Abstract
PurposeDespite the fact that marriage below the age of 18 years is illegal in India, a considerable number of females get married and start childbearing during their adolescent years. There is low prevalence of contraceptive methods and high unmet need for family planning (FP). Realizing this, new government programs have been launched to increase the uptake of sexual and reproductive health services among adolescents. However, evidence specific to this age group remains scarce.Aim and objectivesThe present study was conducted to assess the prevalence of modern contraceptives among married adolescents, and to determine its association with sociodemographic variables, health worker outreach, and media exposure to FP messages in India.MethodsData for this analysis was drawn from the fourth round of the National Family Health Survey (NFHS-4) conducted in India during 2015–16. The sample size is restricted to 13,232 currently married adolescent girls aged 15–19 years, who were not pregnant at the time of the survey. Bivariate and multivariate analysis were conducted to assess the levels of contraceptive use and its predictors among married adolescents.ResultsThe use of modern contraceptives among married adolescents increased from 4 to 10% between 1992–93 and 2015–16. The uptake of modern contraceptives was found to be low among the uneducated, those residing in rural areas, among backward classes, those practising Hindu religion, women in the poorest wealth quintile, women without children, and those with no exposure to FP messages via media or health care workers. Among those who met health care workers and discussed FP issues with them, 34.11% were using modern contraceptives as compared to 11.53% of those who did not have discussions with health care workers.ConclusionsThe evidence suggests that contact with health care workers significantly influences the use of modern contraceptives. Further focus on increasing contact between married adolescents’ and health care workers, and improving the quality of counselling will protect adolescents from early marriage and pregnancy.
Highlights
India constitutes 20% of the world’s 1.2 billion adolescents; of these, at least 1.5 million girls get married each year before they turn 18 years old [1]
The uptake of modern contraceptives was found to be low among the uneducated, those residing in rural areas, among backward classes, those practising Hindu religion, women in the poorest wealth quintile, women without children, and those with no exposure to family planning (FP) messages via media or health care workers
The evidence suggests that contact with health care workers significantly influences the use of modern contraceptives
Summary
India constitutes 20% of the world’s 1.2 billion adolescents; of these, at least 1.5 million girls get married each year before they turn 18 years old [1]. High level of unmet need for FP is seen among the age groups of 15–19 years and 20–24 years (27% and 22%, respectively) as compared to the national average (13%) [3]. Similar patterns of higher unmet need for FP and the burden of unplanned pregnancies among married adolescents as compared to older women are seen in other low- and middle-income countries [4]. Universal access to reproductive and sexual health services, including FP, is increasingly recognised as a public health priority for improving the health outcomes of adolescents [5]. Despite introducing multiple initiatives for adolescent reproductive and sexual health, the progress in improving health outcomes among adolescents has been slow and inconsistent, and calls for more focussed attention towards the contraceptive needs of adolescents [6]
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