The Physicians€™ KAP study on Hormonal Methods and Female Sterilization was carried out between June and July 2001. The study is part of a larger study designed and implemented by the Engender Health in order to collect data from service providers on knowledge, attitudes and practices regarding hormonal methods (oral contraceptives, Norplant, injectables) and female sterilization. A total of 101 physicians were selected and interviewed to determine general trends in the provision of family planning services, knowledge about specific family planning methods, female sterilization, and attitudes towards family planning methods. Results of this survey are expected to guide future family planning training activities and service delivery plans. The majority of the providers were working at Primary Health Care facilities with a regional distribution that resembles that of the health centers. Males outnumbered females at a ratio of 3:2. With a mean age of about 40 years, 91.1% of the providers were married with an average of 3.5 children. While 12.9% of the sampled subjects were new employees at the MoH (less than one year of service), the remaining physicians had worked an average of 4.9 years at the MoH. Only half of the sample reported receiving at least one type of training during the five years preceding the survey. Family planning provision and counseling - During the year preceding the survey, 81.2% of the respondents reported having prescribed or provided at least one method of family planning, while 84.2% reported discussing or counseling women on family planning methods. The Combined Oral Contraceptives was the most commonly prescribed or discussed method. Counseling couples or men on family planning methods was found to be low among the respondents (18.8%). Half of the respondents (55.4%) reported providing family planning counseling to couples that have completed their family size. The IUD was the most common method (57.1%) recommended for such couples. Condoms and traditional methods were the most frequently mentioned methods by providers recommending a delay in first pregnancy. Depot-Provera and the IUD were the methods most frequently mentioned by providers recommending a family planning method for couples wishing to space their next child. Outranked only by the IUD, Tubal Ligation was mentioned by 36.6% of the providers as a recommendation in situations where no more children are desired. Knowledge about family planning - Providers tended to set an age limitation when perceiving oral contraceptives. A high percentage of providers reported not knowing the minimum and maximum age for prescribing Depot-Provera and Norplant and tended to ignore the appropriateness of Progestin only pills for women over the age of 40. With the exception of Norplant, at least 80% of providers who reported a specific minimum number of children for prescribing or referring women for modern family planning methods specified a minimum of 3 children. Providers€™ knowledge of restrictions in providing modern Physicians€™ KAP on Hormonal Methods and Female Sterilization PHCI Family planning methods to women during breast-feeding and immediately postpartum was found to be lacking and not thorough. A clear knowledge deficit was identified in relation to the various contraindications, advantages and disadvantages of the Combined and Progestin only pills, Depot-Provera and Norplant. The most common misconception heard by the providers about the Combined Oral Contraceptives was cancer perception. Meeting the training needs for Norplant provision was a pronounced barrier identified by the providers. Female Sterilization - Less than one third of the providers said that they would refer women for Tubal Ligation indicating mostly medical situations as a reason for such referrals. A completed family size was indicated by 48.4% as a reason for Tubal Ligation referral. The providers considered grand multiparity as both a medical and non-medical indication for Tubal Ligation. About 45% of the providers gave 4.7 children as the average number required before a woman should seeks Tubal Ligation, giving a higher average for the minimum number of boys than for girls (2.6 and 1.9 respectively). Providers tended to limit information offered to couples about Tubal Ligation within the disadvantages of the procedure. Most of the factors reported by the providers as barriers hindering women from accepting Tubal Ligation had a cultural, religious or personal attribute. Attitudes and beliefs - More than a third of the providers believed that female sterilization is Haram. Other modern family planning methods were reported by two thirds of the providers to be acceptable by Islam. About two thirds of the providers believed that men are the primary decision makers in family planning, and that acquisition of a spousal consent prevents women from getting a Tubal Ligation. Nine out of ten providers agreed that even with the husband€™s consent, a woman who gets a Tubal Ligation might face family problems. Forty percent of the providers said that they do not feel comfortable discussing Tubal Ligation with clients. Recommendations - This study recommends increasing the providers€™ knowledge of modern family planning methods, particularly Norplant and Depot-Provera. Developing opportunities for marketing Tubal Ligation among couples or men through a carefully designed information-education-communication (IEC) program is also recommended.