scholarly journals Share of current unmet need for modern contraceptive methods attributed to past users of these methods in India

2020 ◽  
pp. 1-12
Author(s):  
Ankita Shukla ◽  
Anrudh K. Jain ◽  
Rajib Acharya ◽  
F. Ram ◽  
Arupendra Mozumdar ◽  
...  

Abstract Despite persistent efforts, unmet need for contraceptives in India has declined only slightly from 14% to 13% between 2005–06 and 2015–16. Many women using a family planning method discontinue it without switching to another method and continue to have unmet need. This study quantified the share of current unmet need for modern contraceptive methods attributed to past users of these methods in India. Data were drawn from two rounds of the National Family Health Survey conducted in 2005–06 and 2015–16. Using information on women with current unmet need, and whether they used any modern method in the past, the share of past users with current unmet need for modern methods was calculated. Bivariate and multivariate analyses were performed. Among 46 million women with unmet need, 11 million were past users of modern methods in 2015–16. The share of current unmet need attributed to past users of modern contraceptive methods declined from 27% in 2005–06 to 24% in 2015–16. Share of current unmet need attributed to past users was associated with reversible method use. This share rose with increased use of modern reversible methods. With the Indian family planning programme’s focus on increasing modern reversible method use, the share of unmet need attributed to past users of modern methods is likely to increase in the future. The programme’s emphasis on continuation of contraceptive use, along with bringing in new users, could be one of the key strategies for India to achieve the FP2020 goals.

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e054188
Author(s):  
Noudéhouénou Crédo Adelphe Ahissou ◽  
Lenka Benova ◽  
Thérèse Delvaux ◽  
Charlotte Gryseels ◽  
Jean-Paul Dossou ◽  
...  

ObjectivesThe study aimed to assess the determinants of modern contraceptive method use among young women in Benin.DesignA mixed-methods design.Setting and participantsWe used the Benin 2017–2018 Demographic and Health Survey datasets for quantitative analysis. Data collection was conducted using multiple-cluster sampling method and through household survey. Qualitative part was conducted in the city of Allada, one of the Fon cultural capitals in Benin. The participants were purposively selected.OutcomesContraceptive prevalence rate, unmet need for modern method and percentage of demand satisfied by a modern method for currently married and sexually active unmarried women were measured in the quantitative part. Access barriers and utilisation of modern methods were assessed in the qualitative part.ResultsOverall, 8.5% (95% CI 7.7% to 9.5%) among young women ages 15–24 were using modern contraceptives and 13% (12.1% to 14.0%) among women ages 25 or more. Women 15–24 had a higher unmet need, and a lower demand satisfied by modern contraceptive methods compared with women ages 25 or more. 60.8% (56.9% to 64.7%) of all unmarried young women had unmet need for modern contraceptives. Young women were more likely to use male condoms which they obtain mainly from for-profit outlets, pharmacies and relatives. The factors associated with demand satisfied by a modern method were literacy, being unmarried, knowing a greater number of modern contraceptive methods and experiencing barriers in access to health services. On the other hand, the qualitative study found that barriers to using modern methods include community norms about pre-marital sexual intercourse, perceptions about young women’s fertility, spousal consent and the use of non-modern contraceptives.ConclusionContraceptive use is low among young women in Benin. The use of modern contraceptives is influenced by sociodemographic factors and social norms. Appropriate interventions might promote comprehensive sexuality education, increase community engagement, provide youth-friendly services and address gender inequalities.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Fernanda Ewerling ◽  
Lotus McDougal ◽  
Anita Raj ◽  
Leonardo Z. Ferreira ◽  
Cauane Blumenberg ◽  
...  

Abstract Objective To 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. Methods Using 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. Results The 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. Conclusion Indian family planning policy should prioritize women-centered care, making reversible contraceptive methods widely available and promoted.


2021 ◽  
Author(s):  
Fernanda Ewerling ◽  
Lotus McDougal ◽  
Anita Raj ◽  
Leonardo Z. Ferreira ◽  
Cauane Blumenberg ◽  
...  

Abstract 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 (2015-16), 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.


2021 ◽  
Author(s):  
Noudéhouénou Crédo Adelphe AHISSOU ◽  
Lenka BENOVA ◽  
Thérèse DELVAUX ◽  
Charlotte GRYSEELS ◽  
Jean-Paul DOSSOU ◽  
...  

