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Rapid Survey of Contraceptive Prevalence in Uttar Pradesh, India

List of Contents

List of Tablesi

List of Acronyms and abbreviationsiii

Executive Summaryiv

Chapter 1: Introduction1

1.1 Background1

1.2 Objectives of the study2

1.3 Methodology2

1.4 Coverage3

1.5 Data collection4

1.6 Data Entry and Analysis5

Chapter 2: Background characteristics of currently married women and their husbands6

2.1 Currently Married Women6

2.2 Profile of Husbands of Currently Married Women (CMW)8

Chapter 3: Pregnancy, child birth, antenatal care received, outcome of last pregnancy and place of delivery11

3.1 Pregnancy and childbirth11

3.2 Antenatal care received, outcome of last pregnancy and place of delivery12

Chapter 4: Interaction with ASHA during pregnancy and any counseling received15

about family planning15

4.1 Interaction with ASHA during pregnancy15

4.2 Counseling received about family planning during pregnancy or after childbirth16

Chapter 5: Ever use of family planning methods20

5.1 Ever use of family planning methods20

5.2 Duration of first method used21

5.3 Reasons for stopping first use of contraceptive method25

Chapter 6: Current use of family planning methods and unmet need29

6.1 Current use of family planning methods29

6.2 Current use of any family planning method by background characteristics32

6.3Current use of family planning methods by background characteristics33

6.4 Place of sterilization and quality of care and whether packet of condom/oral contraceptive pills was shown35

6.5 Packet of Oral pills/Condom shown37

6.6Knowledge of sources of obtaining family planning methods37

6.7 Duration of use of current method39

6.8 Any payments made for obtaining the method and which method40

6.9Counselling about family planning methods other than most recently used and what to do in case of any side effects experienced41

6.10 Reasons for non-use of contraceptive methods currently42

6.11 Adoption of sterilization by the couple in case they feel that family is complete43

6.12 Unmet need for modern family planning methods44

Chapter 7: Comparison of CPR with AHS and DLHS3 surveys47

7.1 Comparison of CPR of Rapid Assessment Survey (RAS) with DLHS3 and AHS47

7.2 Trend of sterilization acceptors in Uttar Pradesh and selected districts during last 6 years47

7.3 Comparison of current use of family planning methods with re-check48

7.4 Confidence Interval of CPR by any method and modern methods50

7.5 Detailed analysis of rapid assessment results with AHS and DLHS 3 for selected districts51

Annexure I: Questionnaires.....57

Annexure II: List of villages..67

Annexure III: Tabulation.....81

Annexure IV: Female sterilization prevalence from service statistics....135

List of Tables

Table2.1: Background characteristics of currently married women (respondents)7

Table2.2: Background characteristics of husbands of currently married women9

Table3.1: Distribution of currently married women by pregnancy and childbirth11

Table3.2: Distribution of currently married women by antenatal care received during last pregnancy, outcome of pregnancy and place of delivery13

Table 3.2a: Distribution of currently married women (15 -49 years) having child less than 12 months by place of delivery14

Table4.1: Distribution of currently married women by knowledge about ASHA of the village and services provided by ASHA during pregnancy15

Table 4.2: Distribution of currently married women by counselling received about family planning methods during pregnancy or after the birth of child16

Table 4.2a: Distribution of currently married women by place and family planning methods on which counselling received during pregnancy or after the birth of child17

Table4.2b: Distribution of currently married women by advice received from any community health worker or ASHA in home visit or during visit to a facility18

Table 5.1 Ever use of family planning methods and the first method used to avoid or delay the pregnancy20

Table 5.2: Duration of method used by first method adopted21

Table 5.2a: Distribution of respondents by frequency of use of emergency contraceptive24

Table 5.4: Reasons for stopping the first method used25

Table 6.1: Distribution of respondents by current use of family planning methods29

Table 6.1a: Current use of contraceptives by residence30

Table 6.1b: Current use of contraceptive methods by residence31

Table 6.2: Distribution of currently married women using contraceptives by their background characteristics (F9 by B3, B5, B6, B14)32

Table 6.3: Distribution of current users of contraceptives by method used and background characteristics (F10 by B3, B5, B6, B14)34

Table 6.4: Distribution of sterilization users by quality of sterilization services36

Table 6.5: Distribution of users of condom/oral pill by whether packet of condom or Oral contraceptive pills shown37

Table 6.6: Distribution of current users of contraceptives by knowledge of sources of obtaining contraceptive methods39

Table 6.7: Distribution of current users of contraceptives by duration of use40

Table 6.8: Distribution of current users of contraceptives by money paid for obtaining the method41

