Knowledge and attitude of Palestinian women to contraceptives: a cross-sectional study

Contraceptives have documented efficiency, but outcomes are highly dependent on women's understanding of how they should be used. We assessed the knowledge and attitudes of married Palestinian women about contraceptives and understanding of use of the available methods and side-effects.

This cross-sectional study involved married Palestinian women of childbearing age (18-50 years), and was done between Jan 20, 2017, and Jan, 1, 2018. A stratified random sample of 900 women was selected from each Palestinian governorate in the West Bank and East Jerusalem, with the number selected based on population size. An interviewer-assisted questionnaire was completed by each participant.

833 women were selected to participate and 771 (93%) completed the questionnaire. 123 (16%) of women reported not using any method of contraception. Among those who used contraception, intrauterine devices were most commonly used (312 [41%] of 771), followed by oral contraceptives (162 [21%]). Progestagen-only pills were the most frequently used type of oral contraceptive (45 [28%] of 162). Female sterilisation was used as a birth control method by 19 (3%) of 771 women. Investigation of the reasons behind contraception use showed that organisation of pregnancies was most common (511 [79%] of 648), followed by having too many children (131 [20%]) and economic reasons (73 [11%]). Regarding attitudes and beliefs towards contraceptive use, of the 771 participants, 49 (6%) believed that religion forbids their use and 112 (14·5%) considered them socially unacceptable. The study revealed poor scores for knowledge about use and possible side effects of contraceptives (mean 8·2 [SD 2·9] correct answers to 14 questions).

Most Palestinian women have used contraceptives, but poor knowledge of how to use them and side-effects is apparent. The attitudes of Palestinian women and their partners towards contraceptives indicates general acceptance of their use. A strength of our study is that it included representative sample of Palestinian women and our results and conclusions reflect the knowledge and attitudes towards contraceptives in Palestinian society.

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