientific and natural birth control measures should be
explained to them. A certificate must be issued for attending this course. The law should
provide for compulsory registration of marriages. Production of certificate on Responsible
Parenthood must be made compulsory for getting the marriage registered. No compulsion
should be prescribed with respect to the method of family planning. It should be left to the
choice of the eligible couple. The emphasis must be that these measures are safe and easily
available.14
A study was conducted on women’s position and their behaviour towards family
planning with the objective to determine the position of women in their famlies and their
behaviour towards family planning in Surat.Through stratified random sampling every 6th
women of age group 15- 49 years attending the family planning clinic was interviewed. By
oral questionnaire method, a pretested proforma was used to interview women of age group
15 – 49 years having atleast one living child.Results showed that 40% illiterate women and
57.1% of women having education upto primary level have adopted permanent methods.69%
housewives and 50% of service class women have adopted temporary or permanent methods.
A positive relationship observed between son preference and family planning practices which
concludes that education level,occupation and son preference have shown positive impact on
adoption of family planning methods.15
Fertility in India is declining because of contraceptive uptake by illiterate women, and
that fertility decline is outpacing educational transition.The effects of very early sterilisation
on women’s lives should be actively considered by planners.16 It is here that education and
closing the educational gap between the genders would surely be required.17 If women who
have been sterilized in their early twenties then go on to contribute to a skilled and educated
[6]
workforce, and then maybe the extra population growth caused by an early childbearing
strategy can be offset against the benefits gained. The emphasis on improving the access and
quality of reproductive and child health services will enable the increasingly aware and
literate families to attain their reproductive goals in harmony with the national goals.18
Wider access to and use of family planning, especially of long-acting and permanent
methods of contraception, which are the most effective contraceptives available, can
substantially reduce the high levels of maternal mortality and morbidity in developing
countries, as well as unwanted pregnancies and abortion.19
Owing to the current scenario of population explosion and the statistical data
mentioned above, the researcher feels that it turns out to be necessary to know whether the
people are aware about the importance and necessity of acceptance of permanent family
planning methods especially in the couples with two or more children and thereby practicing
it in order to help India to make a better place for all to live in.
[7]
6.2. REVIEW OF LITERATURE
Chopra S. et. al (2010) conducted a study to assess the knowledge, attitude and
practice of contraception in urban population of North India. In person interviews were
carried out with attendinees of Gynaecology and Obstetrics outpatient clinics, and indoor
patients of 3 hospitals of urban population to collect data regarding knowledge, attitude and
practice of family planning methods. Results showed that a total of 55.2% subjects were
aware of contraceptive methods, mostly barrier (53.7%), IUD (46%) and oral pills (43.2%),
but only 31.7% had ever used barrier contraception, IUCD 10.3% and oral pills 3.3%.
Permanent methods were known to nearly 50% subjects but acceptance was very less, 5%
only. Emergency contraception was known to 13.8% subjects who concluded that majority of
women have favourable attitude towards family planning but use of long acting new methods
is still low in our population which needs to be promoted.20
Ko Is et. al (2010) conducted a study on family planning practice and related factors
of married women in Ethopia with an aim to examine the status of permanent family planning
practice and identify interpersonal,intrapersonal and community factors associated with
family planning practice among married Ethopian women.The results shows that almost 67%
of women were currently using atleast one family planning method and most women
obtained permanent family planning from the public health sector.The study generalised the
male involvement in permanent family planning and that counselling would be successful
strategies to minimize permanent family planning practice.21
Char A. et. al (2009) conducted a study on male perception on female sterilization,a
community based study in rural central India.Seven focus group discussions were conducted
among 58 men currently married to women aged(15 - 45), followed by a cross-sectional
survey among 793 men currently married to same aged women.Results showed that 34% of
men reported that their wives had been sterilized,79% of men who did not rely on any
permanent method said that they wanted their wives to be sterilized.Thus it was concluded
that family planning service providers and programme planners need to be aware of males’
knowledge and perception pertaining to family planning.22