Table 6.9: Distribution of current users of contraceptives by whether the provider or any health worker informed them about side effects or problems they might have with the method provided and what you should do in case of problem41

Table 6.9a: Distribution of current users of contraceptives by whether at the time of informing the side effects, did any health worker informed about any other method which they can use easily (other than the most recent/current method) and did they obtain that method42

Table 6.10: Distribution of non-users of contraceptive methods by reasons of not using42

Table 6.11: Distribution of respondents by whether their family is complete and if not, undergone sterilization and reasons for not accepting sterilization43

Table 6.12: Distribution of non-users of family methods who intend to use any method in next 6 months or in future44

Table 6.12a: Distribution of respondents having unmet need by methods45

Table 7.1: Comparison of current use of contraceptives with DLHS3 and AHS47

Table 7.2: Trend of sterilization acceptors in Uttar Pradesh and districts during last 6 years48

Table 7.3: Current use of family planning methods (comparison with re-check)48

Table7.4:Confidence Intervals for CPR, mCPR and Traditional Methods50

List of Acronyms and abbreviations

AHS

Annual Health Survey

ANM

Auxiliary Nurse Mid-wife

AP

Andhra Pradesh

AWW

Anganwadi Worker

CMW

Currently Married Women

CPR

Contraceptive Prevalence Rate

DLHS

District Level Household and Facility Survey

ECP

Emergency Contraceptive Pill

ESB

Ensuring Spacing at Birth

FP

Family Planning

FPIS

Family Planning Indemnity Scheme

HDC

Home based Delivery of Contraceptives

IUCD

Intrauterine Contraceptive Device

mCPR

Contraceptive Prevalence Rate of modern methods

MP

Madhya Pradesh

NFHS

National Family Health Survey

OCP

Oral Contraceptive Pill

PPIUCD

Post -partum IUCD

PPS

Probability Proportionate to Size

SPSS

Statistical Package for Social Sciences

Executive Summary

1. Background

After the launch of NRHM, only one national level survey (DLHS 3) was carried out in India and NFHS 4 is currently in progress and the reports are likely to be available not before 2016. DLHS 4 did not cover the entire states and hence no recent survey based national level estimates on FP indicators are available.

The repositioning of FP program in India has recently implemented many new schemes such as home based Delivery of Contraceptives (HDC), Ensuring Spacing at Birth (ESB), Family Planning Indemnity Scheme (FPIS) and Post-partum IUCD (PPIUCD). In order to bring substantial improvement in addressing the unmet need of couples and increased use of contraception, FP Division has enhanced its efforts in the entire country with special focus in high priority states where current fertility levels are still very high and the decline in fertility rate is slow. These states are UP, Bihar, MP, Rajasthan, Chhattisgarh and Jharkhand.

In order to track the progress made under the FP program initiatives, regular (periodical) data on FP indicators is necessary. Service statistics provide some, but not all, of the data needed to measure the priority FP2020 indicators. However, service statistics data need to be supplemented with other data. One particularly promising source of data is continuing surveys at some intervals. If relevant indicators are captured through such survey, it may provide an ideal source for many of the indicators for which service statistics are not a feasible option.

2. Objectives of the study

The objectives of the study were:

1. Rapid assessment of key FP indicators to understand the current use of contraceptives among the eligible population;

2. Identification of barriers, which prevent the couples in adoption and continuation of methods; and

3. Unmet need for modern contraceptive methods

In addition, the study also compared the findings with other surveys such as AHS/ DLHS.

3. Methodology

The proposed rapid assessment study of FP program was designed to estimate the level of CPR in Uttar Pradesh based on selected 10 districts of Uttar Pradesh spread over different zones of the state. For this purpose, a sample of 600 Currently Married Women (CMW) was taken (determined based on 95% level of confidence) in each of the 10 districts covered in the survey.

In each selected district, the entire sample was sub-divided into rural and urban household and a representative sample was obtained using probability proportionate to size (PPS) method (total of 30 clusters from rural and urban areas in the ratio of 21:9). In each cluster, 20 households with at least one eligible couple was selected in each village or urban ward constituting the cluster. From each selected household, only one currently married woman in the age group 15-49 year was interviewed.

The data was collected on relevant demographic and CPR related indicators using a specially designed questionnaire.

