Factors Affecting Acceptance of Modern Spacing Methods Among Couples in a High Fertility State 'Bihar' in Northern India and Potential Opportunity to Expand its Uses

Abstract

Background: Bihar is one of India’s most populous states with the highest Total Fertility Rate (TFR) and very low level of Contraceptive Prevalence Rate (CPR).1,2 BBC Media Action (NGO arm of British Broadcasting Corporation) implemented a 5-yr. grant from Bill & Melinda Gates Foundation (BMGF) to shape demand and practices around 9 family-health behaviors including family planning. Present paper is based on the analysis of benchmarking survey data on family planning. Objectives: This paper aims to identify factors associated with the acceptance of modern spacing methods among couples in Bihar, India. Study Design: The evaluation design adopts a pretest-posttest design with appropriate statistical controls. Study design includes a cross sectional survey among the various categories of respondents including the mothers. A multi-staged cluster sampling approach used, sample size of 7646 respondents spread across 200 primary sampling units (PSUs) from Bihar, India. Methods: BBC Media Action carried out research with women and their family members, such as husbands and mothers-in-law through community-based cross-sectional survey. Eligible respondents (Women in reproductive age group) were randomly selected and interviewed using pretested structured questionnaire. The data was collected using CAPI questionnaire and analyzed using SPSS. Descriptive statistics were reported, and bivariate and multivariable logistic regression carried out to see the effect of each independent variable on the dependent variable. Results: The study reveals that there is very low use and very high unmet need for spacing post-delivery. About 12% women using modern FP method during 1st yr. of birth and only 9% using within 6 months. 2/3 extended postpartum women expressed unmet need (limiting 40%; spacing 27%). Conclusions: Program needs to identify women with unmet need during extended postpartum period and communication should target the identified triggers-barriers.