[8]
Kane R. et.al (2009) conducted a study on long acting, reversible and permanent
methods of contraception insight into women’s choice of method with the aim to explore the
views of women concerning their choice of long acting method of contraception. Two
hundred and eighty six women who had either been sterilized or fitted with an etonorgestrel
implant were invited to take part. A responsive rate of 54% were achieved. Results showed
that women frequently choose sterilization specifically because it is irreversible and doesnot
involve hormonal treatment. Thus it was concluded that women chose sterilization to avoid
the possible side effects of hormones, and because of its irreversibility.23
Zhang X. J. et.al (2009) conducted a study on current status of contraceptive use
among rural married women in Anhui province of China. The study aimed to explore the
current status of married women in regard of their use of contraceptive methods(permanent
methods versus non permanent methods).A total of 53,652 married women aged 18 – 49
years with a multi stage probability sampling method was used. Results showed that female
sterilization was the first choice with a usage range of 43.6% followed by IUD which was
used by 41.1% of samples. Study concludes that there was a significant increase in
contrasceptive use of rural married women in that particular area where female sterilization
and IUD still play a dominant role.24
Aisen A.O. et. al (2007) conducted a study on minilaprotomy female sterilization
with the objective to evaluate female sterilization through minilaprotomy approach over 20
year period. A study in which 156 clients who accepted permanent method of contraception
out of 14771 acceptors of family planning methods were retrieved and analysed. The results
showed that the incidence of female sterilization was 1%.80.8% had interval sterilization and
tubal occlusion was mainly by Pomeroy’s technique. Local anaesthesia under heavy sedation
was used in 85.9% of clients. Surgical complication occurred in 3.2% but the effectiveness
was 100%.The study concludes that there was a need to scale upcounselling of clients for
permanent method of contraception to improve on its poor acceptability.25
Shistha Jabeen et. al (2006) conducted a study on psychosocial factors and male
sterilization with the objective to study the demographic profile of vasectomy clients and the
psychosocial factors motivating them to be sterilized. One hundred and fifty clients attending
reproductive health services centre (RHSC). Vasectomy unit at Lahore were interviewed.
Results shows that mean age of the sample was 36.13 years.Out of the total sample,62% were
[9]
illiterate.Majority of clients were temporarily as labourers (52.7%) and
unskilled
workers(15%). Financial reasons were the main motivating factor to go for vasectomy.About
63% of clients reported that they had never tried any other contrceptives. The study
concludes that majority of the samples belong to low socio economic class and were mostly
illiterate,employed as labourers or unskilled workers.26
Rajesh Reddy S. et.al (2003) conducted a study on Rapid appraisal of knowledge,
attitude and practcies related to family planning methods among men within 5 years of
married life with an aim to find their opinion regarding men’s involvement in reproductive
health. The study population consisted of 50 men within 5 years of married life in the service
areae of the urban health centre,Kuruchikuppam, Pondichery. An interview was conducted at
the respondents house in the local language.Results showed that tubectomy was the most
popular permanent method of contraception while condoms were used 37.54% of subjects as
a temporary methdo of contarception.Magazines were the main source of knowledge (64%)
about family planning methods.The study concludes that the study population had positive
attitudes towards family planning and the study justifies the need for involving men.27
Thapa S. et. al (1994) performed a study on female sterilization acceptors at
permanent and temporary service delivery settings in Nepal. 4320 currently married women
aged 15 – 49 out of 25,384 ever-married women aged 15 – 49 were protected from pregnancy
by sterilization.1665 of women had undergone sterilization at a hospital and 515 had done so
at a camp.Among birth spacing methods and vasectomy,vasectomy had the highest level of
awareness an both groups (62.3 % for hospital group and 64.4% for camp group). Female
sterilization was the first contraceptive method used by most women (87% for hospital group
and 89.9% for camp group). These results suggest that camps have expanded the availability
and accessibility to sterilization services in Nepal.28
[10]
STATEMENT OF THE PROBLEM
“A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICE OF PERMANANT
FAMILY PLANNING METHODS AMONG THE ELIGIBLE COUPLES IN
SELECTED AREAS OF TUMKUR.”
6.3 OBJECTIVES OF THE STUDY
 To assess the level of knowledge and practice regarding permanent family planning
methods among the eligible couples.
 To find out the couple protection rate in the selected areas by the means of permanent
family planning methods.
 To find out the association between knowledge and practice on permanent family
planning methods.