In order to obtain state level estimate, the study was conducted in following 10 districts:

1. Sitapur

2. Varanasi

3. Banda

4. Lalitpur

5. Bahraich

6. Gorakhpur

7. Etah

8. Ghaziabad

9. Bareilly

10. Kanpur Dehat

For collection of field data, four teams of three Female Investigators each accompanied by a Supervisor were deployed. They were given 3 days training in Lucknow, which included classroom training for understanding the questions and clarifying the doubts of Investigators and supervisors, mock interviews in groups of 2 and field practice. The data collection was completed in nearly one month after training of teams from 3-5 August 2015.The sample covered in each district was 600 except Sitapur (603), Etah (602), Ghaziabad (602), Bareilly (603) and Kanpur Dehat (602).The total sample achieved for the state was 6012 CMW.

Data entry was done in specially designed format in access software and converted into excel later. The cleaning of data was done in the excel file which was used for analysis using SPSS.

4. Findings

4.1 Background characteristics of currently married women and their husbands

Age distribution of respondents and their age at marriage

Nearly 56% women were in the age group of 25-34 years, 27% more than 34 years, 15% in the age group of 20-24 years and only 1.5% were below 20 years of age. The average age of respondents was 31.3 years. The age distribution of women across districts was similar.

Generally the respondents were married when they were in the age group of 15-20 years (81%)but 9% were married before 15 years of age. The average age at marriage in UP was 17.3years. However, more women got married before 15 years of age in Sitapur (16%) and Bareilly (12%) whereas this proportion was lower in Ghaziabad (5.8%) and Banda (6.2%).

Education

Nearly 46% of respondents across 10 districts were illiterate but this proportion was higher in Sitapur (57%), Bahraich (61%) and Bareilly (65%).Only 9% of respondents across the districts had studied upto graduate level and above.

Residence

Nearly 70% of respondents were from rural area and 30% from urban area across the districts.

Caste and religion

Nearly 46% of respondents belonged to OBC, 20% to Scheduled Caste, 1% to Scheduled Tribe, 18% to general category and 15% were Muslim. In addition, most of the respondents belonged to Hindu religion (85%) and 15% were Muslim.

Occupation

Nearly 96% of women were housewives whereas 2% were in farming or agriculture (higher in Sitapur-9%) and 1% each were doing Government /private job and daily wage labourer.

Profile of Husbands of Currently Married Women (CMW)

Age distribution of husbands

Nearly 36% of husbands were in the age group of 18-30 years, 43% were in the age group of 31-40 years, about 20% in the age group of 41-50 years and 1.7% were more than 50 years of age.

The average age of husbands was 35 years. The age distribution of husbands was similar across the districts.

Occupation of husbands

Nearly 26% of husbands were in Govt. or private job (lower in Sitapur-11%), 27% were doing agriculture/farming (higher in Etah-39% and lower in Varanasi 9%), 35% were daily wage labourer (much higher in Bareilly-46%) and less than 1% was doing animal husbandry. Also about 11% were doing other jobs that were mostly shopkeeper or self-employed such as tailor, weaver, painter and driver. Some were unemployed also.

Works inside the district or Outside

Husbands of 88% of CMW were working within the district and 12% were working outside the district.

Frequency of visit to home

The frequency of visit of 21% was once a year, 45% visited 2-3 times in a year (much higher in lalitpur-85%), 13% visited 4 times or more but less than a month, 10% visited more than once a month (higher in Sitapur-30%, Ghaziabad -42% and Bareilly-19%) and 11% didnt have any fixed schedule of visit.

4.2 Pregnancy, child birth, antenatal care received, outcome of last pregnancy and place of delivery

Pregnancy and childbirth

Nearly 94% respondents reported to have given birth at the time of survey. The age at first pregnancy was 19-21 years for 49% of respondents, below 19 years for 31% and 22 years or more for 20% of the respondents.

Number of boys born alive was reported as one by 43%, 2 by 35%, 3-4 by 19% and only 3% reported 5 or more boys.Number of girls born alive was reported as one by 44%, 2 by 29%, 3-4 by 23% and 4% reported 5 or more girls. The total number of surviving children was reported as one by 17%, 2 by 27%, 3-4 by 40% and 5 and above by 16% of respondents.

Antenatal care received, outcome of last pregnancy and place of delivery

Nearly 60% of respondents, who became pregnant, reported1-3 times antenatal care received and only 10.5% received 4 or more antenatal care whereas 30% didnt receive any antenatal care (Sitapur-43% and Bareilly-40%). Only in Ghaziabad, 26% women reported to have received antenatal care 4 or more times.

Live birth as the outcome of last pregnancy was reported by 97% of respondents and only 2% reported abortion and 1% reported stillbirth.

Home as the place of delivery, was reported by 45% (54% in Bahraich and Etah each and 52% in Bareilly), Government facility by 35% and private facility by 20%. Delivery in Govt. facility was much higher in Banda (52%) and Lalitpur (55.5%) whereas delivery in private facility was much lower in these districts. However, institutional deliveries have increased from 55% to 70% during last one year and home deliveries have gone down from 45% to 30%. Home deliveries have gone down considerably in Varanasi (14%), Banda and Lalitpur (18% each).

