Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021

Abstract Background Eliminating unmet need for family planning by 2030 is a global priority for ensuring healthy lives and promoting well-being for all at all ages. We estimate the sub-national trends in prevalence of unmet need for family planning over 30 years in India and study differences based...

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Main Authors: Kirtana Devaraj, Jewel Gausman, Raman Mishra, Akhil Kumar, Rockli Kim, S. V. Subramanian
Format: Article
Language:English
Published: BMC 2024-04-01
Series:Reproductive Health
Subjects:
Online Access:https://doi.org/10.1186/s12978-024-01781-6
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author Kirtana Devaraj
Jewel Gausman
Raman Mishra
Akhil Kumar
Rockli Kim
S. V. Subramanian
author_facet Kirtana Devaraj
Jewel Gausman
Raman Mishra
Akhil Kumar
Rockli Kim
S. V. Subramanian
author_sort Kirtana Devaraj
collection DOAJ
description Abstract Background Eliminating unmet need for family planning by 2030 is a global priority for ensuring healthy lives and promoting well-being for all at all ages. We estimate the sub-national trends in prevalence of unmet need for family planning over 30 years in India and study differences based on socio-economic and demographic factors. Methods We used data from five National Family Health Surveys (NFHS) conducted between 1993 to 2021 for the 36 states/Union Territories (UTs) of India. The study population included women of ages 15–49 years who were married or in a union at the time of the survey. The outcome was unmet need for family planning which captures the prevalence of fecund and sexually active women not using contraception, who want to delay or limit childbearing. We calculated the standardized absolute change to estimate the change in prevalence on an annual basis across all states/UTs. We examined the patterning of prevalence of across demographic and socioeconomic characteristics and estimated the headcount of women with unmet need in 2021. Results The prevalence of unmet need in India decreased from 20·6% (95% CI: 20·1– 21·2%) in 1993, to 9·4% (95% CI: 9·3–9·6%) in 2021. Median unmet need prevalence across states/UTs decreased from 17·80% in 1993 to 8·95% in 2021. The north-eastern states of Meghalaya (26·9%, 95% CI: 25·3–28·6%) and Mizoram (18·9%, 95% CI: 17·2–20·6%), followed by the northern states of Bihar (13·6%, 95% CI: 13·1–14·1%) and Uttar Pradesh (12·9%, 95% CI: 12·5–13·2%), had the highest unmet need prevalence in 2021. As of 2021, the estimated number of women with an unmet need for family planning was 24,194,428. Uttar Pradesh, Bihar, Maharashtra, and West Bengal accounted for half of this headcount. Women of ages 15–19 and those belonging the poorest wealth quintile had a relatively high prevalence of unmet need in 2021. Conclusions The existing initiatives under the National Family Planning Programme should be strengthened, and new policies should be developed with a focus on states/UTs with high prevalence, to ensure unmet need for family planning is eliminated by 2030.
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spelling doaj.art-79f10a44267c446a8a76db360faffeb72024-04-14T11:18:13ZengBMCReproductive Health1742-47552024-04-0121111310.1186/s12978-024-01781-6Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021Kirtana Devaraj0Jewel Gausman1Raman Mishra2Akhil Kumar3Rockli Kim4S. V. Subramanian5Department of Chemical Engineering and Applied Chemistry, University of TorontoDepartment of Global Health and Population, Harvard T. H. Chan School of Public HealthInterdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea UniversityFaculty of Arts and Science, University of TorontoInterdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea UniversityHarvard Center for Population and Development StudiesAbstract Background Eliminating unmet need for family planning by 2030 is a global priority for ensuring healthy lives and promoting well-being for all at all ages. We estimate the sub-national trends in prevalence of unmet need for family planning over 30 years in India and study differences based on socio-economic and demographic factors. Methods We used data from five National Family Health Surveys (NFHS) conducted between 1993 to 2021 for the 36 states/Union Territories (UTs) of India. The study population included women of ages 15–49 years who were married or in a union at the time of the survey. The outcome was unmet need for family planning which captures the prevalence of fecund and sexually active women not using contraception, who want to delay or limit childbearing. We calculated the standardized absolute change to estimate the change in prevalence on an annual basis across all states/UTs. We examined the patterning of prevalence of across demographic and socioeconomic characteristics and estimated the headcount of women with unmet need in 2021. Results The prevalence of unmet need in India decreased from 20·6% (95% CI: 20·1– 21·2%) in 1993, to 9·4% (95% CI: 9·3–9·6%) in 2021. Median unmet need prevalence across states/UTs decreased from 17·80% in 1993 to 8·95% in 2021. The north-eastern states of Meghalaya (26·9%, 95% CI: 25·3–28·6%) and Mizoram (18·9%, 95% CI: 17·2–20·6%), followed by the northern states of Bihar (13·6%, 95% CI: 13·1–14·1%) and Uttar Pradesh (12·9%, 95% CI: 12·5–13·2%), had the highest unmet need prevalence in 2021. As of 2021, the estimated number of women with an unmet need for family planning was 24,194,428. Uttar Pradesh, Bihar, Maharashtra, and West Bengal accounted for half of this headcount. Women of ages 15–19 and those belonging the poorest wealth quintile had a relatively high prevalence of unmet need in 2021. Conclusions The existing initiatives under the National Family Planning Programme should be strengthened, and new policies should be developed with a focus on states/UTs with high prevalence, to ensure unmet need for family planning is eliminated by 2030.https://doi.org/10.1186/s12978-024-01781-6Family planningUnmet needNFHSIndiaStatesUnion Territories
spellingShingle Kirtana Devaraj
Jewel Gausman
Raman Mishra
Akhil Kumar
Rockli Kim
S. V. Subramanian
Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021
Reproductive Health
Family planning
Unmet need
NFHS
India
States
Union Territories
title Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021
title_full Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021
title_fullStr Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021
title_full_unstemmed Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021
title_short Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021
title_sort trends in prevalence of unmet need for family planning in india patterns of change across 36 states and union territories 1993 2021
topic Family planning
Unmet need
NFHS
India
States
Union Territories
url https://doi.org/10.1186/s12978-024-01781-6
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