Objectives The study aimed to assess the determinants of modern contraceptive method use among young women in Benin. Design A mixed-methods design. Setting and participants We used the Benin 2017-18 Demographic and Health Survey datasets for quantitative analysis. Data collection was conducted using multiple-cluster sampling method and through household survey. Qualitative part was conducted in the city of Allada, one of the Fon cultural capitals. The participants were purposively selected. Outcomes Contraceptive prevalence rate, unmet need for modern method, and percentage of demand satisfied by a modern method for currently married and sexually active unmarried women were measured in the quantitative part. Access barriers and utilization of modern methods were assessed in the qualitative part. Results Overall, 8.5% (95%CI: 7.7-9.5%) among young women ages 15 to 24 were using modern contraceptives and 13% (95%CI: 12.1-14.0%) among women ages 25 or more. Women 15-24 had a higher unmet need, and a lower demand satisfied by modern contraceptive methods compared to women aged 25 or more. 60.8% (56.9-64.7%) of all unmarried young women had unmet need for modern contraceptives. Young women were more likely to use male condoms which they obtain mainly from for-profit outlets, pharmacies, and relatives. The factors associated with demand satisfied by a modern method were literacy, being unmarried, knowing a greater number of modern contraceptive methods, and experiencing barriers in access to health services. On the other hand, the qualitative study found that barriers to using modern methods include community norms about pre-marital sexual intercourse, perceptions about young women's fertility, spousal consent, and the use of non-modern contraceptives. Conclusion Contraceptive use is low among young women in Benin. The use of modern contraceptives is influenced by socio-demographic factors and social norms. Appropriate interventions might promote comprehensive sexuality education, increase community engagement, provide youth-friendly services, and address gender inequalities.


2021 ◽  
Vol 4 ◽  
pp. 160
Author(s):  
Kristin Bietsch ◽  
Ali Arbaji ◽  
Jennifer Mason ◽  
Rebecca Rosenberg ◽  
Malak Al Ouri

Background: Between the two most recent Population and Family Health Surveys, Jordan saw a dramatic decline in the Total Fertility Rate (TFR) from 3.5 to 2.7 in 5.5 years.  Over the same period, modern contraceptive use also declined, from 61.2% to 51.8% among married women.  This decrease in both TFR and the contraceptive prevalence rate (CPR) diverges from the typical relationship seen between these two factors whereby historically as CPR increases, TFR decreases.  This paper explores this unique pattern using multiple methodologies.  Methods: First, we validate the survey data using nationally collected data on fertility and contraceptive distribution.  Second, we look to changes that have historically influenced changes in CPR and TFR, including changes in ideal family size and wanted fertility rates. Third, we explore proximate determinants and other influences on fertility and changes in contraception, examining the changes in the method mix and unmet need; marriage patterns, including the demographics of the married population, spousal separation, and time since last sex; postpartum insusceptibility; infecundity, both primary and secondary; and abortion, to see if any have shifted significantly enough to allow for fertility to decline with less contraceptive use. Results: We find that the decline in fertility in Jordan was driven by a reduction in mistimed or unwanted pregnancies and there was a significant increase in the share of reproductive aged women who are infecund. We also concluded that the changes in fertility and contraceptive use are driven by changes in Jordanian nationals, not by the growing Syrian refugee population. Conclusions: Jordan is not the only country to be experiencing a shift in the typical relationship between CPR and TFR.  Results can inform both future approaches for family planning programs and our expectations regarding what kind of change our family planning investments might buy.


2019 ◽  
Vol 7 (2) ◽  
pp. 223-227
Author(s):  
Hajiieh Bibi Razeghi Nasrabad ◽  
Malihe Alimondegari ◽  
Zeinab Mohseni Nejhad

Objectives: Despite the increasing knowledge about family planning and modern contraceptive methods, as well as high failure rates of the traditional method, a significant percentage of couples use withdrawal for contraception. Accordingly, the present study mainly aimed to investigate the determinants of using withdrawal to avoid pregnancy in Tabriz. Materials and Methods: The sample of the study included 383 married women aged 15-49 years. Multivariate logistic regression analyses were employed to determine factors associated with using withdrawal as a contraceptive method. Results: Based on the results, about 19.5% of the women were relying on withdrawal. In addition, 55% reported that they were currently using a modern method to avoid pregnancy while the remaining 25.5% used no method in order to prevent contraception. The results of multivariate logistic regression demonstrated that university-educated couples with no child who were within the age range of 15-24 and born in urban areas were more likely to use withdrawal rather than modern contraceptive methods (P<0.05). Conclusions: In general, the rate of employing the traditional method in Iran and, especially in Tabriz is increasing. Regarding higher proportion of withdrawal use among higher educated women due to the fear of side effects resulted from other methods, family planning providers and reproductive health services should be sensitive to the women’s concern and provide programs to decrease the unmet need of family planning.


Author(s):  
Anita Pal ◽  
Jeetendra Yadav ◽  
Sunita . ◽  
Kh. Jitenkumar Singh

Background: Many women in low and middle-income countries would like to limit or delay their pregnancy, but they do not enough access to consistent use of modern contraceptive methods. The concept of unmet need for family planning is focus to reproductive health policies, as it endures serious implications for the women, the child, family and the whole society. The aims of the study are to assess the spatial dimensions of extent of unmet need for family planning and also identify association between individual, household, community and district level covariates with the level of unmet need for family planning among married women of reproductive age group in Bihar, India.Methods: The study uses data from fourth round of the National Family Health Survey (NFHS-4). To meet the objective the analysis included descriptive, spatial visualization, spatial autocorrelation and multilevel logistic model. In the first step of analysis the multivariate analysis was used to know the levels of unmet need for family planning by selected background characteristics.Results: This study indicating that nearly one in five or more women experiences unmet need for family planning suggests that the problem remains of considerable magnitude and that action is needed to fill the gap in contraceptive use, which is currently estimated at a lowest 24 percent. Apart from providing a current estimate of unmet need, our study identified a number of relevant socioeconomic and demographic factors likely to shape the probability that a women experiences unmet need. It is observed across individual level, community/psu level and district level.Conclusions: Considering this fact, family planning program in Bihar should also focus on eliminating misconceptions and fear about contraception through proper counselling of couples and information, education and communication activities in the community and try to improve the quality of advice and care services related to family planning.


