Does locality have more impact than ethnicity on contraceptive use?

Abstract

Ethnicity and locality influence contraceptive use and are important in family planning programs. As ethnicity is unmodifiable, the locality may be left to help promote contraceptive use. This study aimed to determine whether locality impacts contraceptive use more than ethnicity. The prevalence ratios of ethnicity (11 categories) and locality (14 regions) for the top three contraceptive methods were estimated from the Nepal Demographic and Health Survey dataset in 2016. The locality had a greater impact on male condom use and injection practices than ethnicity. In contrast, both locality and ethnicity strongly influenced the use of female sterilization; however, ethnicity had a greater impact than locality. Our findings suggest that, depending on the contraceptive method, family planning activities should be adapted to locality and that careful consideration of ethnicity is required for female sterilization.