Predictors of Modern Contraceptive Use Among Married Women in Pakistan, India, and Bangladesh

Abstract

Background: Pakistan, Bangladesh, and India are all facing challenges related to large, growing populations with low levels of contraception. While, Bangladesh has the highest CPR (62%), close to the world’s CPR of 64%, India stands at 58%, followed by the lowest for Pakistan at 35%. Objective: To analyze the differences in the socio-economic determinants of modern contraception use in Pakistan, India, and Bangladesh. Methods: This study uses data from the latest rounds of Demographic and Health Surveys for Pakistan (2017-2018), Bangladesh (2017-2018), and India (2015-16) to examine the socioeconomic determinants of traditional, modern, and the most popular method of contraception among married women across the three countries by employing logistic regressions. The sample consists of currently married and fecund women only (Bangladesh=10,738; India=224,070; Pakistan=4,255). Results: In Bangladesh, Oral contraception Pills (OCPs) are the most popular method of contraception (44%), followed by the use of other modern contraception(38%) and traditional contraception(18%). In India, 60% of women using contraception, reported using female sterilization, 27% uses other forms of modern contraception, and 13% reported using traditional methods. For Pakistan, 29% of the women reported using condoms as a source of contraception, 43% of women reporting using other modern methods, and 29% of women reported using traditional methods of contraception. Logistic regressions in Bangladesh and Pakistan show that female educational attainment level is positively associated with the use of modern methods and the country’s most popular method of contraception but negatively associated with female sterilization, the most popular contraception method in India. Additionally, the socioeconomic status of the household is positively associated with the use of the most popular method of contraception in Pakistan but negatively associated with other modern methods. Contraception decision making if done by women in Bangladesh is positively associated with the use of both the most popular methods as well as modern methods of contraception. In India, the household's socioeconomic status and women’s age are positively associated with the use of modern contraception. Conclusion: For these countries to lower the population growth rate, achieve replacement-level fertility, and increase the use of modern contraception, they need to focus on relevant determinants that would help them achieve the desired results.