4.3 Interaction with ASHA during pregnancy and any counseling received about family planning

Interaction with ASHA during pregnancy

Nearly 68% of respondents knew ASHA of the village. Among the women who knew ASHA of the village, nearly half (51%) informed that ASHA visited their home to talk about their last pregnancy and childbirth. The frequency of visit of ASHA during current pregnancy at home was reported as 1-2 by 54%, 3-4 by 41% but 5 and more visits were informed by 4.5% only.

Majority (51%) of respondents informed the last contact with ASHA a month back whereas contact more than 3 months back was mentioned by 13% (higher in Ghaziabad-26% Sitapur-25% and Bareilly-24%),1-2 months back by 24% (higher in Etah-43%) and 2-3 months back was informed by 13% of currently pregnant women (higher in Lalitpur, Banda and Etah-21% each).

4.4 Counseling received about family planning during pregnancy or after childbirth

Though 41% respondents said that they received counselling or advice on family planning, the number of such women was higher in Ghaziabad (69%), and Bareilly (56%). Of these women, 43% received advice from ASHA, 20% from ANM, 5% from AWW and 32% from others (largely from husband/family members -61%, doctor/private doctor-20% and neighbour/relative/Mass Media-(20%).

Place of receiving information and family planning methods discussed

Information on family planning methods was largely received at home (36%) followed by Sub-centre (21%), PHC (11%), Village Health and Nutrition day (6%) and 27% from others (mainly ASHA home visit/Anganwadi worker, doctor /private or Govt. hospital and neighbor/in village).Information received at home was higher in Bahriach (46%), Ghaziabad (40%) and Bareilly (39%).

The information received about methods was mainly female sterilization (76%), condom/Nirodh (53%), Copper T (48%), OCP (40%), injectables (22%), PPIUCD (8.5%) and male sterilization (4.7%).

Further, about 19% of CMW received advice from AWW, ASHA or any other community health worker about family planning during their home visit or during visit to a heath facility or a camp.

In addition, 41% reported to have visited a health facility or camp for themselves or children and among them, 41% said that any staff member at the health facility or camp talked to them about family planning methods.

4.5 Ever use of family planning methods, duration of use and reasons for discontinuation

Ever use of any family planning method to avoid or delay the pregnancy was reported by 34.5% (higher in Gorkhpur-58% and Varanasi-53%). The first use of family planning method was after 18 years of age (31% during 19-23 years, 38% during 24-28 years and 28% after 28 years).

The first method used was largely sterilization (48%). It was higher in Lalitpur (77%), Banda (70%) and Sitapur (60%) but only a few (none in five of the 10 districts) reported male sterilization. The next method used most was condom (23%) and it was higher in Etah (30%) and Bahraich (28%).OCP as the first method was used by 8% and IUCD by 5% only. Nearly 14% also used standard days (safe period) method as the first method. Other methods were used by less than 1% of respondents.

Average duration of method used was 7 years for female sterilization, male sterilization was 1 year or less, male condom was 2.3 years, OCP was 2.6 years except Sitapur (8.5 years), IUCD was 3.1 years except Sitapur (7.5 years) and Bareilly (6.3 years). The number of first users of injectables was very small though average duration of use was 2.5 years (higher in Banda-5 years and Varansi-3.7 years) and standard days (safe period ) was 2.8 years except Bareilly (11 years). Only few reported first use of emergency contraceptives and traditional medicine.

Reasons for stopping first use of contraceptive method

Sterilization:Only 1.5% reported stopping of female sterilization due to method failureand it was highestin Etah (7.7%).

Male condom: Most of them (79%) stopped it to become pregnant and only 6% each stopped it because husband didntlike it or problem with method.

OCP: Main reasons were to get pregnant (51%) and problem with method (36%).

IUCD: It was mainly stopped due to problem with the method (62%) or wanted to become pregnant (31%).

Injectables: Main reason was problem with the method or wanted to become pregnant (37% each).

Standard days (safe period) method was stopped mainly to become pregnant (94%).

4.6 Current use of family planning methods and duration of use

Current use of family planning methods

In Uttar Pradesh, 51% were using any method for avoiding or delaying the birth of a child. It was higher than state average in Lalitpur (69%), Gorakhpur (67%), Varanasi (66%) and Banda (62%).

The methods mix of modern methods shows that in Uttar Pradesh, Female sterilization was 19%. It was higher than state average in Lalitpur (39%), Varanasi (29%), Banda (29%) and Gorakhpur (28%).

