Family Welfare Expenditure, Contraceptive Use, Sources and Method-Mix in India

Making universal access to sexual and reproductive health care a reality, and thus building momentum for comprehensive family planning by 2030, is key for achieving sustainable development goals. However, in the last decade, India has been retreating from progress achieved in access to family planning. Family planning progress for a large country such as India is critical for achieving sustainable developmental goals. Against this backdrop, the paper investigated the question of how far family welfare expenditure affects contraceptive use, sources of contraceptive methods, and method-mix using triangulation of micro and macro data analyses. Our findings suggest that, except for female sterilizations, modern methods of contraception do not show a positive relationship with family welfare expenditure. Notwithstanding a rise in overall family welfare expenditure, spending on core family planning programs stagnates. State-wise and socio-economic heterogeneity in source-mix and method-mix continued to influence contraceptive access in India. Method-mix continued to skew towards female sterilization. Public sector access is helpful only for promoting female sterilization. Thus, the source-mix for modern contraceptives presents a clear public-private divide. Over time, access to all contraceptive methods by public sources declined while the private sector has failed to fill the gap. In conclusion, this study identified a need for revitalizing family planning programs to promote spacing methods in relatively lower-performing states and socio-economic groups to increase overall contraceptive access and use in India through the rise in core family planning expenditure.

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The everlasting outmoded contraceptive method mix in Brazil and its legacy.

Revista Brasileira de Estudos de População ◽

10.20947/s0103-3098a0103 ◽

2019 ◽

Vol 36 ◽

pp. 1-29

Author(s):

Suzana Cavenaghi ◽

José Eustáquio Diniz Alves

Keyword(s):

Family Planning ◽

Contraceptive Method ◽

Fertility Transition ◽

National Health Survey ◽

Contraceptive Methods ◽

Female Sterilization ◽

Family Planning Programs ◽

Short Period ◽

The 1960S ◽

Method Mix

Fertility transition occurred in a short period of time in Brazilian the absence of family planning programs, and most noticeable, in a context of illegality in the provision of means of fertility selfregulation. These events did not happen without consequences. Based in the literature and facts registered during that time, the paper first discusses how the resistance to the implementation of family planning programs from the 1960s to the 1980s have contributed to the unbalanced contraceptive method mix in the 1990’s. Secondly, the paper will discuss problems around contraceptive data collection in the National Health Survey, and, performing an adjustment of the data, we analyze trends in the use of contraceptive methods from 1986 to 2013, showing that method mix continues to be very concentrated in the same two methods, an even more outdated scheme, with the daily pill exchanging first place with female sterilization. Finally, the paper discusses some fertility characteristics associated with the outdated contraceptive mix, still prevailing at the end of fertility transition, arguing that this could be avoided or minimized if policies and laws are based in reproductive rights of all people only.

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The everlasting outmoded contraceptive method mix in Brazil and its legacy

Revista Brasileira de Estudos de População ◽

10.20947/s0102-3098a0103 ◽

2019 ◽

Vol 36 ◽

pp. 1-29

Author(s):

Suzana Cavenaghi ◽

José Eustáquio Diniz Alves

Keyword(s):

Family Planning ◽

Contraceptive Method ◽

Fertility Transition ◽

National Health Survey ◽

Contraceptive Methods ◽

Female Sterilization ◽

Family Planning Programs ◽

Short Period ◽

The 1960S ◽

Method Mix

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USE OF MALE METHODS OF CONTRACEPTION WORLDWIDE

Journal of Biosocial Science ◽

10.1017/s0021932016000560 ◽

2016 ◽

Vol 49 (5) ◽

pp. 648-663 ◽

Cited By ~ 7

Author(s):

John Ross ◽

Karen Hardee

Keyword(s):