 To determine the association between knowledge and practice on permanent family
planning methods with the selected demographic variables.
6.4. Operational definitions
 ASSESS: It refers to the systematic and organized continuous process of collecting
information on knowledge and practice of permanent family planning methods
among the eligible couples.
 KNOWLEDGE: It refers to the level of understanding and awareness of the eligible
couples regarding permanent family planning methods as assessed by the response to
items of the knowledge questionnaire.
 PRACTICE: It refers to the activity carried out by the eligible couples in terms of
the use of permanent family planning methods.
 PERMANENT FAMILY PLANNING METHODS: It refers to the permanent
methods for men, women and couples to regulate the number of children in a family
who believe they never wish to have children in the future.
[11]
 ELIGIBLE COUPLE: It refers to the married couple with two or more children
wherein the wife is in the reproductive age which is generally assumed to lie between
the age of 15-45 years.
6.5 RESEARCH HYPOTHESIS
H1: There will not be a significant association between knowledge and practice of
permanent family planning methods among the eligible couples.
H2: There will be a significant association between knowledge and practice of permanent
family planning methods among the eligible couples and the demographic variables.
6.6 ASSUMPTIONS
 The tool which is prepared by the researcher will be adequate to measure the knowledge and
practice of permanent family planning methods among the eligible couples.
 The eligible couples will have some knowledge regarding permanent family planning
methods.
 Even though the eligible couples have some knowledge about permanent family planning
methods, its practice would be inadequate.
6.7 DELIMITATIONS OF THE STUDY
 The study is limited to the eligible couples with two or more children.
 Assessments of the knowledge of the eligible couples will be done through written responses
as elicited by structured questionnaire; hence the knowledge displayed might not be
comprehensive.
 The study is limited to the eligible couples who are willing to participate in the study.
6.8 VARIABLES
Variables are an attribute of a person or objects that varies or takes different values.
 DEPENDENT VARIABLE
: Knowledge and practice of eligible couples regarding
permanent family planning methods.
 DEMOGRAPHIC VARIABLES : Age,Sex,Gender,Religion,Education,Type of family and
Place of living,income.
[12]
6.9 PILOT STUDY
The pilot study will be conducted on 6 samples.
The purpose of the pilot study is to:
 find out the feasibility of conducting the final study.
 Determine the methods of data analysis.
 Assess the practicability of carrying out the main study.
7 MATERIALS AND METHODS OF THE STUDY
7.1.1 SOURCES OF DATA COLLECTION
The data will be collected from the eligible couples in selected areas of Oorkere and Kestur
at TUMKUR.
7.1.2 RESEARCH DESIGN
Non experimental research design is selected to assess the knowledge and practice of the
eligible couples regarding permanent family planning methods.
7.1.3 RESEARCH APPROACH
A descriptive survey approach is considered appropriate for this study.
7.1.4 RESEARCH SETTING
The study will be conducted in selected areas at TUMKUR.
7.1.5 POPULATION
The target population of the present study comprises of the eligible couples with two or
more children residing in the selected areas at TUMKUR.
The accessible population of the present study comprises of the eligible couples present
during the study with two or more children residing in the selected areas at TUMKUR.
7.1.6 METHODS OF DATA COLLECTION
The data collection procedure will be carried out for a period of one and a half month.
The study will be initiated after obtaining permission from the concerned authorities and
[13]
informed consent from the samples.
Phase I: The data will be collected from the eligible couples on knowledge regarding
permanent family planning methods using a structured self administered questionnaire.
Phase II: The data will be collected from the eligible couples regarding the practice on
permanent family planning methods.
7.2.1 SAMPLING TECHNIQUE
In this study,the subjects will be selected by purposive sampling technique.
7.2.2 SAMPLE SIZE
The sample size of the study consists of 60 eligible couples of selected areas of TUMKUR.
SAMPLING CRITERIA
7.2.3 INCLUSIVE CRITERIA
Eligible couple:
 who are present at the time of data collection.
 with two or more children.
7.2.4 EXCLUSIVE CRITERIA
Eligible couple:
 who are not willing to participate in the study.
 who cannot understand English or Kannada.
