旁遮普邦和曼尼普尔邦避孕措施使用的比较分析：探索超越女性教育和赋权。
Comparative analysis of contraceptive use in Punjab and Manipur: exploring beyond women's education and empowerment.
机构信息
International Institute for Population Sciences (IIPS), Mumbai, India.
Population Council, New Delhi, India.
出版信息
BMC Public Health. 2022 Apr 18;22(1):781. doi: 10.1186/s12889-022-13147-3.
BACKGROUND
Women's education and empowerment are important predictors of contraceptive use across countries. However, two of the Indian states, namely, Punjab and Manipur, showed large variations in contraceptive use, despite the similar level of women's educational attainment and empowerment. Therefore, this paper attempts to understand variation in contraceptive use between these states, despite having similar level of educational attainment and empowerment among the married women.
METHODS
This study primarily used cross-sectional data of the National Family Health Survey (NFHS) 2015-16 and to some extent the District Level Household Survey (DLHS) 2012-13 data. The analytical sample includes 13,730 currently married women in Punjab and 8,872 in Manipur. Modern contraceptive prevalence rate (mCPR) is the key outcome variable of this study. Bivariate, multivariate, and multilevel regression analysis are applied to understand the differences in mCPR between these states and its determinants.
RESULTS
Mean years of schooling was about 8 years among women of both the states, and about 34% of the women in Punjab and 27% of the women in Manipur have high level of autonomy. Despite this, use of modern method was 66% in Punjab and only 13% in Manipur. Coverage of family planning program indicators were significantly lower in Manipur than Punjab - frontline workers' (FLWs) outreach for family planning was only 18% in Manipur compared to 52% in Punjab. Similarly, only 11% of the public health facilities in Manipur compared to 50% of the health facilities in Punjab were ready to provide at least one clinical method of family planning.
CONCLUSION
Despite the similar level of individual level characteristics across the two states, poor coverage of family planning programs - low outreach of FLWs, low level of facility readiness, as well as sociocultural norms discouraging contraceptive use - might be responsible for lower contraceptive use in Manipur than Punjab. This implies for strengthening the health system for family planning in Manipur to meet the contraception needs of women by addressing sociocultural barriers in the state.
背景
在各国，妇女的教育和赋权是避孕药具使用的重要预测因素。然而，印度的两个邦，即旁遮普邦和曼尼普尔邦，尽管已婚妇女的受教育程度和赋权水平相似，但避孕药具的使用情况却存在很大差异。因此，本文试图了解这两个邦之间避孕药具使用情况的差异，尽管已婚妇女的受教育程度和赋权水平相似。
方法
本研究主要使用了 2015-16 年全国家庭健康调查（NFHS）的横断面数据，并在一定程度上使用了 2012-13 年的地区家庭调查（DLHS）数据。分析样本包括旁遮普邦的 13730 名已婚妇女和曼尼普尔邦的 8872 名已婚妇女。现代避孕药具使用率（mCPR）是本研究的关键结果变量。应用了单变量、多变量和多层次回归分析来了解这两个邦之间 mCPR 的差异及其决定因素。
结果
这两个邦的妇女平均受教育年限约为 8 年，约 34%的妇女在旁遮普邦和 27%的妇女在曼尼普尔邦具有较高的自主权。尽管如此，现代方法的使用率在旁遮普邦为 66%，而在曼尼普尔邦仅为 13%。曼尼普尔邦的计划生育项目指标覆盖率明显低于旁遮普邦——计划生育的前线工作人员（FLWs）的外展服务仅在曼尼普尔邦占 18%，而在旁遮普邦占 52%。同样，在曼尼普尔邦，只有 11%的公共卫生设施能够提供至少一种计划生育临床方法，而在旁遮普邦，这一比例为 50%。
结论
尽管这两个邦的个体特征水平相似，但计划生育项目的覆盖率较低——FLWs 的外展服务不足、设施准备水平较低以及阻碍避孕的社会文化规范——可能是导致曼尼普尔邦避孕药具使用率低于旁遮普邦的原因。这意味着需要加强曼尼普尔邦的计划生育卫生系统，通过解决该邦的社会文化障碍，满足妇女的避孕需求。
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