Abstract
Background: Empowering women to choose timing and number of children is the key to improve her reproductive and overall health. This requires availability of basket of contraceptives to choose from, improving access to contraceptive methods to women for acceptance of long term and short-term family planning methods. To date, efforts to assess progress on this front have been largely limited to the estimation and projection of family planning indicators at the national and state level but they are much needed at the district level, particularly for the most populous state in India with large demographic diversity like Uttar Pradesh. Methods: We have used a statistical model that can generate estimates and projections of rates and trends in indicators related to access to reproductive health at the national and subnational levels. For this, Avenir Health has packaged this model in the form of a user-friendly web application, the Family Planning Estimation Tool (FPET), which can be operated by local stakeholders with little external support. We present annual estimates and projections of rates and trends in the modern contraceptive prevalence rate, unmet need, and met demand for modern family planning methods for Uttar Pradesh state and all its 75 districts from 1991 to 2025 produced with FPET. Findings: There is a large amount of heterogeneity between the districts; only six districts have high modern contraceptive prevalence rate (mCPR > 50%) and are likely to reach met demand with a modern contraception of more than 70 percent by 2025 whereas Uttar Pradesh will reach 57.5 percent by 2025. Two districts out of 75 districts are likely to reach met demand with a modern method greater than 74 percent by 2025. Indeed, based on the increase in the modern contraceptive rate needed to achieve 74 percent or more demand satisfied with modern methods by 2025, three districts, namely, Balrampur, Basti and Shrawasti should be prioritized as these districts are at the bottom of the table with less than 20 percent of mCPR in 2020, and need additional support to increase needed modern contraceptive users, Uttar Pradesh demands most attention with a more than 4.5 million additional users of modern contraceptives required from 2015. Interpretation: The identification of districts that are performing better or worse helps decentralized planning effectively. The analysis can be generalized to other states and districts as well as other types of population subgroups. This can be done easily using FPET.
Highlights
Empowering women to choose timing and number of children is the key to improve her reproductive and overall health
With the expiry of Millennium Development Goal 5 (MDG5), there has been interest in setting targets around the indicators of modern contraceptive prevalence, unmet need for modern contraceptive methods and demand met by modern contraceptive methods for the post2015 global development agenda in recent literature (Brown et al, 2014; Fabic et al, 2014, FP2020, 2014)
We present here the results on three key family planning indicators for the state of Uttar Pradesh and its 754 districts: namely, modern contraceptive prevalence, unmet need for modern contraceptive methods and demand for family planning satisfied with modern contraceptive methods, including an assessment of the uncertainty bounds in their levels for the years 1991, 2015 and 2025 and the progress made during this period
Summary
Empowering women to choose timing and number of children is the key to improve her reproductive and overall health. Methods: We have used a statistical model that can generate estimates and projections of rates and trends in indicators related to access to reproductive health at the national and subnational levels. We present annual estimates and projections of rates and trends in the modern contraceptive prevalence rate, unmet need, and met demand for modern family planning methods for Uttar Pradesh state and all its 75 districts from 1991 to 2025 produced with FPET. MPV programme focuses on districts of 7 states with total fertility rates (TFRs) ≥ 3 to reach replacement level fertility goal of 2.1 by 2025. It has identified 146 high focus districts
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