The next method used by large number was condom/Nirodh. It was 13% in Uttar Pradesh and higher than state average in the districts of Bahraich (18%), Gorakhpur (15%), Lalitpur (14%) and Banda (13%).

Use of Oral contraceptive pill was 2.3% in Uttar Pradesh. Similarly, use of IUCD/Copper T in Uttar Pradesh was 1.3% and use of PPIUD was 0.3%.It was not reported in the districts of Baharich and Gorakhpur but it was higher in Ghaziabad (1.33%).Injectables use was also very low (0.52%) in Uttar Pradesh.

The prevalence of modern contraceptive methods in Uttar Pradesh was 36.4%. It was higher in Lalitpur (57.33%), Gorakhpur (46.67%), Banda (46%) and Varanasi (44.5%).

Use of traditional methods in Uttar Pradesh was 14.7%, which mainly included standard days (safe period method). Only few reported withdrawal method (except Sitapur district). Use of traditional methods was very high in Bahraich (27%), Varanasi (21%), Gorakhpur (20%) and Banda (16%).

The use of any method of family planning in urban areas across districts and state was higher than rural area except Banda where prevalence in rural area was higher and Lalitpur where prevalence was nearly equal. However, prevalence of modern method is much higher in urban area than in rural area except Banda where prevalence of modern methods in rural area is slightly higher than urban area.

Current use of family planning method by background characteristics

The current use by religion shows that 87% of Hindu and 13% of Muslim used any method of family planning. The use of any method among Muslims was higher in Bahraich (32%), Sitapur (23%) and Bareilly (22%).

By caste, use of any method in Uttar Pradesh was highest among OBC (53%) followed by scheduled caste and general (23% each). Use of any method among OBC was higher in Bareilly (77%) followed by Etah (65.5%) and Varanasi (61%). Use of any method among scheduled caste was higher in Sitapur (49%).

Be education, use of any method in Uttar Pradesh) was highest among Illiterate (45%) followed by those who had studied between class 5-8 (24%) and class 9-12 years (19%). Use among those educated upto graduate and higher was low (9%). This is similar across districts.

By parity, use of any method in Uttar Pradesh was highest among those women who had 3-4 children (47%) followed by those having 2 children (29%) and one child (9%). It was 15% among women having 5 or more children and negligible in women with no children.

The current use of sterilization (male and female) in Uttar Pradesh was 38.8%, which constituted 96% Hindu and 4% Muslims. Similar was the case with other modern and traditional methods except ECP which was used more by Muslims than Hindu.

Generally, the method use was higher in OBC followed by general and then scheduled caste. Use of methods by scheduled Tribe was very low.

By caste, female sterilization was higher in OBC (52%) followed by scheduled caste (25%) and general (21.5%) but male sterilization was higher in general category (57%). Copper T was higher in OBC (51%) followed by general (39%) whereas PPIUCD was higher in OBC (62%) followed by Schedule caste (25%). Similar was the situation with other methods by caste.

By education, female sterilization was higher among illiterate (54%) followed by those who have studied upto 5-8 years (26%) whereas male sterilization was equal among illiterate and those who have studied upto graduate and above (37.5%). Use of IUCD (31%) and PPIUCD (39%) was more among those who have studied upto 9-12 years followed by those who have studied upto 5-8 years.

By parity, sterilization use was higher among those with 3-4 children whereas use of copper T was higher among those who have 2 children followed by those having 3-4 children.

Use of spacing methods was higher among women with low parity. None of the women, who had no surviving children, was using any contraceptive. Use of injectables and OCP was higher among those with 3-4 children followed by those having 2 children whereas condom use was 57% among those having 1-2 children.

4.7 Place of sterilization and quality of care and whether packet of condom/oral contraceptive pills was shown

Place of sterilization was mostly Govt. facility (90.4%). Private facility was used by 9.5% and only 0.1% got it done at NGO facility (only Sitapur). Similar was the trend in the districts under study.

Age at the time of sterilization of males was between 25-35 years and females was between 26-35 years.

The quality of care received was mentioned bad or not so good largely in Sitapur, Bahraich, Banda and Lalitpur. In addition, 2% regretted after being sterilized in Uttar Pradesh (higher in Kanpur Dehat -5.9% and Etah -5.6%).

In addition, only 21% of users of condom or Oral contraceptive pills could show the packet of these contraceptives reported to have used by them.

4.8 Knowledge of sources of obtaining family planning methods

PPIUCD: Source of obtaining PPIUCD was reported correctly by 42% as Govt. or private facility.

