Department of the Population and Development, International Institute for Population Sciences (IIPS), Mumbai, India.
Department of Family and Generations, International Institute for Population Sciences (IIPS), Mumbai, India.
BMC Public Health. 2022 Jun 28;22(1):1264. doi: 10.1186/s12889-022-13662-3.
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.
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.
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.
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.
与其他发达国家相比，印度女性使用现代避孕方法的比例相对较低。即使在印度国内，不同邦在计划生育方面的使用情况也存在差异，这导致了意外怀孕的发生。关于现代避孕方法使用的决定因素及其相关不平等程度的证据非常有限。因此，本研究旨在评估印度目前已婚女性中现代避孕方法使用的不平等程度。
本研究使用了 2015-2016 年进行的第四次全国家庭健康调查（NFHS-4）的数据。我们的分析将避孕方法分为三种现代计划生育方法，即短期可逆避孕法（SARC）、长效可逆避孕法（LARC）和永久性避孕方法。SARC 包括避孕药、注射剂和避孕套，而 LARC 包括宫内节育器、植入物和永久性避孕方法（即男性和女性绝育）。我们采用集中指数来评估利用现代避孕方法的社会经济不平等程度。
研究结果表明，在较高年龄组（40-49 岁）中，目前已婚女性中永久性避孕方法的使用率高于较低年龄组（25-29 岁）。与 25-29 岁的女性相比，25-29 岁的女性使用 SARC 方法的可能性高出 3.41 倍（OR：3.41；95%CI：3.30-3.54）。同样，受过 15 年以上教育和较富裕的女性更有可能使用 LARC 方法。在区域层面上，我们发现南部地区使用永久性避孕方法的可能性是其他地区的三倍。我们的分解结果表明，40-49 岁的女性、有 2-3 个孩子的女性和较富裕的财富五分位数对女性中现代避孕方法使用不平等的贡献更大。
边缘化和社会经济地位较低的女性使用 SARC 和 LARC 方法的比例明显较低。为边缘化女性提供普遍免费的计划生育方法和在农村地区开展宣传活动，可能是减少印度目前已婚女性避孕方法使用不平等的潜在政策建议。
