Understanding patterns of temporary method use

among urban Indian women

Janine Barden-O’Fallon, MEASURE Evaluation PRHLisa Calhoun, MLELivia Montana, MLEPriya Nanda, MLEIlene Speizer, MLE

Presentation Overview

Background Research objectives Data Methods Results Limitations Conclusions

Photo by JHU-CCP

Background: Contraceptive use in India

CPR is 56% among currently married women– Sterilization is most common method (66% of use)– Condoms (9% of use) and rhythm (9% of use)

Temporary method users are more likely to be better educated and wealthier than sterilized women

One year discontinuation rate for temporary methods is high: condoms 45%, pills 49%, rhythm method 32%

-All data from NFHS-3, 2005-06

Research Objectives

Examine differences in demographic characteristics and use patterns among temporary method users in urban Uttar Pradesh, India

Descriptive analysis using contraceptive data from a two year period

Measurement, Learning & Evaluation (MLE)

Evaluation of the Urban Reproductive Health Initiative (URHI):– 5 year project funded by the Bill & Melinda Gates

Foundation– Goal is to increase modern contraceptive use– Four countries: Senegal; Kenya; Nigeria; and Uttar

Pradesh, India Carolina Population Center (University of North Carolina,

Chapel Hill) in partnership with International Center for Research on Women

http://www.urbanreproductivehealth.org/

Data for Analysis

Longitudinal surveys of women in 4 intervention cities:– Baseline (2010) - Representative sample of married

women 15-49 with an oversample of slum populations (N=17,643)

– Mid-term sub-sample (2012) - 85.8% response rate (N=5,790)

Contraceptive calendar used to collect month-by-month data on contraceptive use, non-use, reason for discontinuation, pregnancy and birth, for 2 year period between surveys

Methods

Construct meaningful categories of women based on patterns of contraceptive use during the calendar period

Descriptive comparison of socio-demographic characteristics, fertility desires, discontinuation and method switching, and pregnancy outcomes

Assess reasons for discontinuation by order of discontinuation during the calendar period

Results: Socio-demographic characteristics and fertility intentions

No use(n=1,406)

Sterilized during

calendar(n=137)

Condom(n=948)

Traditional(n=977)

Other modern(n=407)

Multiple temporary methods(n=148)

% % % % % %

12+ yrs education

30.0 27.7 53.8 38.4 47.4 37.4

Wealthiest 15.9 14.5 28.0 20.8 24.9 21.9

Scheduled caste

23.9 30.3 16.1 23.6 16.1 21.3

Desire no more births

46.9 62.4 69.7 70.9 79.0 78.4

Slum 19.9 22.9 14.0 14.7 13.6 13.1

Results: Method use characteristics

No use(n=1,406)

Sterilized during

calendar(n=137)

Condom(n=948)

Traditional(n=977)

Other modern(n=407)

Multiple temporary methods(n=148)

Mean # months of use

0 13.2* 22.9 23.3 21.0 21.9

Mean # discons 0 0.31 0.16 0.14 0.16 1.36

% >= 1 month of non-use

100 77.5 36.6 33.9 44.0 55.2

* Use of sterilization only

Results: Mean number of pregnancies and terminations during 2 year period

Results: Reasons for discontinuation

Results: Reasons for discontinuation

Limitations

Potential for underreporting pregnancy and terminations

Potential for data heaping Calendar may not be best measure of use for

temporary methods most common in India

Conclusions

Identified a number of socio-demographic differences between temporary method users during a 2 year time period

Relatively high incidence of pregnancy and termination among multiple method users

Traditional method users vs. condom users Discontinuation due to problems with the method

persists and leads to questions about service quality

The Measurement, Learning & Evaluation (MLE) Project for the Urban Reproductive Health Initiative is funded by the Bill

& Melinda Gates Foundation. The MLE project is implemented by the Carolina Population Center at the

University of North Carolina at Chapel Hill, in partnership with International Center for Research on Women. The views

expressed in this presentation do not necessarily reflect the Gates Foundation.

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