IUCD/Copper T: Nearly 90% reported correctly the source of obtaining IUCD from Govt. facility, private facility or ANM.

Oral Contraceptive pills (OCP) : About 37% women knew of availability of OCP from Govt. facility, 27.5% from Private facility and 26% from medical store. Only 5% mentioned its availability from ASHA and ANM. Nearly 17% in Sitapur and 11% in Bareilly mentioned its availability from general store, which is incorrect.

Injectable contraceptive: Nearly 25% in Uttar Pradesh mentioned its availability from Govt. facility, which is wrong. This misunderstanding was common in most of the districts except Sitapur, Etah and Bareilly.

Condom/Nirodh: The knowledge of sources of availability of condom was very good though its availability with ASHA and ANM was known to only 18% and 12%, respectively (higher in Varanasi).

ECP: Knowledge about availability of ECP from Govt. or private facility was very low (3% each). Its availability from medical store was known to 11% in Uttar Pradesh. Very few CMW in Varanasi and Etah mentioned Its availability with ANM.

4.9 Duration of methods used currently

The duration of current use of method was for 1-3 years by 32% followed by 4-6 years (20%) whereas 29% have been using for more than 6 years in Uttar Pradesh. The method use for less than one year is 19%. The overall use by about half of users is during last 3 years.

4.10 Any payments made for obtaining the method and which method

About 34% respondents in Uttar Pradesh reported to have paid money for obtaining family planning method (higher in Ghaziabad and Sitapur-43% each and Bahriach-67%). The payment was made largely for condom (70%) followed by OCP (8%) which shows that these users were purchasing it from market. Only 5% mentioned payment for IUCD whereas 3% mentioned payment for injectables (not in Govt. programme). Few users of PPIUCD in Varanasi and Ghaziabad also mentioned payment for PPIUCD , which shows that they got it from private facility after delivery there. Payment for ECP was reported by 28

28.25

37.17

29.65

34.2

30.04

14.55

20.17

28.42

27.59

38.36

37.82

N=No. ever used any FP method

2074

113

317

231

283

220

347

95

203

146

119

First method used to delay or avoid pregnancy

Female Sterilization

48.31

60.18

41.32

69.7

77.03

12.37

31.12

41.05

49.26

51.37

56.3

Male Sterilization

0.29

0

0

0.43

0.35

0.35

0

0

0.99

0

0.84

Condom/Nirodh

22.9

25.66

18.3

15.15

15.19

28.27

23.63

30.53

26.6

26.71

21.85

Female Condom

OCP

8.2

8.85

4.73

7.36

5.65

11.31

4.9

10.53

13.3

12.33

6.72

IUCD

4.92

5.31

6.62

4.33

1.06

5.65

3.17

8.42

7.39

4.79

4.2

PPIUCD

EC

0.19

0

0

0.43

0

0.35

0.58

0

0

0

0

Injectables

0.92

0

0.95

0.43

0

0.71

1.44

2.11

0.99

2.05

0.84

LAM

0.05

0

0.32

0

0

0

0

0

0

0

0

Std days/cycle beads

14.08

0

27.76

2.16

0.71

18.73

34.58

7.37

1.48

2.05

9.24

Others (Traditional method)

0.14

0

0

0

0

0

0.58

0

0

0.68

0

N=No. ever used any FP method

2074

113

317

231

283

220

347

95

203

146

119

5.2 Duration of first method used

Average duration of method used was 7 years for female sterilization, male sterilization was 1 year or less, male condom was 2.3 years, OCP was 2.6 years except Sitapur (8.5 years), IUCD was 3.1 years except Sitapur (7.5 years) and Bareilly (6.3 years). The number of first users of injectables was very small though average duration of use was 2.5 years (higher in Banda-5 years and Varansi-3.7 years) and standard days (safe period ) was 2.8 years except Bareilly (11 years). Only few reported first use of emergency contraceptives and traditional medicine (Table 5.2).

Table 5.2: Duration of method used by first method adopted

Particulars

Uttar Pradesh

District

Sitapur

Varanasi

Banda

Lalitpur

Bahr-aich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

%

%

%

%

%

%

%

%

%

%

%

Duration of method used by first method adopted


Less than 1 year

0.30

0.00

0.00

0.00

0.46

0.00

0.00

2.56

1.00

0.00

0.00

1-3 years

25.05

29.41

26.72

22.36

25.23

11.43

25.00

25.64

30.00

25.33

22.39

4-6 years

25.05

30.88

22.90

22.98

25.23

37.14

23.15

28.21

19.00

32.00

23.88

7-9 years

17.47

14.71

22.14

21.12

16.97

25.71

16.67

15.38

10.00

13.33

17.91

> 10

32.14

25.00

28.24

33.54

32.11

25.71

35.19

28.21

40.00

29.33

35.82

Average duration of use (in years)

