What gets measured, gets managed

Introduction : Contraceptive Use

There has been a substantial increase in the knowledge of contraceptive methods, particularly spacing methods, among married women in UP. The knowledge of pills increased from 65 percent in 1992-93 to 85 percent in 1998-99, of IUCD from 56 percent to 74 percent, and of condoms from 67 percent to 83 percent (NFHS I and NFHS II). In fact the contraceptive knowledge level in UP is one of the highest in the country. Use of contraception, however, is not commensurate with the knowledge levels.

The use of any method of contraception increased from 19.8 percent in 1992-93 (NFHS I) to 28.1 percent in 1998-99(NFHS II)—an increase of 41 percent in a period of six years. There was some increase in condom and female sterilization method use while the proportion of pill and IUCD users remained more or less constant. UP has the highest proportion of spacing method users (30 percent) among modern method users compared to any other major state, except Punjab and West Bengal. There are major differentials in contraceptive method use in urban and rural areas of UP. While 45 percent in urban areas used any method of contraception in 1998-99, only 24 percent in rural areas were users.

The rural-urban differentials remained the same. One of the causes of concern is the decline in acceptance of male sterilization, which was until the 1980s the predominant method used. Only 11 percent of total permanent method users were male sterilization method users in 1993-94 and this further declined to 4.5 percent in 1998-99. However, innovative efforts to improve the quality, demand and access dimensions of the programme in 15 Innovations in Family Planning Services Project (IFPS) districts of UP have clearly and decisively demonstrated that with concerted efforts contraceptive use can substantially be increased and that people are not averse to the use of contraception.

Unmet need for family planning is a measure of the extent to which married women desire to space or limit the number of children but do not do so because of various factors such as non-availability of easily affordable and readily accessible quality services and lack of consensus in the family. Married women in UP have consistently reported a large unmet need for family planning in recent years and the proportion of those with unmet need has increased over a period of time. In 1992-93, 32 percent wanted no more children and another 26 percent wanted a child after two or more years. In 1998-99, 38 percent wanted no more children and 18 percent wanted children after two or more years. The unmet need for sterilization has increased substantially in the past six years. In 1992-93, only 24 percent of women with two children did not want another child and this has increased to 37 percent in 1998-99 (NFHS I and NFHS II). The data clearly show that there is a huge untapped potential for family planning services, particularly for permanent methods.

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