Determinants of Modern Contraceptive Usage among Married Women: A Mixed-Methods Study in a Rural Community of India

Authors

  • Trina Sengupta Department of Preventive & Social Medicine, All India Institute of Hygiene & Public Health, Kolkata
  • Bobby Paul Department of Occupational Health, All India Institute of Hygiene & Public Health, Kolkata
  • Lina Bandyopadhyay Department of Preventive & Social Medicine, All India Institute of Hygiene & Public Health Kolkata
  • Ranjan Das Department of Preventive and Social Medicine, All India Institute of Hygiene & Public Health Kolkata
  • Ankush Banerjee Department of Preventive & Social Medicine, All India Institute of Hygiene & Public Health Kolkata

DOI:

https://doi.org/10.33192/Smj.2022.78

Keywords:

Contraceptive, Empowerment, Family support, India, Mixed method

Abstract

Objective: A woman’s multifaceted feelings, knowledge, and perceptions of their intimate relations greatly influence their contraceptive behavior. In addition, women empowerment has been increasingly recognized as a key factor in family planning and reproductive health outcomes. This study aimed to assess modern contraceptive usage and its determinants among currently married women of reproductive-age (WRA) in rural Bengal.

Materials and Methods: This mixed-method study was conducted in a rural area of Hooghly District, West Bengal from April to September 2021. The quantitative strand of the study was conducted by interviewing 210 currently married WRA. The qualitative strand was conducted via focussed group discussions among husbands/mothersin-law and in-depth interviews with healthcare workers. SPSS software was utilized for quantitative data analysis and factors associated with contraceptive usage were analyzed using logistic regression models. Qualitative data were analyzed thematically.

Result: Currently 114 (54.8%) study participants were using modern contraceptive methods. Education (aOR=7.65, 95% CI=1.85-31.67), empowerment through freedom from family domination (aOR=5.56, 95% CI=1.30-23.66), attitude on contraception (aOR=4.67, 95% CI=1.26-17.19), and family planning counselling (aOR=4.41, 95% CI=1.12-17.33) were found to be significantly associated with modern contraceptive usage. Lack of couple counselling, family support, and knowledge gap was identified as the major barriers to contraceptive usage.

Conclusion: Since a woman’s decision-making ability significantly affects their sexual and reproductive health outcomes, effective measures should be undertaken to empower them by creating awareness regarding their rights and freedom to make strategic life choices. Couple counselling should be prioritized to enhance male involvement and eliminate perceived barriers.

References

Centre for Health Informatics of the National Health Portal. National Family Planning Programme [Internet]. New Delhi, India: National Health Portal; 2017 [cited 2022 Mar 23]. Available from: https://humdo.nhp.gov.in/about/national-fp-programme/

International Institute for Population Sciences. National Family Health Survey-5 [Internet]. Mumbai, India: International Institute for Population Sciences;2019-21 [cited 2022 May 20]. Available from: http://rchiips.org/nfhs/

Parkpinyo N, Panichyawat N, Sirimai K. Early Removal of the Etonogestrel Contraceptive Implant and Associated Factors Among Users at the Urban Family Planning Clinic in Siriraj Hospital, Bangkok, Thailand. Siriraj Med J. 2021;73(6):399-405.

Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, et al. The incidence of abortion and unintended pregnancy in India, 2015. Lancet Glob Health. 2018;6(1):e111-20.

Shakya HB, Dasgupta A, Ghule M, Battala M, Saggurti N, Donta B, et al. Spousal discordance on reports of contraceptive communication, contraceptive use, and ideal family size in rural India: a cross-sectional study. BMC Womens Health. 2018;18(1):147.

Kabeer N. Resources, agency, achievements: Reflections on the measurement of women's empowerment. Dev Change. 1999;30(3):435-64.

Blanc AK. The effect of power in sexual relationships on sexual and reproductive health: an examination of the evidence. Stud

Fam Plann. 2001;32(3):189-213.