7.3

6.5

7.0

7.7

7.3

7.7

7.7

6.7

7.4

7.1

7.6

N=

1002

68

131

161

218

35

108

39

100

75

67

Male Sterilization

Less than 1 year

66.67

100.00

0.00

100.00

50.00

100.00

1-3 years

33.33

0.00

100.00

0.00

50.00

0.00

4-6 years

7-9 years

> 10


0.8

0.0

0.0

0.8

1.1

0.8

0.0

0.0

0.8

0.0

0.5

N=

6

0

0

1

1

1

0

0

2

0

1

Male Condom/Nirodh

Less than 1 year

27.58

0.00

20.69

25.71

30.23

10.00

25.61

68.97

53.70

15.38

50.00

1-3 years

52.63

31.03

72.41

62.86

51.16

65.00

56.10

27.59

35.19

46.15

46.15

4-6 years

13.68

41.38

6.90

8.57

16.28

21.25

14.63

3.45

7.41

10.26

3.85

7-9 years

3.37

20.69

0.00

2.86

2.33

2.50

2.44

0.00

3.70

5.13

0.00

> 10

2.74

6.90

0.00

0.00

0.00

1.25

1.22

0.00

0.00

23.08

0.00


2.3

5.1

1.8

1.8

1.9

2.4

2.3

0.8

1.4

4.8

1.1

N=

475

29

58

35

43

80

82

29

54

39

26

OCP

Less than 1 year

30.59

0.00

40.00

11.76

25.00

15.63

35.29

70.00

44.44

27.78

62.50

1-3 years

42.94

20.00

46.67

47.06

68.75

46.88

52.94

30.00

40.74

22.22

37.50

4-6 years

17.65

30.00

13.33

35.29

6.25

37.50

11.76

0.00

7.41

11.11

0.00

7-9 years

3.53

10.00

0.00

5.88

0.00

0.00

0.00

0.00

3.70

16.67

0.00

> 10

5.29

40.00

0.00

0.00

0.00

0.00

0.00

0.00

3.70

22.22

0.00


2.6

8.5

1.3

2.8

1.9

2.6

1.3

0.8

1.9

4.7

0.8

N=

170

10

15

17

16

32

17

10

27

18

8

IUCD

Less than 1 year

17.65

0.00

14.29

30.00

0.00

6.25

27.27

37.50

20.00

14.29

20.00

1-3 years

49.02

16.67

66.67

30.00

33.33

62.50

54.55

50.00

40.00

42.86

40.00

4-6 years

26.47

33.33

19.05

40.00

66.67

31.25

18.18

12.50

33.33

0.00

40.00

7-9 years

1.96

16.67

0.00

0.00

0.00

0.00

0.00

0.00

0.00

14.29

0.00

> 10

4.90

33.33

0.00

0.00

0.00

0.00

0.00

0.00

6.67

28.57

0.00


3.1

7.5

2.7

2.4

4.1

2.7

2.0

2.0

2.8

6.3

2.4

N=

102

6

21

10

3

16

11

8

15

7

5

ECP

Less than 1 year

50.00

100.00

0.00

50.00

1-3 years

50.00

0.00

100.00

50.00

4-6 years

7-9 years

> 10


1.3

0.0

0.0

0.2

0.0

1.0

1.9

0.0

0.0

0.0

0.0

N=

4

0

0

1

0

1

2

0

0

0

0

Injectables

Less than 1 year

15.79

0.00

0.00

0.00

40.00

0.00

50.00

0.00

0.00

1-3 years

57.89

66.67

0.00

100.00

40.00

50.00

50.00

66.67

100.00

4-6 years

26.32

33.33

100.00

0.00

20.00

50.00

0.00

33.33

0.00

7-9 years

> 10


2.5

0.0

3.7

5.0

0.0

1.5

2.0

3.3

0.9

3.3

1.0

N=

19

0

3

1

0

2

5

2

2

3

1

LAM

Less than 1 year

1-3 years

4-6 years

100.00

100.00

7-9 years

> 10


4.0

0.0

4.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

N=

1

0

1

0

0

0

0

0

0

0

0


Less than 1 year

8.90

9.09

20.00

50.00

5.66

8.33

28.57

0.00

0.00

9.09

1-3 years

66.10

75.00

20.00

0.00

62.26

65.83

57.14

66.67

0.00

72.73

4-6 years

19.86

10.23

40.00

50.00

32.08

20.83

14.29

33.33

0.00

18.18

7-9 years

1.71

0.00

0.00

0.00

0.00

3.33

0.00

0.00

33.33

0.00

> 10

3.42

5.68

20.00

0.00

0.00

1.67

0.00

0.00

66.67

0.00


2.8

0.0

2.5

4.4

2.0

2.7

2.9

2.6

2.5

11.0

2.2

N=

292

0

88

5

2

53

120

7

3

3

11

Traditional medicine

Less than 1 year

1-3 years

66.67

100.00

0.00

4-6 years

33.33

0.00

100.00

7-9 years

> 10


1.8

0.0

0.0

0.0

0.0

0.0

1.1

0.0

0.0

3.2

0.0

N=

3

0

0

0

0

0

2

0

