A Comparative analysis of rural–urban disparities in acceptance of injectable contraceptive MPA (Antara) among women of reproductive age in Rohtak, Haryana

Abstract

Background: Family planning is a key component of reproductive health, yet the use of injectable contraceptives in India remains low despite their inclusion in the national Antara program. Limited awareness, sociocultural barriers, and misconceptions particularly affect rural women, while urban–rural disparities further shape contraceptive adoption. Aim: To compare awareness, utilisation, knowledge, attitude, and barriers related to acceptance of injectable contraceptive medroxyprogesterone acetate (MPA) under the Antara program among women of reproductive age in rural and urban communities of Rohtak, Haryana. Methods: A descriptive, comparative cross-sectional survey was conducted among 400 women (200 rural, 200 urban) aged 18–49 years attending selected primary health centers in Rohtak. Data were collected using structured, validated tools assessing awareness, knowledge, attitude, and barriers. Descriptive and inferential statistics, including chi-square tests, t-tests, and Pearson correlation, were applied at a significance level of p<0.05. Results: Only 40.7% of women were aware of MPA, with higher awareness in urban areas (47%) than rural (34.5%). Utilisation was low overall (9.9%), though slightly higher among urban women (11.7%). Knowledge was poor in 54.6% of participants, especially rural (68.1% vs. 44.6% urban). Attitudes were largely unfavourable (48.5%), more so in rural women (57.9%). Major barriers included fear of injection, menstrual irregularities, concerns about delayed fertility, and spousal or community opposition. Awareness and attitude significantly influenced utilisation, while knowledge was a key predictor in rural women. Conclusion: Awareness and acceptance of injectable contraceptives remain low in Rohtak, with marked rural–urban disparities. Strengthening counselling, addressing myths, involving families, and targeted interventions are essential to improve uptake and achieve a balanced contraceptive method mix.