Understanding patterns of temporary method use among urban Indian women Janine Barden-O’Fallon,...
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Transcript of Understanding patterns of temporary method use among urban Indian women Janine Barden-O’Fallon,...
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.
THANK YOU