Condom Use ◽

Time Trends ◽

Contraceptive Use ◽

Contraceptive Methods ◽

Female Sterilization ◽

Geographic Variations ◽

Male Contraceptive ◽

Use Patterns ◽

Method Mix ◽

Male Sterilization

SummaryThis article analyses male contraceptive use, both globally and for developing countries. Shares of all contraceptive use due to males are examined, in the context of female use and all use. Patterns according to wealth quintiles are analysed, as well as time trends and geographic variations. Data are drawn primarily from compilations by the UN Population Division and from the Demographic and Health Series and subjected to relatively simple statistical methods including correlation/regression applications. Contraceptive methods that men use directly, or that require their co-operation to use, including condoms, withdrawal, rhythm and male sterilization, account for one-quarter of all contraceptive use worldwide. This represents 13% of married/in-union women. Both the share and the prevalence of male methods vary widely by geography and by the four methods, as well as by quintile wealth groups. With greater wealth there is an unbroken rise for total use; among the male methods, the shares of condom use and rhythm rise by wealth quintiles, while the share of withdrawal drops. The share for male sterilization is highest in the lowest and highest wealth quintiles and dips for the middle quintiles. The overall time trend since the 1980s has been steady at one-quarter of all use involving men; moreover, the share is about the same at all levels of total use. The female-only methods continue to dominate: female sterilization, IUD, pill, injectable and implant, again with great diversity geographically. In surveys men report less total use but more condom use, while females report more injectable use. For the future the male share of one-quarter of use seems secure, with little prospect of an increase unless concerted programmatic efforts are made to expand access to male methods and promote their use as part of a broadened contraceptive method mix.

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A qualitative exploration of contraceptive use and discontinuation among women with an unmet need for modern contraception in Kenya

Reproductive Health ◽

10.1186/s12978-021-01094-y ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Susan Ontiri ◽

Lilian Mutea ◽

Violet Naanyu ◽

Mark Kabue ◽

Regien Biesma ◽

...

Keyword(s):

Family Planning ◽

Side Effects ◽

Peer Influence ◽

Contraceptive Use ◽

Unmet Need ◽

Modern Contraceptive ◽

Modern Contraception ◽

Modern Contraceptives ◽

Family Planning Programs ◽

Contraceptive Discontinuation

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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Knowledge, attitude and practice of family planning among married women of reproductive age in a VDC of eastern Nepal

Journal of Chitwan Medical College ◽

10.3126/jcmc.v6i1.16655 ◽

2017 ◽

Vol 6 (1) ◽

pp. 48-53 ◽

Cited By ~ 3

Author(s):

S Uprety ◽

I S Poudel ◽

A Ghimire ◽

M Poudel ◽

S Bhattrai ◽

...

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Descriptive Analysis ◽

Married Women ◽

Reproductive Age ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Cross Sectional ◽

Attitude And Practice ◽

Knowledge Attitude And Practice

Contraceptive use and fertility rates vary substantially among developing countries. An important factor, which affects the fertility of any population, is Contraceptive. Contraceptive use varies by age. Nepal over the past 15 years show an impressive increase in the use of modern contraceptive methods from 26 percent in 1996 to 43 percent in 2011. Objectives of the is to assess the knowledge, attitude regarding family planning and the practice of contraceptives among the married women of Dhabi VDC of Eastern Nepal. A descriptive cross-sectional observational study was done in Dhabi VDC. Total of 300 married women age 15-49 sample were taken from family planning center situated in Dhabi. Knowledge, attitude and practice on contraceptives were evaluated with the help of a predesigned questionnaire. Descriptive analysis was done by using SPSS 11.5 software to obtain frequencies and percentages. Out of 300 interviewed women, the mean age was 27.94 years, 98% had heard about Family planning method. Radio was the main Source of family planning information. Regarding the usage of contraceptive methods, about 79.3% had ever used and 63.3 had current using some sort of contraception, among the method used Injectables were the commonly used methods About 71% of married women other child in the further. Despite the knowledge of all family planning methods majority of the women used Injectables. Easily accessible and easily to use were the main reasons for choosing Injectables methods.

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The effect of Women’s decision-making autonomy on family Planning acces in Senegal in 2017

European Journal of Public Health ◽

10.1093/eurpub/ckz186.125 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

N M Sougou ◽

O Bassoum ◽

M M M M Leye ◽

A Tal-Dia

Keyword(s):

Decision Making ◽

Family Planning ◽

Contraceptive Method ◽

Contraceptive Use ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Modern Contraceptive Method ◽

