Assessing the Impact of Family Planning Advice on Unmet Need and Contraceptive Use among Currently Married Women in Uttar Pradesh, India

Abstract

BackgroundCounseling/advice is one of the key interventions to promote family planning (FP) in developing countries, including India. It helps to improve the quality of care and reduce maternal deaths. This paper investigates the continuity of maternal health (MH) service utilization from antenatal care to post-natal care and the impact this service utilization has on contraceptive use and on meeting the demand for family planning among currently married women in rural Uttar Pradesh, India.Methods and FindingsThe study assesses the impact of FP advice on unmet need and contraceptive use by adopting the propensity score matching method. It uses data from the District Level Household Survey (DLHS) (2007–08) that covered 76,147 currently married women (CMW) in the age group 15–44 years in Uttar Pradesh. Results show that the utilization of MH services [Antenatal care (ANC), institutional delivery, Postnatal care (PNC)] and FP advice during ANC and PNC has led to increase in current use of contraception by 3.7% (p<.01), 7.3% (p<.01) and 6.8% (p<.01), respectively. However, a greater utilization of these services has not translated into a reduction of unmet need for contraception at a similar manner.ConclusionMH service utilization including FP advice is more effective in increasing current use of spacing methods as compared to limiting methods. Findings support the need for “effective FP advice” interventions to reduce unintended births and unmet need. However, women from Scheduled Caste/Scheduled Tribe communities are less likely to receive MH services. Thus, efforts are required to ensure that currently married women across socio-economic backgrounds have equal opportunity to receive MH services and information on contraceptive use to meet the demand for family planning methods.

Predictors of Time-to-Contraceptive Use from Resumption of Sexual Intercourse after Birth among Women in Uganda

“…In our study, the longer time-to-contraceptive use observed among women who attended 1-3 ANC visits compared with those who attended the recommended four or more visits supports this finding as noted elsewhere [51]. Thus, strengthening the integration of family planning into ANC services [23,26,52,53] would certainly go a long way in promoting modern contraceptive use, particularly during the postpartum period.…”

“…In a recent study on family planning advice and contraceptive use, Yadav and Dhillon [26] show that use of critical maternal health services (ANC, institutional delivery, and postnatal care) encourages subsequent contraceptive use. In Tanzania, findings that showed counseling had an influence on the intention to use contraception [50].…”

“…Recent studies provide insights into factors that determine contraceptive use among (i) women in the postpartum period [3,6,23,24], (ii) sexually active women in the reproductive age [20,25,26], and (iii) sexually active males [27]. However, studies are limited in providing an understanding of the factors among women particularly after resumption of sexual intercourse following a birth.…”

<p>Unmet Need for Contraception Among Young Married Women in Eastern Ethiopia</p>

“…The supply-side factors including inaccessibility of comprehensive contraceptive services and poor information dissemination are among the factors related to young women unmet need for contraception. [15][16][17] Limited knowledge of contraceptive methods was also found to have a significant effect on the unmet need for contraception. 18,19 Demographic and economic characteristics including women's age, age of marriage, educational status, residence of living, duration after marriage, and wealth status were also associated with young married women unmet need for contraception in previous studies.…”

Multitasking and Heterogeneous Treatment Effects in Pay-for-Performance in Health Care: Evidence from Rwanda

“…We include whether the child was breastfed for 6 months or more as a favorable event. Adverse outcomes include the prevalence of anemia in children and pregnant women; the prevalence of vision 14 A number of studies have demonstrated that family planning visits and counseling are associated with the increased use of modern contraceptive methods, thereby supporting our use of the reported prevalence of modern contraception use as a proxy measure for family planning visits (Ahmed and Mosley 2002, Barber 2007, Borges, OlaOlorun et al 2015, Yadav and Dhillon 2015.…”