Trends in Contraceptive Use and Method Mix from Equity Perspective in the Past Two Decades: Evidence from Two East Indian States

Abstract

Method: mix is a key determinant of the fertility impact of contraceptive practices; the use of effective and right methods by couples can produce a greater decline in fertility than use of less effective methods. The present paper tries to understand contraceptive use with a special focus on spacing methods in the state of Bihar and Odisha during 1992-2014. Indian National Family Health Surveys (NFHS) of 1992-93, 1998-99 and 2005-06 and project Ujjwal Survey data (2014) in Bihar and Odisha were used in the analyses. Data on currently married fecund women were used for the present study. Both bivariate and multivariate analysis was used to understand the changes in different methods and factors associated with the methods. The results show there is an increase in contraceptive prevalence rate both nationally (1992-2006) and in both the states (1992- 2014). The share of sterilization has increased in the high fertility state of Bihar whereas it has gone down in moderate fertility state of Odisha. There is a steady increase in short-term modern methods in Odisha largely contributing to its increase in contraceptive prevalence whereas in Bihar the spacing methods don’t show a clear pattern. The multivariate analysis shows the predicated probability of using modern spacing method is lowest among Muslims, Poor and older women in both the states in both the states after adjusting socio-economic variables. This paper brought the significance of method-mix in contraceptive prevalence in the states. The initiatives by NGOs and experiments with public-private partnerships are one of the leading contributors to increase in spacing methods. The social marketing and social franchising of selected reproductive health services by project Ujjwal is one such example. Similar initiatives on prioritizing spacing methods in family planning may be successful in improving access to contraceptive in Bihar. Abbreviations