Assessment of Sexual and Reproductive Health Interventions in Rural Sindh: A Community-Based Cross-Sectional Study

Abstract

Background: Pakistan faces significant sexual and reproductive health (SRH) challenges, with an annual population growth rate of 2.55%.  Particularly in rural Sindh, the SRH and FP uptake condition is poor due to inadequate health literacy and awareness.

Methodology: A cross-sectional study was conducted in four rural districts of Sindh, Pakistan (Sanghar, Dadu, Umerkot, and Ghotki), between October-December 2024, using a structured questionnaire. 1400 Married Women of Reproductive Age (MWRAs) with age (16-49) and 214 Community Health Workers (Marvi workers) were identified and included in the study. The study aimed to examine the current status of SRH knowledge, contraceptive use, and practices in rural Sindh household surveys. Ethical clearance and informed consent were acquired before the start of the study. SPSS version 24 was used for statistical data analysis.

Results: The findings revealed that modern CPR (mCPR) was 31.1%, with considerable variation across districts. Among contraceptive methods, injectable contraceptives and oral pills were the most commonly used methods among MWRAs, while uptake remained lower among young women and among MWRAs with a smaller number of children. Furthermore, the study identified Marvi workers as the primary source of verified SRH awareness and contraceptive access, with high community trust. However, low access to formal healthcare facilities and ongoing socio-cultural barriers and gaps in services still remain that need to be addressed.

Conclusion: The study concludes that SRH education and accessible FP services are effective interventions to improve the knowledge and perception, and to reduce unintended pregnancies among MWRAs.