2020 ◽  
Vol 4 ◽  
pp. 160
Author(s):  
Kristin Bietsch ◽  
Ali Arbaji ◽  
Jennifer Mason ◽  
Rebecca Rosenberg ◽  
Malak Al Ouri

Background: Between the two most recent Population and Family Health Surveys, Jordan saw a dramatic decline in the Total Fertility Rate (TFR) from 3.5 to 2.7 in 5.5 years.  Over the same period, modern contraceptive use also declined, from 61.2% to 51.8% among married women.  This decrease in both TFR and the contraceptive prevalence rate (CPR) diverges from the typical relationship seen between these two factors whereby historically as CPR increases, TFR decreases.  This paper explores this unique pattern using multiple methodologies.  Methods: First, we validate the survey data using nationally collected data on fertility and contraceptive distribution.  Second, we look to changes that have historically influenced changes in CPR and TFR, including changes in ideal family size and wanted fertility rates. Third, we explore proximate determinants and other influences on fertility and changes in contraception, examining the changes in the method mix and unmet need; marriage patterns, including the demographics of the married population, spousal separation, and time since last sex; postpartum insusceptibility; infecundity, both primary and secondary; and abortion, to see if any have shifted significantly enough to allow for fertility to decline with less contraceptive use. Results: We find that the decline in fertility in Jordan was driven by a reduction in mistimed or unwanted pregnancies and there was a significant increase in the share of reproductive aged women who are infecund. We also concluded that the changes in fertility and contraceptive use are driven by changes in Jordanian nationals, not by the growing Syrian refugee population. Conclusions: Jordan is not the only country to be experiencing a shift in the typical relationship between CPR and TFR.  Results can inform both future approaches for family planning programs and our expectations regarding what kind of change our family planning investments might buy.


2021 ◽  
Vol 37 (10) ◽  
Author(s):  
Adriana Kramer Fiala Machado ◽  
Débora Dalmas Gräf ◽  
Fabiane Höfs ◽  
Franciele Hellwig ◽  
Karoline Sampaio Barros ◽  
...  

Monitoring trends of contraceptive use and identifying the groups with less coverage are needed to guide public policies and make them more efficient. But, in Brazil, recent data about these aspects are limited. This study aimed to investigate the prevalence of contraceptive use and its inequalities during adolescence and early adulthood. Data from the 1993 Pelotas birth cohort, Rio Grande do Sul State, Brazil, were used. At 15, 18 and 22 years, respectively, 335, 1,458 and 1,711 women reported having started their sexual lives and were included in analysis. Prevalence and 95% confidence intervals were obtained to describe the most used contraceptive methods. Inequalities in modern contraceptive use were evaluated according to wealth index, scholastic backwardness and ethnicity. In all follow-ups, more than 80% of women used at least one modern method. The use of barrier methods decreased with age; at 22 this prevalence was 36.3%. Such use concomitant with other modern methods was lower than 50% in all follow-ups. We observed inequalities in the use of modern contraceptive methods, mainly in barrier methods used with other modern methods. These findings may contribute and improve the public policies in family planning.


2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Susan Ontiri ◽  
Lilian Mutea ◽  
Violet Naanyu ◽  
Mark Kabue ◽  
Regien Biesma ◽  
...  

Abstract Background Addressing the unmet need for modern contraception underpins the goal of all family planning and contraception programs. Contraceptive discontinuation among those in need of a method hinders the attainment of the fertility desires of women, which may result in unintended pregnancies. This paper presents experiences of contraceptive use, reasons for discontinuation, and future intentions to use modern contraceptives. Methods Qualitative data were collected in two rural counties in Kenya in 2019 from women with unmet need for contraception who were former modern contraceptive users. Additional data was collected from male partners of some of the women interviewed. In-depth interviews and focus group discussions explored previous experience with contraceptive use, reasons for discontinuation, and future intentionality to use. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Results Use of modern contraception to prevent pregnancy and plan for family size was a strong motivator for uptake of contraceptives. The contraceptive methods used were mainly sourced from public health facilities though adolescents got them from the private sector. Reasons for discontinued use included side effects, method failure, peer influence, gender-based violence due to covert use of contraceptives, and failure within the health system. Five reasons were provided for those not willing to use in the future: fear of side effects, cost of contraceptive services, family conflicts over the use of modern contraceptives, reduced need, and a shift to traditional methods. Conclusion This study expands the literature by examining reasons for contraceptive discontinuation and future intentionality to use among women in need of contraception. The results underscore the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help garner support for contraception, rather than focusing exclusively on women. The results of this study can inform implementation of family planning programs in Kenya and beyond to ensure they address the concerns of former modern contraception users.


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