Significant Difference ◽

Modern Contraceptive Use ◽

The Impact

Abstract Background The impact of access to decision-making on women’s health in the choice of fertility control has been highlighted by research. The aim of this study was to analyze the impact of access to decision-making for women’s health on access to family planning in Senegal in 2017. Methods The analyses of this study had been done on the Individual Records file of Senegal’s Demographic Health Survey 2017. This data covered 8865 women aged 15 to 49 years. The propensity scores matching method had been done. The variable access to the decision was considered as the variable of interest. Matching was done using variables that were not modified by the effect of the treatment. These were religion and socio-economic level. The outcome variables were modern contraceptive use, the existence of unmet needs and the type of modern contraceptive method used. Significance was at 5%. The condition of common support had been respected. The analysis was done with the STATA.15 software. Results Six percent (6.26%) of women could decide about their health on their own. Access to decision-making increased significantly with the woman’s age (p < 0.05). Fifteen percent (15.24%) women used a modern contraceptive method. Women using a contraceptive method were more numerous in the group with access to decision-making (29.43%) with a significant difference with the other group of 8% (p < 0.05). After matching, there was no significant difference between women in terms of modern contraceptive use and the existence of unmet needs. There was a significant difference in the type of contraceptive method used between the two groups of women. These differences were 23.17% for Intra Uterine Device, 52.98% for injections, 08.9% for implants and 10.79% for condoms. Conclusions Access to decision-making for health would facilitate women’s access to long-acting contraceptive methods. These findings show the importance of implementing gender transformative interventions in improving access to family planning. Key messages Access to decision-making for health would allow better access to modern contraceptive methods, especially those with a long duration of action. Better consideration of gender disparity reduction could improve access to family planning in Senegal.

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A rise in births following contraceptive failure in France between 2010 and 2016: results from the French national perinatal surveys

BMC Women s Health ◽

10.1186/s12905-021-01255-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Camille Bonnet ◽

Béatrice Blondel ◽

Caroline Moreau

Keyword(s):

Contraceptive Method ◽

Contraceptive Use ◽

Significant Proportion ◽

Adult Women ◽

Contraceptive Methods ◽

Subsequent Increase ◽

Contraceptive Failure ◽

Live Births ◽

Socially Disadvantaged ◽

Method Mix

Abstract Background In France, while the prevalence of contraception is high, a significant proportion of pregnancies are unintended. Following the 2012 pill scare, the contraceptive method mix, which was mostly comprised of pills and intrauterine devices (IUD), has become more diversified. In this changing landscape, our objective was to describe trends in live births resulting from contraceptive failure and evaluate how patterns of contraceptive use have contributed to observed changes between 2010 and 2016. Methods We used data from the 2010 and the 2016 French National Perinatal surveys which included all births from all maternity units in France over a one-week period. Interviews collecting information about pre-conception contraceptive practices were conducted in the maternity ward post-delivery. Women were classified as having a contraceptive failure if they discontinued contraception because they were pregnant. Our study sample included adult women who had a live birth, had ever used contraception and did not undergo infertility treatment (n = 11,590 in 2010 and n = 9703 in 2016). We evaluated changes in contraceptive failure over time using multivariate Poisson regressions to adjust for sociodemographic characteristics and pre-pregnancy contraceptive methods. Results Pre-pregnancy contraception evolved between 2010 and 2016 with a 12.3% point-drop in pill use, and conversely, 4.6%- and 3.2%-point increases in IUD and condom use, respectively. Use of other barrier or natural methods doubled between 2010 and 2016 but remained marginal (1.4% in 2010 vs 3.6% in 2016). Between 2010 and 2016, the proportion of live births resulting from contraceptive failure rose from 7.8 to 10.0%, with higher risks among younger, parous and socially disadvantaged mothers. The risk ratio of contraceptive failure in 2016 compared to 2010 remained higher after sociodemographic adjustments (aRR = 1.34; 95% CI; 1.23–1.47) and after adjusting for pre-pregnancy contraceptive method mix (aRR = 1.35; 95% CI; 1.25–1.49). Increases in contraceptive failures were concentrated among pill and condom users. Conclusions Recent shifts in contraceptive behaviors in France following the 2012 pill scare may be associated with a subsequent increase in births resulting from short acting contraceptives failures.

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Contraceptive Use in India: A Data Mining Approach

International Journal of Population Research ◽

10.1155/2014/821436 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 11

Author(s):

Aalok Ranjan Chaurasia

Keyword(s):

Data Mining ◽

Family Planning ◽

Contraceptive Use ◽

Universal Access ◽

Standard Of Living ◽

Social Characteristics ◽

Data Mining Approach ◽

Important Policy ◽

Use Pattern ◽

Years Of Schooling

This paper uses data mining approach to analyse patterns of contraceptive use in India by comparing contraceptive use among groups of women with distinct demographic, economic, cultural, and social characteristics. The analysis suggests that currently married, nonpregnant women aged 15–49 years in India can be classified into 13 mutually exclusive groups on the basis of six characteristics of women—surviving children, household standard of living, religion, women’s years of schooling, husbands’ education, and residence. Contraceptive use pattern in these 13 groups is essentially different and reflects the orientation of family planning efforts, especially, official family planning efforts in the country. The observed differences in the patterns of contraceptive use have important policy and programme implications in the context of universal access to family planning.

