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

Abstract

Background The unmet need for family planning has been a public health concern in developing countries, especially in the south-east region. In India, the expanding roles of women has led to a growing need for family planning and contraception. However, tribal women still struggle with reproductive and sexual health issues. Unfortunately, most tribal women are not informed about the potential health risks associated with contraceptive use, as service providers often neglect to provide this information. As a result, tribal women often suffer in silence, which can lead to serious health problems. Thus, the present study aimed to understand the patterns and factors associated with modern contraceptive usage as well as the district level variation in usage among tribal married women. Methods We included 91,976 tribal married women participants aged 15 to 49 years from National Family Health Survey 5 conducted during the years 2019 to 2021. Descriptive statistics were used to compute the prevalence of modern contraceptive usage along with 95% confidence interval (CI) as a measure of uncertainty. The association between various socio-demographic predictors and modern contraceptive usage were assessed by multivariable logistic regression and presented as an adjusted odds ratio (AOR). Results The overall prevalence of modern contraceptive practices was found to be 53% among tribal married women, which was below the national average. Sterilization was the most preferred method of modern contraceptive, whereas injectables were the least preferred method. More than 80% of the married women get the family planning information from the public health facility and health workers. Districts of eastern and north-eastern states have comparatively less modern contraceptive prevalence than central and southern states. Age, education, parity and access to media were significantly associated with the use of modern methods of contraception. Conclusion Improving contraceptive use and reducing unmet needs for contraception among tribal women requires sustained efforts from healthcare workers, including Information Education and Communication (IEC) through mass media to raise awareness. A tailored family planning strategy is crucial to address the specific needs of tribal women at both the local and national levels, with adequate resources and monitoring for impact with this India can achieve Total Fertility Rate (TFR) 2.1 among tribals.

Challenges in Modern Contraception Access among Married Bonda Women: Insights from a Qualitative Study on Family Planning Barriers and Healthcare Dynamics

“…Various similar studies have also been reported on the Indian subcontinent among different population groups, including tribal populations (Panda et al, 2023), (Hall et al, 2008), (Ghule et al, 2018), (Palo et A review of the literature reveals that barriers to the acceptance and use of modern FP methods and contraceptive use are still found at low utilization levels and are very unsatisfying among tribal populations; moreover, even a number of microlevel community-based studies have not been performed in diverse socioenvironmental settings. To ll this gap, the present study involved a qualitative investigation to obtain an in-depth understanding of the existing barriers to modern FP, contraceptive use, the management of unwanted pregnancies, and the spacing between two children among the Bonda, a particular vulnerable tribe group (PVTG), which is con ned to the restricted hill pockets of the Eastern Ghats Mountain Range located in the Malkangiri district of Odisha, India.…”

“…Worldwide, among the 1.9 billion (15-49 years) women, 966 million who use any contraception methods are categorized as 874 million who have adopted a modern method and 92 million who have adopted a traditional contraceptive method (UNDESA, 2022). The National Family Health Survey 5 (NFHS-5), which was conducted between 2019 and 2021, reported that 53% of tribal married women in India use any modern contraceptive practices (i.e., below the national average), where more than 80% of the users receive FP-related information from health workers as well as from public health facilities (Panda et al, 2023).…”

Adoption of contraception following a pregnancy loss in India

“…The information is scarce and to the best of the authors' knowledge no large‐scale study in India has so far been carried out which has studied the contraceptive behavior of women post pregnancy loss. The existing literature details post abortion contraceptive behavior 21,22 but little is known about the contraceptive behavior of women whose pregnancy was otherwise terminated. The objective of this study was to describe the post pregnancy loss contraceptive behavior of Indian women in a reproductive age group using a recent nationally representative dataset.…”