The unmet need for contraception in India

Mumbai: India’s total fertility rate (TFR) may have declined significantly over the years but there remains significant challenges in family planning, according to new research. In an Economic and Political Weekly article, Purushottam M. Kulkarni of Jawaharlal Nehru University suggests that there is a significant unmet need for contraception in India.

Using data from various rounds of National Family Health Surveys (NFHS), he shows that while there was a decline in the unmet need for contraceptive services from 1992-93 (NFHS-1) through to 2005-06 (NFHS-3), between 2005-06 and 2015-16 (NFHS-4), there has not been any significant improvement in access to contraception.

The ‘unmet need’ for contraception is measured as the proportion of women considered fertile who want to postpone their next birth or stop childbearing altogether, but are not using contraception. It also includes those women who have an unwanted current pregnancy and whose last birth was mistimed or unwanted.

Kulkarni highlights that about 13% of couples fell under this category but did not receive the contraceptive services they desired. Within that category, there are notable interstate differences.

In Uttar Pradesh, Bihar, Nagaland, and Meghalaya, the unmet need is higher (exceeding 25%) and has been so since 1992-93. In contrast, Andhra Pradesh, Punjab, Telangana, and West Bengal have significantly lower unmet need (less than 8%). Within states, it is the poorest sections of the population that are the worst affected.

The author suggests India’s unmet need for contraception is a public health service failing. He argues that the fall in fertility rates have meant that family planning is no longer prioritized among public health workers.

Also read: Stagnancy in the Unmet Need for Family Planning in India

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