Knowledge, attitudes and practices of contraception among women in an urban slum of Coimbatore, Tamil Nadu: a community-based cross-sectional study of a Gondi tribal settlement

Background: Urban slum communities in India bear a disproportionate burden of unmet reproductive health needs, driven less by unawareness than by barriers to access and use, compounded by gendered norms that assign reproductive responsibility to women. This study assessed contraceptive knowledge, attitudes, and practices (KAP) among women of Gondi tribal descent in an urban slum of Coimbatore, Tamil Nadu. Methods: A community-based cross-sectional survey of 190 married women aged 18-45 years was conducted using a structured interviewer-administered questionnaire covering sociodemographics, reproductive history, and KAP, supplemented by field observations. Socioeconomic status was classified using the updated BG Prasad scale (2025). Descriptive statistics and chi-square tests were used. Results: Mean age was 32.9 years; 50.5% were illiterate and 51.6% belonged to the lower socioeconomic class. Awareness was highest for female sterilization (79.5%) and injectables (68.4%) and lowest for oral contraceptive pills (8.9%); 20.0% had never heard of any method. Although 95.8% wanted no more children, only 51.1% had ever used contraception. Female sterilization accounted for 46.4% of ever-users; the remainder had used reversible or traditional methods, but fewer than 5% of all women were currently using a reversible method. No husband had undergone vasectomy. Higher parity and any formal education were significantly associated with ever-use (p<0.001 for both). Conclusions: The knowledge-practice gap in this Gondi community is shaped by social isolation, gendered norms excluding men from reproductive responsibility, undifferentiated fear of side effects, and reactive healthcare use. Doorstep outreach, male partner engagement, and community-based education on all methods are needed.