Abstract
For young women aged 15 to 24, unintended pregnancies remain very common, reflecting lower contraceptive use. Given the socio-cultural and traditional beliefs and practices, the unmet need for family planning is a crucial indicator for tracking the progress in contraceptive prevalence, ensuring young women’s reproductive and sexual rights. This article aims to analyze spatial heterogeneity in the unmet need for family planning among young women age 15 to 24 and their mesoscale correlates. Using data from the recent round of Indian DHS (2015–2016), commonly known as the National Family Health Survey (NFHS), this study identifies the significant correlates of unmet need of contraception among young married women in India. The statistical methods range from multinomial logistic regression, spatial autocorrelation in terms of Moran’s I statistics, to spatial auto regression, to understand the spatial dependence and clustering in the unmet need across India’s districts. The contraceptive prevalence rate among young married women age 15 to 24 in India was 24%, while almost the same proportion of them (23%) had an unmet need for contraception. Current age, education, religion, poverty, number of children, media exposure, awareness about family planning, and birth occurred in the last 3 years were significant predictors of unmet need. The univariate Moran’s I for unmet need was 0.50, suggesting strong spatial heterogeneity in India. The auto regression models become much more influential after including the spatial weights in the model, where illiteracy, unawareness, poverty, and rural residence were statistically significant predictors of unmet need of family planning among young married women in India. Findings of the study providing complex cultural ecologies of contraceptive use dynamics may give vital inputs in designing gender-sensitive interventions that can create a suitable support system and enabling environment for increasing use of contraception and reducing the unmet need of family planning.
Highlights
Background and RationaleFamily planning (FP) has always been a matter of public health concern in India, targeting to reduce the fertility rate to 2.1% by 2025
Analyzing the complex cultural ecologies of health, fertility-related beliefs and gender norms, and how they interact with the FP decisions of young women age 15 to 24; this study explores the predictors of unmet need among married young women age 15 to 24 in India, and identify spatial covariates as a proxy of cultural ecologies of unmet need of contraception
The adolescents who have been in the marital union for less than 5 years had the highest preponderance of unmet need (22.7%)
Summary
Background and RationaleFamily planning (FP) has always been a matter of public health concern in India, targeting to reduce the fertility rate to 2.1% by 2025. Women are considered to have an unmet need for spacing if they are at risk of becoming pregnant, not using contraception, and either does not want to become pregnant within the two years or are unsure if or when they want to become pregnant It includes pregnant women with a mistimed pregnancy or in postpartum amenorrhoeic for up to two years following a mistimed birth and not using contraception. Women are considered to have an unmet need for limiting if they are at the risk of becoming pregnant, not using contraception, and want no (more) children or pregnant with an unwanted pregnancy or in postpartum amenorrhoeic for up to two years following an unwanted birth and not using contraception.
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