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Contraceptive prevalence and factors influencing utilization among women in Pakistan: a focus on gender-based violence

Fulbright Review of Economics and Policy ◽

10.1108/frep-05-2021-0032 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Thao Thi Nguyen ◽

Sarah Neal

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Modern Contraceptive ◽

Gender Based Violence ◽

Contraceptive Methods ◽

Content Type ◽

Modern Contraception ◽

Factors Influencing ◽

Contraceptive Prevalence ◽

Gender Based

PurposeIn this study, the authors determined the prevalence of contraceptive use among Pakistani women and assessed factors influencing the utilization of contraception with a particular focus on the experience of gender-based violence.Design/methodology/approachThe dataset used in this study was the Pakistan Demographic Health Survey 2018, which includes married women only. Bivariate analysis and multivariate logistic regression were used to investigate the association between contraceptive use and a number of explanatory variables including experience of gender-based violence.FindingsFrom 2006 to 2018, the contraceptive prevalence rate (CPR) and the use of modern contraceptive methods increased slowly. The findings of this study demonstrated that higher educational level and wealth index increased the likelihood of contraceptive uptake and the use of modern contraception. Media exposure to family planning and spousal communication were protective factors that encouraged women to use contraception, including modern contraception, to avoid unwanted pregnancy. Women who experienced gender-based violence (GBV) were more likely to use contraception than women who did not experience GBV.Research limitations/implicationsThe use of secondary data limited the variety of important variable that should be investigated including knowledge of women on SRH, the attitude of women toward SRH and family planning, the skills of a healthcare provider on counseling family planning, and other barrier variables such as transportation and willingness to pay for contraceptive methods. 10;The sensitivity of the topic is considered as another challenge when collecting data. Women might be hesitant to share about their GBV experience. The experience to GBV is also hard to define and depends on the feeling of each person, especially emotional violence.Originality/valueThis paper is one of the very few studies to examine the association between GBV and contraceptive use, and thus is valuable in opening up debate about the links between these two factors.

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Family planning providers and contraceptive users in Rwanda employ strategies to prevent discontinuation

BMC Women s Health ◽

10.1186/s12905-021-01503-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hilary Schwandt ◽

Angel Boulware ◽

Julia Corey ◽

Ana Herrera ◽

Ethan Hudler ◽

...

Keyword(s):

Family Planning ◽

Side Effects ◽

Contraceptive Use ◽

First Year ◽

Modern Contraceptive ◽

Group Discussions ◽

Program Success ◽

Family Planning Programs ◽

Contraceptive Discontinuation

Abstract Background In Rwanda, nearly a third of contraceptive users discontinue within the first year of use. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users and minimizing discontinuation is imperative for long-term family planning program success. This study explores the efforts providers and contraceptive users in Rwanda employ to prevent one of the greatest challenges to family planning programs: contraceptive discontinuation. Methods This was a qualitative study conducted in Rwanda between February and July 2018. It included eight focus group discussions with 88 family planning providers and 32 in-depth interviews with experienced modern contraceptive users. Data were collected in two districts with the highest (Musanze) and lowest (Nyamasheke) rates of contraceptive use. Data were analyzed using thematic content approach. Results Family planning providers in this study used the following strategies to prevent discontinuation: counseling new users on the potential for side effects and switching, reminding clients about appointments for resupply, as well as supporting dissatisfied users by providing counseling, medicine for side effects, and discussing options for switching methods. Users, on the other hand, employed the following strategies to prevent discontinuation: having an understanding that experiences of side effects vary by individuals, supporting peers to sustain use, persisting with use despite experiences of side effects, and switching methods. Conclusions The strategies used by family planning providers and users in Rwanda to prevent discontinuation suggest the possibility of long-term sustained use of contraception in the country. Harnessing and supporting such strategies could contribute to sustaining or improving further contraceptive use in the country.

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