Abstract
Background: Reproductive choice is one of the rights of any woman, but women are often ambivalent towards fertility desires and choice of contraception. Our study explores how the change in fertility desires influence the change in use of modern contraception over time in six cities of Uttar Pradesh, India. Methods : Data for this study comes from the Measurement, Learning and Evaluation (MLE) Project for Urban Health Initiative in six cities of Uttar Pradesh. Our study sample consists of 8735 women (weighted n=8655) who were fertile, non-sterilized and non-pregnant at the time of baseline survey. Potential bias due to lost to follow up was addressed using inverse probability weighing and then generalized estimating equations were applied to get odds for change in use of modern contraceptives. Results: Contraceptive use increased by different magnitudes from baseline to endline across all six cities. At baseline and endline, women who desired no more children reported a higher use of modern contraception than those who desired more children over time. Women from all cities who desired no more children at baseline had higher odds of modern contraceptive use than that of women who desired more children. The tempo of change in use of modern contraception over time among women with different fertility desires differed across the considered cities. Conclusion : Although there were city-wise differences observed, women's fertility intentions have an impact on their use of modern contraceptives over the time period between baseline to endline. To obtain greater insight into city-level differences, mixed method studies will be more effective.
Highlights
Women’s fertility desire is one of the most widely used measure for assessing fertility preferences
Research hypotheses Our study aims to investigate for following research questions, which are converted into testable hypotheses: 1) Our first hypothesis is that whether the women are differing in their fertility intentions and differ in their contraceptive use?, i.e., if fertility intentions are powerful predictor of family planning (FP) use women who do not desire more children at baseline should report higher use of contraceptives both at baseline and endline in contrast to women who desire more children at baseline
The magnitude of change in use of modern contraceptives between baseline and endline differed across cities, but the proportion of women using modern contraceptives increased over all six cities (Agra (0.5%), Aligarh (6.5%), Allahabad (6.3%), Gorakhpur (5%), Moradabad (3.6%) and Varanasi (4.3%)) of Uttar Pradesh
Summary
Women’s fertility desire is one of the most widely used measure for assessing fertility preferences. The importance of knowing women’s fertility preferences is that it gives us idea about proportion of women who want to delay or limit childbearing This knowledge helps providers to assist women in choosing most suitable protective device to control fertility or none at all. Empowering a woman to control her fertility allows her to complete her education or employment aspirations Evidence from both developing[1,2,3,5,10,11] and developed countries[12,13,14] shows that fertility desires of women frequently vary with corresponding contraceptive use, and women are often uncertain about getting pregnant and choosing a suitable contraceptive among several available contraceptive methods. To obtain greater insight into city-level differences, mixed method studies will be more effective
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