Understanding drivers of family planning in rural northern India: An integrated mixed-methods approach

Author:

Jain Mokshada,Caplan Yael,Ramesh B. M.,Isac ShajyORCID,Anand Preeti,Engl Elisabeth,Halli Shiva,Kemp Hannah,Blanchard James,Gothalwal Vikas,Namasivayam Vasanthakumar,Kumar Pankaj,Sgaier Sema K.ORCID

Abstract

Background Family planning is a key means to achieving many of the Sustainable Development Goals. Around the world, governments and partners have prioritized investments to increase access to and uptake of family planning methods. In Uttar Pradesh, India, the government and its partners have made significant efforts to increase awareness, supply, and access to modern contraceptives. Despite progress, uptake remains stubbornly low. This calls for systematic research into understanding the ‘why’—why people are or aren’t using modern methods, what drives their decisions, and who influences them. Methods We use a mixed-methods approach, analyzing three existing quantitative data sets to identify trends and geographic variation, gaps and contextual factors associated with family planning uptake and collecting new qualitative data through in-depth immersion interviews, journey mapping, and decision games to understand systemic and individual-level barriers to family planning use, household decision making patterns and community level barriers. Results We find that reasons for adoption of family planning are complex–while access and awareness are critical, they are not sufficient for increasing uptake of modern methods. Although awareness is necessary for uptake, we found a steep drop-off (59%) between high awareness of modern contraceptive methods and its intention to use, and an additional but smaller drop-off from intention to actual use (9%). While perceived access, age, education and other demographic variables partially predict modern contraceptive intention to use, the qualitative data shows that other behavioral drivers including household decision making dynamics, shame to obtain modern contraceptives, and high-risk perception around side-effects also contribute to low intention to use modern contraceptives. The data also reveals that strong norms and financial considerations by couples are the driving force behind the decision to use and when to use family planning methods. Conclusion The finding stresses the need to shift focus towards building intention, in addition to ensuring access of trained staff, and commodities drugs and equipment, and building capacities of health care providers.

Funder

Surgo Foundation

Publisher

Public Library of Science (PLoS)

Subject

Multidisciplinary

Reference42 articles.

1. Maternal deaths averted by contraceptive use: an analysis of 172 countries;S Ahmed;The Lancet,2012

2. Birth spacing and child mortality: an analysis of prospective data from the Nairobi urban health and demographic surveillance system;JCCJ Fotso;Journal of Biosocial Science,2013

3. Investing in Family Planning: Key to Achieving the Sustainable Development Goals. Global Health;E Starbird;Science and Practice,2016

4. FP2020: The Way Ahead 2016–2017. 2017. Accessed November 19, 2020. http://2016-2017progress.familyplanning2020.org/en.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3