International Institute for Population Sciences, Govandi East, Mumbai, India.
Department of Humanities and Social Sciences, Humanities and Science Block, IIT Madras, Chennai, Tamil Nadu, India.
PLoS One. 2022 Jun 15;17(6):e0269170. doi: 10.1371/journal.pone.0269170. eCollection 2022.
According to the latest round of National Family Health Survey-4 (NFHS (2015-16)) maternal and child health care (MCH) services improved drastically compared to NFHS-3. Previous studies have established that the uptake of MCH services increases the likelihood of early adoption of contraceptives among women. So, our study aims to examine if the early initiation of contraceptive has proportionately improved with the recent increase in MCH services.
This study used the reproductive calendar of NFHS-4, 2015-16, to evaluate contraceptive initiation within 12 months after the last birth among 1,36,962 currently married women in India. A complementary log-log regression model was created to examine the link between the time of initiation of contraception and MCH care at the national level.
It was found that only a quarter of women within 12 months from last birth have adopted the modern contraceptive method. Among those majority of the females adopted sterilization mostly at the time of birth. The multivariable model identified, that the period of initiation of contraceptive depends on the gender composition of children and access to MCH services. It was found that the odds of early initiation of contraceptive use was higher when a women have only son (AOR = 1.15,95% CI- 1.22, 1.18) compared to women with only daughter. Also, it was found that women who have availed MCH services were more likely to adopt contraceptives earlier.
The number of women availing MCH services has increased in India, but it did not result in a proportional increase in initiation of contraception after childbirth. Facilitating family planning services alongside MCH services will be beneficial in low-resource settings. It is a golden opportunity to educate and encourage women for early adoption of contraceptive.
根据最新一轮全国家庭健康调查-4（NFHS（2015-16）），与 NFHS-3 相比，母婴保健（MCH）服务有了显著改善。先前的研究表明，MCH 服务的利用率增加了妇女早期采用避孕措施的可能性。因此，我们的研究旨在检验最近 MCH 服务的增加是否使避孕措施的早期开始比例有所提高。
本研究使用 NFHS-4，2015-16 年的生育日历，评估了印度目前已婚的 136962 名女性在最后一次分娩后 12 个月内开始避孕的情况。创建了一个互补对数回归模型，以检查国家一级避孕措施开始时间与 MCH 护理之间的联系。
研究发现，只有四分之一的女性在最后一次分娩后 12 个月内采用了现代避孕方法。在这些女性中，大多数人主要在分娩时采用了绝育。多变量模型确定，避孕措施的开始时间取决于儿童的性别构成和获得 MCH 服务的情况。研究发现，当女性只有儿子时，早期开始使用避孕措施的可能性更高（AOR=1.15，95%CI-1.22，1.18），而与只有女儿的女性相比。此外，研究还发现，获得 MCH 服务的女性更有可能更早地采用避孕措施。
印度获得 MCH 服务的女性人数有所增加，但这并没有导致产后避孕措施的开始比例相应增加。在资源有限的环境中，将计划生育服务与 MCH 服务结合起来将是有益的。这是一个教育和鼓励女性早期采用避孕措施的黄金机会。