7.2.5 TOOLS FOR DATA COLLECTION
The structured self administered questionnaire is used to collect the data from the eligible
couples.Content validity will be established by requesting the experts to go through the
developed tool and give their valuable suggestions.
The structured self administered questionnaire schedule consist of the following sections:
Section A : Structured self administered questionnaire related to the demographic variables.
Section B : Structured self administered questionnaire to assess the knowledge of eligible
couples regarding permanent family planning methods.
Section C: Checklist to assess the practice of eligible couples on permanent family planning
methods.
[14]
7.2.6 DATA ANALYSIS METHOD
The data will be organized,tabulated and analysed by using descriptive and inferential
statistics.The data will be planned to present in the form of tables and figures.
 DESCRIPTIVE STATISTICS:
Frequency and percentage for analysis of demographic data; mean percentage and standard
deviation will be used for assessing the level of knowledge.
 INFERENTIAL STATISTICS:
“Chi-square test” will be used to find out the association between the knowledge and practice
with the selected demographic variables.
“Unpaired t-test” will be used to find out the knowledge and practice scores of the eligible
couples.
7.2.7 TIME AND DURATION
The time and duration of the study will be limited to three months as per the guidelines of the
university.
7.3 DOES
THE
STUDY
INTERVENTION TO BE
REQUIRE
ANY
INVESTIGATION
OR
CONDUCTED ON PATIENTS OR OTHER
HUMANS OR ANIMALS?IF SO PLEASE DESCRIBE BRIEFLY.
No. Since the study is descriptive, interventions are not required.
7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR
INSTITUTIONS?
The pilot study and the main study will be conducted after the approval of the research
committee.Permission will be obtained from the concerned head of the institution.The purpose
and the details of the study will be explained to the study subjects and an informed consent will
be obtained from them.Assurance will be given to the study subjects regarding the
confidentiality and anonymity of the data collected from them.
[15]
8.References:
1. Family welfare programme in India. Availablefrom
http://www.mohfw.nic.in/dofw%20website/family%20welfare%20programme/intro.htm
2. National Family welfare programme. Available from
http://pbhealth.gov.in/pdf/FW.pdf
3. K Park.Preventive and social medicine.20th edition.Jabalpur:Banarsidas
Banot.2009.437-440.
4. Family welfare programme:An overview. Available from
http://www.cicmanipur.nic.in/HTML/family_welfare_programme.html
5. Family welfare programme. Available from
http://www.tn.gov.in/policynotes/archives/policy200809/pdf/health/family_welfare.pdf
6. S Kamalam.Essentials in Community nursing practice.1st edition.New Delhi:
Jaypee;2005.319-322.
7. Health and family welfare. Available from
http://www.delhi.gov.in/wps/wcm/connect/DoIT_Health/health/home/family+wel
fare/
8. Operational Guidelines on FDS (Fixed Day Static) approach for Sterilization
Services under the Family Welfare Programme. Available from
http://203.193.146.66/hfw/PDF/Services_Operational%20Guideline.pdf
9. A H Suryakanta.Community Medicine With Recent Advances.2nd edition.New
Delhi:Jaypee;2010.621-624.
10. Female Sterilization. Available from
http://health.indiamart.com/familyplanning/female-sterilization.html
11. Birth control and family planning. Available from
http://www.nlm.nih.gov/medlineplus/ency/article/001946.html
12. M C Gupta,B K Mahajan.Textbook of Preventive and social medicine.3rd edition.
New Delhi:Jaypee;2003.556-560
13. WHO Guidance for Family Planning Use. Available from
http://www.medscape.com/viewarticle/560964_2.
[16]
14. Family Planning - Permanent birth control. Available from
http://www.faqs.org/health-encyc/The-Begining-of-a-Family/Family-PlanningPermanent-birth-control.html
15. Rajesh K Chudasama,Naresh R Godara,Mohua Moitra. Women’s position and their
behaviour towards family planning.Internet journal of family practice 2009;7(2).
