Contraceptive Scenario in India

Contraceptive Scenario in
India
Contraceptive Updates Seminar, October 2005

Contraceptive Scenario in
India
Contraceptive Knowledge Ever use Current

method among eligible (%) use
population (%) (%)
Any method 99 55.1 48.2
For all modern methods 98.9 49.3 42.8
Combined Oral pills 79.5 8.4 2.1
IUDs 70.6 5.6 1.6
Condoms 71 7.9 3.1
Female sterilization 98.2 34.2 34.2
Male Sterilization 89.3 2 1.9
Natural methods 48.9 11.8 5
1
Contraception among
currently
married women
Percent
50
36
31
25
6 7
4 5
0
Sterilization* Modern temporary Traditional
methods methods
NFHS-1, 1992-93 NFHS-2, 1998-99
*Includes female and male sterilization Note: Figures have been rounded off
2
Method Mix
Pill: 2.1%
IUD: 1.6%
Not using any

method: 51.7%
Female
sterilization: 34.2%
Male
Any traditional or sterilization: 1.9%
natural method: 5.4% Condom: 3.1%
3
Source of contraceptives
Other Source
5%
Don’t know/ Missing
1%
Private Medical Sector
17%
Public Medical Sector
76%
NGO or Trust
1%
Source: NFHS-2, India, 1998-99
4
Reasons for discontinuation
REASON Urban Rural Total
Method failed/got pregnant 3.6 4.7 4.3
Lack of sexual satisfaction 1.7 1.8 1.8
Created menstrual problem 9.2 6.9 7.7
Created health problem 14.4 12.7 13.3
Inconvenient to use 2.2 1.5 1.7
Hard to get method 0.5 1.9 1.4
Gained weight 0.3 0.1 0.2
Did not like the method 4.2 5.1 4.8
Wanted to have a child 29.8 29.2 29.4
Wanted to replace dead child 0.6 0.5 0.5
Lack of privacy for use 0.8 0.7 0.7
Husband away 8.2 13.4 11.6
Costs too much 0.9 2.3 1.8
Others 23.2 18.3 20.0
Missing 0.4 0.9 0.8
Total percent 100.0 100.0 100.0
5
Unmet need for FP
Currently married women not using
contraception but who
Do not want any more children or
Want to wait for two or more years before

having another child
are defined as having an unmet need for

family planning.
6
Not using contraception
Pregnant or amenorrhoeic Not pregnant or amenorrhoeic
Pregnancy Pregnancy Pregnancy Fecund In fecund

intended mistimed unwanted
Want later Want no Want

more soon
Need for Need for Need for Need for

spacing limiting spacing limiting
Total Unmet Need 7

Unmet need
need by age among
women
Percent
50
27
25 19
16
10
TOTAL 15-19 25-29 35-39
Age of woman
8
Married women with an unmet
need for contraception –
Selected states
Nagaland 30
Arunachal Pradesh 27
Utter Pradesh 25
Bihar 25
Rajasthan 18
INDIA 16
Madhya Pradesh 16
Orissa 16
Maharashtra 13
Tamil Nadu 13
West Bengal 12
Andhra Pradesh 8
Panjab 7
0 Percent 25 50
9
Trends in unmet need
Spacing Limiting
30
24.6
21
20 20
% 11.9 % 11.7
8.9 10.8
8.6 10 9 8.4 8.5
10 8.1 7.8
6.7 6.4 6.7
5.8
4.2 4.5
0.9 0.6
0 0
15-24 25-34 35+ Urban Rural 15-24 25-34 35+ Urban Rural
Age Residence Age Residence
1992-93 1998-99
10
Barriers in meeting
meeting
contraceptive needs
Knowledge gaps; fear of side effects
Opposition by husband/other family members

Limited choice of methods
Limited access to, and availability of,
services
Poor quality of services
11
Limited knowledge
Particularly true for adolescents,
women in
post-partum and in rural areas
Best known spacing method: OCPs - 80%
Linked with women’s status within their

families
Myths and misconceptions, concerns about
side
effects rampant
12
Opposition from husbands
Lack of inter-spousal communication
Choice of method usually with husbands
Family pressure
Limited male involvement
13
Limited choice
Same basket of contraceptives
Varying contraceptive needs
Provider bias in offering the methods
14
Limited access
Access improved in last 10 years
Public sector centers a major source but poorly
staffed
Facility survey data:
- Only 16% PHCs have doctors trained in STR
- Only 2/3 have at least 1 IUD trained staff
IUD trained ANMs not confident about

insertion
Post-partum FP advice only to 1/3 of those counseled
Stock outs and erratic supplies at public sector
sites
15
Poor Quality
Rapid Household Survey–1: Follow-up after
acceptance of a method
STR - 27% IUD - 13% OCPs - 7%
Poor tracking of continuation
Adherence with service delivery standards

in delivery of contraceptive services
Monitoring FP quality
16

Contraceptive Scenario in India

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Contraceptive Scenario in India

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Contraceptive Scenario in

Contraceptive Updates Seminar, October 2005

Contraceptive Knowledge Ever use Current

NFHS-1, 1992-93 NFHS-2, 1998-99

Not using any

Source: NFHS-2, India, 1998-99

Do not want any more children or

Want to wait for two or more years before

are defined as having an unmet need for

Pregnant or amenorrhoeic Not pregnant or amenorrhoeic

Pregnancy Pregnancy Pregnancy Fecund In fecund

Want later Want no Want

Need for Need for Need for Need for

Total Unmet Need 7

TOTAL 15-19 25-29 35-39

Opposition by husband/other family members

Linked with women’s status within their

Choice of method usually with husbands

Limited male involvement

Varying contraceptive needs

Provider bias in offering the methods

IUD trained ANMs not confident about

Poor tracking of continuation

Adherence with service delivery standards

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