Modern contraceptive use among women in need of family planning in India: an analysis of the inequalities related to the mix of methods used

Reproductive Health

Lotus McDougal¹  Anita Raj¹  Cauane Blumenberg²  Fernanda Ewerling³  Leonardo Z. Ferreira⁴  Aluisio J. D. Barros⁴  Divya Parmar⁵ 

[1] Center on Gender Equity and Health, University of California San Diego, San Diego, USA;International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil;International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil;Marechal Deodoro 1160, 3rd floor, Pelotas, RS, Brazil;International Center for Equity in Health, Universidade Federal de Pelotas, Pelotas, Brazil;Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil;King’s Centre for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, King’s College London, London, UK;

关键词: Family planning;    Contraceptive use;    Health inequalities;   

DOI  :  10.1186/s12978-021-01220-w

来源: Springer

【 摘 要 】

ObjectiveTo evaluate the type of contraceptives used by women in need of family planning in India and the inequalities associated with that use according to women's age, education, wealth, subnational region of residence and empowerment level.MethodsUsing data from the Indian National Family and Health Survey-4 (2015–2016), we evaluated the proportion of partnered women aged 15–49 years with demand for family planning satisfied (DFPS) with modern contraceptive methods. We also explored the share of each type of contraception [short- (e.g., condom, pill) and long-acting (i.e., IUD) reversible contraceptives and permanent methods] and related inequalities.ResultsThe majority (71.8%; 95% CI 71.4–72.2) of women in need of contraception were using a modern method, most (76.1%) in the form of female sterilization. Condom and contraceptive pill were the second and third most frequently used methods (11.8% and 8.5%, respectively); only 3.2% reported IUD. There was a nearly linear exchange from short-acting to permanent contraceptive methods as women aged. Women in the poorest wealth quintile had DFPS with modern methods at least 10 percentage points lower than other women. We observed wide geographic variation in DFPS with modern contraceptives, ranging from 23.6% (95% CI 22.1–25.2) in Manipur to 93.6% (95% CI 92.8–94.3) in Andhra Pradesh. Women with more accepting attitudes towards domestic violence and lower levels of social independence had higher DFPS with modern methods but also had higher reliance on permanent methods. Among sterilized women, 43.2% (95% CI 42.7–43.7) were sterilized before age 25, 61.5% (95% CI 61.0–62.1) received monetary compensation for sterilization, and 20.8% (95% CI 20.3–21.3) were not informed that sterilization prevented future pregnancies.ConclusionIndian family planning policy should prioritize women-centered care, making reversible contraceptive methods widely available and promoted.

【 授权许可】

CC BY