Trends and Determinants of Unmet Need for Family Planning in Bihar (India): Evidence from National Family Health Surveys

Amit Kumar, Aditya Singh

International Institute for Population Sciences, Mumbai, India.
School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.

DOI: 10.4236/aasoci.2013.32021                

Abstract

Using data from all three rounds of the National Family Health Survey, this study examines the trends and determinants of unmet need for family planning in the state of Bihar. Bivariate analysis was carried out to examine the level and trends of unmet need for family. Binary logistic regression was used to examine the factor affecting unmet need for family planning. About 25% of the currently married women, aged 15 - 49 years, in Bihar at present have an unmet need for family planning services, 11% for spacing and 12% for limiting. Only 18% of total demand for spacing methods is met compared to about 72% of total demand for limiting methods. The unmet need for family planning among Muslim (32%), rural (24%) and adolescent (36%) and poor women (26%) is relatively higher than other groups. “Religious prohibition” and “husband opposed” were the main reasons for not using contraception. A considerable proportion of older women (45 - 49 years) and those living in urban areas cited method-related reasons. About 86% of Muslim women cited opposition to use as the main reason for not using family planning. The same is also substantiated by logistic regression analysis where the odds of unmet need were significantly higher among Muslim women (OR = 1.88; p < 0.05). Women from Other Backward Castes (OR = 0.74; p = 0.05) and rich households (OR = 0.55; p = 0.00) had lower odds of unmet need for family planning. The results highlight the need of an effective implementation of information, education and communication activities in the communities and improvement in the quality of advice and care services related to family planning. Family planning policies and programs in Bihar should focus on reaching out to the women from disadvantaged groups such as adolescent, Muslim, poor and Scheduled Caste.

Keywords

Family Planning; Unmet Need; Fertility; Bihar; National Family Health Survey

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Arokiasamy, P. (2009). Fertility decline in India: Contributions by uneducated women using contraception. Economic and Political Weekly, 44, 55-64.
[2]	Balabdaoui, F., Bocquet-Appel, J. P., Lajaunie, C., & Irudaya Rajan, S. (2001). Space-time evolution of the fertility transition in India, 1961-1991. International Journal of Population Geography, 7, 129-148. doi:10.1002/ijpg.213
[3]	Bhattacharya, B., Singh, K. K., & Singh, U. (1995). Proximate determinants of fertility in eastern Uttar Pradesh. Human Biology, 67, 867.
[4]	Bongaarts, J., Frank, O., & Lesthaeghe, R. (1984). The proximate determinants of fertility in sub-Saharan Africa. Population and Development Review, 10, 511-537. doi:10.2307/1973518
[5]	Bradley, S. E. K., Croft, T. N., Fishel, J. D., & Westoff, C. F. (2012). Revising unmet need for family planning. DHS Analytical Studies No. 25, Calverton, MA: ICF International.
[6]	Guilmoto, C. Z., & Rajan, S. I. (2004). Spatial patterns of fertility transition in Indian districts. Population and Development Review, 27, 713-738. doi:10.1111/j.1728-4457.2001.00713.x
[7]	International Institute for Population Sciences (IIPS) & ORC Macro (2000) National Family Health Survey (NFHS-II) 1998-1999. Mumbai: IIPS
[8]	International Institute for Population Sciences (IIPS) and Macro International (2007). National Family Health Survey (NFHS-III) 2005-2006. Mumbai: IIPS.
[9]	International Institute for Population Sciences (IIPS) and ORC Macro (1995). National Family Health Survey (NFHS-1) 1992-1993. Mumbai: IIPS.
[10]	Jain, A. K., & Jain, A. (2010). Family planning and fertility in India. UNFPA—ICOMP REGIONAL CONSULTATION—Family Planning in Asia and the Pacific: Addressing the Challenges, Bangkok, 8-10 December 2010. http://www.icomp.org.my/new/uploads/fpconsultation/India.pdf
[11]	Karki, Y. B., & Radha K. (2008). Factors responsible for the rapid decline of fertility in Nepal—An interpretation: Further analysis of the 2006 Nepal demographic and health survey. Calverton, MA: Macro International Inc.
[12]	Kishore, J. (2007). National health programs of India (7th ed.). New Delhi: Century Publication.
[13]	Laya, K. S. (2012). Prevalence and determinants of unmet need for family planning among women in India. Research and Social practices in Social Sciences, 7, 59-70.
[14]	Mishra, V. K., Retherford, R. D., Nair, P. S., & Feeney, G. (1999). Reasons for discontinuing and not intending to use contraception in India. NFHS Subject Report, No. 13, Mumbai: IIPS.
[15]	Office of Registrar General of India (ORGI) (2012). Sample registration system, Ministry of Home Affairs, Government of India. New Delhi: Government of India.
[16]	Ojakaa, D. (2008). Trends and determinants of unmet need for family planning in Kenya. DHS Working Papers No. 56. Calverton, MD: Macro International, Inc.
[17]	Pasha, O., Fikree, F., & Vermund, S. (2001). Determinants of unmet need for family planning in squatter settlements in Karachi, Pakistan. Asia-Pacific Population Journal, 16, 93-108.
[18]	Pathak, K. B., Griffith F., & Norman Y. L. (1998). Contraceptive use in India, 1992-1993. National Family Health Survey Subject Reports, No. 7. Mumbai: International Institute for Population Sciences; and Honolulu: East-West Centre.
[19]	Sibanda, A., Woubalem, Z., Hogan, D. P., & Lindstrom, D. P. (2003). The proximate determinants of the decline to below-replacement fertility in Addis Ababa, Ethiopia. Studies in Family Planning, 34, 1-7. doi:10.1111/j.1728-4465.2003.00001.x
[20]	Stata Corp (2011). Stata statistical software: Release 12. College Station, TX: Stata Corp.
[21]	Subramanyam, M. A., Kawachi, I., Berkman, L. F., & Subramanian, S. V. (2010). Socioeconomic inequalities in childhood undernutrition in India: Analyzing trends between 1992 and 2005. PLoS One, 5, e11392. doi:10.1371/journal.pone.0011392
[22]	Visaria, L. (1999). Proximate determinants of fertility in India: An exploration of NFHS data. Economic and Political Weekly, 34, 3033-3040.
[23]	Visaria, P., & Chari, V. (1998). India’s population policy and family planning program: Yesterday, today, and tomorrow. In A. K. Jain (Ed.), Do population policies matter? Fertility and politics in Egypt, India, Kenya, and Mexico (pp. 53-112). New York: Population Council.
[24]	Westoff, C. F. (1988). The potential demand for family planning: A new measure of unmet need and estimates for five Latin American countries. International Family Planning Perspectives, 14, 45-53. doi:10.2307/2947679
[25]	Wilson, C. (2001). On the scale of global demographic convergence 1950-2000. Population and Development Review, 27, 155-171. doi:10.1111/j.1728-4457.2001.00155.x