Inequalities in short-acting reversible, long-acting reversible and permanent contraception use among currently married women in India

Abstract

Background In India, the usage of modern contraception methods among women is relatively lower in comparison to other developed economies. Even within India, there is a state-wise variation in family planning use that leads to unintended pregnancies. Significantly less evidence is available regarding the determinants of modern contraception use and the level of inequalities associated with this. Therefore, the present study has examined the level of inequalities in modern contraception use among currently married women in India. Methods This study used the fourth round of National Family Health Survey (NFHS-4) conducted in 2015-16. Our analysis has divided the uses of contraception into three modern methods of family planning such as Short-Acting Reversible Contraception (SARC), Long-Acting Reversible Contraception (LARC) and permanent contraception methods. SARC includes pills, injectable, and condoms, while LARC includes intrauterine devices, implants, and permanent contraception methods (i.e., male and female sterilization). We have employed a concentration index to examine the level of socioeconomic inequalities in utilizing modern contraception methods. Results Our results show that utilization of permanent methods of contraception is more among the currently married women in the higher age group (40–49) as compared to the lower age group (25–29). Women aged 25–29 years are 3.41 times (OR: 3.41; 95% CI: 3.30–3.54) more likely to use SARC methods in India. Similarly, women with 15 + years of education and rich are more likely to use the LARC methods. At the regional level, we have found that southern region states are three times more likely to use permanent methods of contraception. Our decomposition results show that women age group (40–49), women having 2–3 children and richer wealth quintiles are more contributed for the inequality in modern contraceptive use among women. Conclusions The use of SARC and LARC methods by women who are marginalized and of lower socioeconomic status is remarkably low. Universal free access to family planning methods among marginalized women and awareness campaigns in the rural areas could be a potential policy prescription to reduce the inequalities of contraceptive use among currently married women in India.

Women’s empowerment indicators and short- and long-acting contraceptive method use: evidence from DHS from 11 countries

“…For instance, a multi-country study on household wealth and contraception use reported that poorer women in Bangladesh and India had higher inclination towards long-acting contraception methods, than the wealthier women [ 26 ]. This notwithstanding, other scholars have reported inconsistent findings, possibly due to variation in study design or differences in the socio-demographic characteristics of the samples studied [ 26 , 27 ].…”

“…Evidence suggest that motivation for using long-acting methods include long term protection against unintended pregnancies, effectiveness and better child-spacing [ 12 , 33 ]. Though short-acting methods have competitive advantages, this finding might suggest that as women advance in age, they weigh long-acting methods to be more protective, safe, and reliable as compared with short term contraceptive methods [ 27 ].…”

Prevalence and factors associated with the use of long-acting reversible and permanent contraceptive methods among women who desire no more children in high fertility countries in sub-saharan Africa

“…DHS asked about the type of contraceptive women aged 15–49 use, and those who were using an intrauterine device (IUD), implant and tubal litigation were categorised as using LARC/PMs, and other types of contraceptive use were categorised as not using LARC/PMs. The use of LARC/PMs or not was restricted to sexually active women who desire no more children in high fertility countries in SSA, as it has been measured in similar studies [ 7 , 21 , 31 ].…”

Long-acting reversible contraceptives utilization and its determinants among married Yemeni women of childbearing age who no longer want children

“…[ 25 ] Also, most researchers agree that rural women have limited access to and utilization of reproductive health services, including contraceptives. [ 32 , 40 ] National data from Yemen indicates that more than half of women of reproductive age rely on the public sector for contraceptive needs. [ 11 ] Unfortunately, the country’s protracted conflict has deteriorated the already fragile health system, resulting in severe gaps in the availability and access to vital health treatments, including family planning, among urban and rural women.…”