Saha I, Paul B. Essential of Biostatistics & Research Methodology. 3rd Edition. Kolkata: Academic Publishers; 2020.

Nanda G. Compendium of Gender Scales [Internet]. Washington DC, USA: FHI 360/C-Change; 2011 [cited 2022 May 20]. Available from: http://gender.careinternationalwikis.org/_media/c-change_gender_scales_compendium.pdf.

Dalvi TM, Khairnar MR, Kalghatgi SR. An update of BG Prasad and Kuppuswamy socio-economic status classification scale for Indian population. Indian J Pediatr. 2020;87(7):567-8.

Ahirwar RK, Kumar S, Gupta S, Niranjan A, Prajapati K, Rawal S. A study to assess the socio-demographic factor and knowledge, attitude, and practice of family planning methods in Lohpeeta migrants tribe located in Shivpuri central India. J Family Med

Prim Care. 2021;10(3):1308-12.

Dixit A, Johns NE, Ghule M, Battala M, Begum S, Yore J, et al.Male–female concordance in reported involvement of women in contraceptive decision-making and its association with modern contraceptive use among couples in rural Maharashtra, India. Reprod Health. 2021;18(1):139.

Ewerling F, McDougal L, Raj A, Ferreira LZ, Blumenberg C, Parmar D, et al. Modern contraceptive use among women in need of family planning in India: an analysis of the inequalities related to the mix of methods used. Reprod Health. 2021;18(1):173.

Talungchit P, Lertbunnaphong T, Russameecharoen K. Prevalence of repeat pregnancy including pregnancy outcome of teenage women. Siriraj Med J. 2017;69(6):363-9.

Chopra S, Dhaliwal L. Knowledge, attitude and practices of contraception in urban population of North India. Arch Gynecol Obstet. 2010;281(2):273-7.

Reed E, Donta B, Dasgupta A, Ghule M, Battala M, Nair S, et al.Access to money and relation to women’s use of family planning methods among young married women in rural India. Matern Child Health J. 2016;20(6):1203-10.

Samari G. Women’s empowerment and short-and long-acting contraceptive method use in Egypt. Cult Health Sex. 2018;20(4):458-73.

Jain M, Caplan Y, Ramesh BM, Isac S, Anand P, Engl E, et al. Understanding drivers of family planning in rural northern India: An integrated mixed-methods approach. PLoS One. 2021;16(1):e0243854.

McClendon KA, McDougal L, Ayyaluru S, Belayneh Y, Sinha A, Silverman JG, et al. Intersections of girl child marriage and family planning beliefs and use: qualitative findings from Ethiopia and India. Cult Health Sex. 2018;20(7):799-814.

Shafi S, Mohan U. Perception of family planning and reasons for low acceptance of NSV among married males of urban slums of Lucknow city-A community based study. J Family Med Prim Care. 2020;9(1):303-9.

Wulifan JK, Brenner S, Jahn A, De Allegri M. A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries. BMC Womens Health. 2016;16:2.

Kc H, Shrestha M, Pokharel N, Niraula SR, Pyakurel P, Parajuli SB. Women’s empowerment for abortion and family planning

decision making among marginalized women in Nepal: a mixed method study. Reprod Health. 2021;18(1):28.

Walker SH, Hooks C, Blake D. The views of postnatal women and midwives on midwives providing contraceptive advice and methods: a mixed method concurrent study. BMC Pregnancy Childbirth. 2021;21(1):411.

Published

01-10-2022

How to Cite

Sengupta, T. ., Paul, B., Bandyopadhyay, L. ., Das, R. ., & Banerjee, A. (2022). Determinants of Modern Contraceptive Usage among Married Women: A Mixed-Methods Study in a Rural Community of India. Siriraj Medical Journal, 74(10), 666–674. https://doi.org/10.33192/Smj.2022.78

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Original Article