印度北方邦避孕措施覆盖的地理和社会经济不平等。

Geographic and socioeconomic inequalities in the coverage of contraception in Uttar Pradesh, India.

机构信息

Department of Community Health Sciences, Institute for Global Public Health,, University of Manitoba, Winnipeg, Canada.

India Health Action Trust, Lucknow, Uttar Pradesh, India.

出版信息

Reprod Health. 2024 Apr 11;21(1):50. doi: 10.1186/s12978-024-01784-3.

DOI:10.1186/s12978-024-01784-3

PMID:38600560

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11007924/

Abstract

BACKGROUND

Uttar Pradesh (UP) is the most populous state in India, with a historically lower level of family planning coverage than the national average. In recent decades, family planning coverage in UP has significantly increased, yet there are considerable geographic and socio-economic inequalities.

METHODS

The data used for the study is derived from a cross-sectional quantitative survey of 12,200 currently married women conducted during December 2020-February 2021 in UP by the Technical Support Unit. Univariate and bivariate analyses were performed and equiplots were used to make visualizing inequalities easy.

RESULTS

The findings of the study reveal significant variation in family planning coverage indicators amongst currently married women in reproductive ages by administrative divisions in UP. For instance, in the Jhansi division, it was 72.4%, while in Faizabad, it was 39.3%. Jhansi division experienced the highest modern contraceptive coverage with the lowest inequity compared to other divisions. However, the range of coverage within the division by Accredited Social Health Activist (ASHA) areas is 25% to 75%. In fact, for some ASHA areas in the Jhansi division, the family planning demand satisfied for modern contraception ranged from more than 85% to less than 22%. On the other hand, the Gonda division with the lowest coverage and lowest inequity for demand satisfied for modern contraception has some ASHA areas with less than 5% and some with more than 36%. The study also revealed intersectionality of education, wealth, place of residence and geographic divisions in identifying inequity patterns. For instance, in case of Mirzapur and Varanasi, the demand satisfied among the illiterates was 69% and the corresponding percentage for literates was 49%. With respect to place of residence, Basti division, where the coverage for modern contraception is extremely low, demand satisfied for modern contraceptive methods is 16.3% among rural residents compared to 57.9% in the case of urban residents.

CONCLUSIONS

The findings showed inequality in the modern family planning methods coverage in UP in both best and worst performing divisions. The inequalities exist even in extremely small geographies such as ASHA areas. Within the geographies as well, the socio-economic inequalities persisted. These inequalities at multiple levels are important to consider for effective resource allocation and utilization.

摘要

背景

北方邦（Uttar Pradesh，简称 UP）是印度人口最多的邦，其计划生育覆盖水平历来低于全国平均水平。近几十年来，北方邦的计划生育覆盖面显著增加，但仍存在相当大的地域和社会经济不平等。

方法

本研究使用的数据来自于 2020 年 12 月至 2021 年 2 月期间由技术支持单位在北方邦对 12200 名已婚育龄妇女进行的横断面定量调查。进行了单变量和双变量分析，并使用等距图使不平等可视化变得容易。

结果

研究结果显示，北方邦不同行政区的已婚育龄妇女在计划生育覆盖指标方面存在显著差异。例如，在占西（Jhansi）地区，这一比例为 72.4%，而在法扎巴德（Faizabad）地区，这一比例为 39.3%。占西地区的现代避孕方法覆盖率最高，与其他地区相比，不平等程度最低。然而，该地区的 ASHA 地区的覆盖率范围在 25%到 75%之间。事实上，在占西地区的一些 ASHA 地区，现代避孕方法的计划生育需求满足率从 85%以上到 22%以下不等。另一方面，戈拉达（Gonda）地区的覆盖率最低，现代避孕方法的需求满足率也最低，但该地区的一些 ASHA 地区的覆盖率不到 5%，而另一些地区的覆盖率则超过 36%。该研究还揭示了教育、财富、居住地和地理分区的交叉性，用于确定不平等模式。例如，在米尔扎布尔（Mirzapur）和瓦拉纳西（Varanasi）地区，文盲的需求满足率为 69%，而识字者的相应比例为 49%。就居住地而言，避孕方法覆盖率极低的巴西特（Basti）地区，农村居民现代避孕方法的需求满足率为 16.3%，而城市居民的这一比例为 57.9%。