Socioeconomic inequalities in contraceptive use among female adolescents in south Asian countries: a decomposition analysis

Abstract

Background Contraceptive knowledge and use has been an emerging topic of interest in adolescents in Asia. This study quantified the contribution of the socioeconomic determinants of inequality in contraceptive use among currently married female adolescents (15–24) in four south Asian countries: India, Bangladesh, Nepal and Pakistan. Data and methods The data of Demographic Health Survey (DHS) for four South Asian countries, i.e. India (NFHS 2015–16), Nepal (DHS 2016), Bangladesh (DHS 2014) and Pakistan (DHS 2012–2013) has been used for examining the contraceptive use and inherent socioeconomic inequality. After employing logistic regression, concentration curves based on decomposition analysis have been made to analyse the socioeconomic inequality. Results The results reveal that the use of contraception among female adolescents remains low and factors like education, employment, having one or more children, media exposure were positively associated with it. In terms of socioeconomic inequality, a significant amount of variation has been observed across the countries. In India, poor economic status (95.23%), illiteracy (51.29%) and rural residence (23.06%) contributed maximum in explaining the socioeconomic inequality in contraceptive use among female adolescents. For Bangladesh, the largest contributors to inequalities were rural residence (260%), illiteracy (146.67%) while birth order 3 + (− 173.33%) contributed negatively. Illiteracy (50%), poor economic status (47.83%) and rural residence (16.30%) contributed maximum to the inequalities in contraceptive use in Pakistan while birth order 3 + (− 9.78%) contributed negatively. In Nepal, the important operators of inequalities were unemployment (105.26%), birth order 3 + (52.63%) and poor economic status (47.37%), while rural residence contributed negatively (− 63.16%) to inequalities in contraceptive use. Conclusions Using a cross country perspective, this study presents an socioeconomic inequality analysis in contraceptive use and the important factors involved in the same. Since the factors contributing to inequalities in contraceptive use vary across countries, there is a need to imply country-specific initiatives which will look after the special needs of this age-group.

Decomposing the Gap in Contraceptive Use Among Female Adolescents and Young Women Aged 15-24 in India: An Analysis of Appended Datasets of NFHS-4 and 5

“…The use of contraception among female adolescents is low and socioeconomic factors contributed substantially to it. 24 The results of this study revealed that adolescents residing in rural areas showed a low preponderance of using contraception. Uneducated women, women from the poorest strata of society and belonging to disadvantageous social groups like the OBCs, used less contraception as a result of their socioeconomic profile.…”

Spatial distribution and factors influencing modern contraceptive practice among tribal married women in India: evidence from National Family Health Survey 5 (2019–2021)

“…Despite being disadvantaged and facing various socio-economic challenges, it was found that illiterate women were using modern contraceptive methods more frequently compared to their literate counterparts, the possible reason could be the higher sterilization rate and the financial incentive associated with it. However previous studies have suggested that the higher education level is associated with the modern contraceptive use [ 9 , 22 , 26 ]. Tribal women following Hindu religion were associated with the increased modern contraceptive use, however previous studies also confirms the same [ 27 , 28 ]…”

Cost-effectiveness of increased contraceptive coverage using family planning benefits cards compared with the standard of care for young women in Uganda

“…The FPBC could potentially lead to increased savings, reduced mortalities, and contribute towards long-life span, attaining the SDGs and economic growth and development in the long run. The FPBC could also be used as one of the panaceas to the worldwide gross inequalities in accessing modern contraception since it covers the financial risk of out-of-pocket expenditure on modern contraception among marginalized groups [8][9][10][11][12][13][14].…”

“…The inequality of access to modern contraception is a reality not only in low-income countries but also in highincome countries. Different studies have shown that the utilization of long-term modern contraception methods varies across the area (region of residence), age, and socioeconomic status -with poor access among low-income earners, the unemployed, and rural dwellers [8][9][10][11][12][13][14]. The question researchers and policymakers worldwide should be asking is, what interventions or strategies are currently in place to reduce inequalities in accessing modern contraception?…”