Available from
http://www.ispub.com/journal/the_internet_journal_of_family_practice/volume_7_numb
er_2_19_article_printable/women_s_position
and_their_behaviour_towards_family_planning.html
16. Permanent Family Planning.Available from
http://www.ehow.com/facts_6170347_permanent-family-planning.html
17. Family planning council. Available from
http://www.familyplanning.org/reprofacts_birthcontrol.shtml
18. Long-Acting and Permanent Methods. Available from
http://www.engenderhealth.org/our-work/family-planning/long-acting-andpermanent-methods.php
19. G M Dhaar,I Robbani.Foundations of community medicine.1st edition.New
Delhi:Elsevier;2006.200-205.
20. Chopra S,Dhaliwal L.Knowledge ,attitude and practices of contraception in urban
population of North India.Archives of Gynaecology and Obstetrics 2010 February;
281(2)273-7. Available from http://www.ncbi.nlm.gov/pubmed/19404657.
21. Ko Is, You Ma, Kim ES, Lee TW, Kims, Kim YM, Nam JJ, Lee HK. Family planning
practice and related factors of married women in Ethiopia. International Nursing Review
2010 September;57(3)377-82. Available from
http://www.ncbi.nlm.gov/pubmed/20796069.
22. Char A, Saavala M,Kulmala T. Male perceptions on female Sterilization:a community
based study in rural central India.International prospective on sexual and reproductive
health 2009 September;35(3) 131-8. Available from
http://www.ncbi.nlm.gov/pubmed/19805018.
23. Kane R,Irrving G, Brown S,Parkes N,Walling M,Kallick S.Long acting,irreversible and
permanent methods of contraception:insight into women’s choice of method.Quality in
primary care 2009;17(2)107-14. Available from
http://www.ncbi.nlm.gov/pubmed/19416603.
[17]
24. Zhang XJ, Wang GY, Shen Q,Yu YL, Sun YH, Yu GB, Zhao D,Ye DQ. Current status of
contraceptive use among rural married women in Anhui province of China. International
Journal of Obstetrics and Gynaecology 2009 November;116(12) 1640-5. Available from
http://www.ncbi.nlm.gov/pubmed/19735377.
25. Aisien AO,Oronsaye AU.Minilaprotomy laprotomy female sterilization at the university
of Benin Teaching Hospital.The Nigerian post graduate medical journal 2007
March;14(1)67-71.Available from http://www.ncbi.nlm.gov/pubmed/17356596.
26. Shaista Jabeen,Shabana Afshan,Muhammad Amjad Ramzan,Haroon Rashid
Chaudry.Psychosocial factors and male sterilization. Pakistan journal of medical sciences
2006 July-September 2006;22(3) 277-81. Available from
http://www.pakmedinet.com/view.php?id=9484
27. Rajesh Reddy S,KC Premarajan, K A Narayan,Akshaya Kumar Mishra. Rapid appraisal
of knowledge,attitude and practices related to family planning methods among men
within 5 years of married life. Available from
http://docs.google.com/viewer?a=v&q=cache:2GUQQn32exAJ:medind.nic.in/ibl/t03/i1/i
blt03i1p62o.pdf+indian+journal+of+preventive+and+social+medicine.volume.34+no.1%
262,2003&hl=en&gl=in&pid=bl&srcid=ADGEESiJbYRlfn5eN9FPG21ghyJ8N9ZQBGY7F5Jw6n_2-WLtubvebilio5luues7uQRBKRWXd5fO2Ni_8KRocsgnKCcEt9BUxObBtD4Vq139WwbEwtpAlBwk5dgC
PMhQaLhmUes9M-&sig=AHIEtbSkSY7j5EFYySuvVpAloNdoVVcchw
28. Thapa S,Pandey KR,Shrestha H.Female sterilization acceptors at permanent and
temporary service delivery settings in Nepal.Journal of the Nepal medical
association1994 July- September;32(111)144-53. Available from
http://www.ncbi.nlm.gov/pubmed/12154939.
[18]
9.
SIGNATURE OF THE CANDIDATE
10. REMARKS OF THE GUIDE
11. 11.1 NAME AND DESIGNATION OF GUIDE
11.2 SIGNATURE
11.3 CO-GUIDE
11.4 SIGNATURE
11.5 HEAD OF THE DEPARTMENT
11.6 SIGNATURE
12
12.1 REMARKS OF THE CHAIRMAN
AND THE THE PRINCIPAL
12.1 SIGNATURE
[19]
[20]