0

1

0

Frequency of use of emergency contraceptive (Table 5.2a) was reported by 1-2% and it was mostly once.

Table 5.2a: Distribution of respondents by frequency of use of emergency contraceptive

Particulars

Uttar Pradesh

District

Sitapur

Varanasi

Banda

Lalitpur

Bahr-aich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

%

%

%

%

%

%

%

%

%

%

%

Frequency of use of EC in last 12 months

Never

99.0

97.8

99.5

98.6

98.5

99.5

98.8

98.3

100.0

98.6

98.1

1

0.6

0.0

0.5

1.4

0.0

0.0

0.8

1.7

0.0

0.0

1.9

2

0.3

0.0

0.0

0.0

1.5

0.0

0.4

0.0

0.0

1.4

0.0

3

0.1

0.0

0.0

0.0

0.0

0.5

0.0

0.0

0.0

0.0

0.0

4

0.1

2.2

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

N=Yes in F1 except sterilization users

1085

46

188

71

66

184

243

59

102

74

52

5.3 Reasons for stopping first use of contraceptive method

Table 5.4 presents the reasons for stopping the first method of family planning used.

Sterilization:Only 1.5% reported stopping of female sterilization due to method failureand it was highestin Etah (7.7%).

Male condom: Most of them (79%) stopped it to become pregnant and only 6% each stopped it because husband didnt like it or problem with method.

OCP: Main reasons were wanted to get pregnant (51%) and problem with method (36%).

IUCD: It was mainly stopped due to problem with the method (62%) or wanted to become pregnant (31%).

Injectables: Main reason was problem with the method or wanted to become pregnant (37% each).

Standard days (safe period) method was stopped mainly to become pregnant (94%).

Table 5.4: Reasons for stopping the first method used

Particulars

Uttar Pradesh

District

Sitapur

Varanasi

Banda

Lalitpur

Bahr-aich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

%

%

%

%

%

%

%

%

%

%

%

Reason for stopping the most recent method used


In use

98.50

100.00

99.24

98.76

99.08

100.00

97.22

92.31

99.00

97.33

98.51

Sterilization failed

1.50

0.00

0.76

1.24

0.92

0.00

2.78

7.69

1.00

2.67

1.49

N=

1002

68

131

161

218

35

108

39

100

75

67

Male Sterilization

In use

100.00

100.00

100.00

100.00

100.00

100.00

N=

6

1

1

1

2

1

Male Condom/Nirodh

Wanted to become pregnant

78.95

34.48

72.41

94.29

93.02

97.50

92.68

55.17

70.37

74.36

50.00

Problem with the method

5.68

13.79

6.90

2.86

2.33

1.25

1.22

10.34

12.96

2.56

15.38

Husband didn't like it

5.68

17.24

13.79

2.86

2.33

1.25

1.22

13.79

1.85

7.69

7.69

Opposition from family members

0.21

0.00

0.00

0.00

2.33

0.00

0.00

0.00

0.00

0.00

0.00

Non-availability of method

1.47

0.00

0.00

0.00

0.00

0.00

0.00

3.45

1.85

2.56

15.38

Infrequent sex/husband away

4.21

17.24

0.00

0.00

0.00

0.00

2.44

13.79

9.26

5.13

7.69

Wanted more effective method

1.05

6.90

5.17

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

Costs too much

0.63

6.90

0.00

0.00

0.00

0.00

0.00

0.00

1.85

0.00

0.00

Other

Change the method

0.21

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

2.56

0.00

Husband away

0.21

0.00

0.00

0.00

0.00

0.00

1.22

0.00

0.00

0.00

0.00

Hysterectomy

0.21

3.45

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

Menopause

1.05

0.00

1.72

0.00

0.00

0.00

0.00

3.45

1.85

5.13

0.00

not needed

0.42

0.00

0.00

0.00

0.00

0.00

1.22

0.00

0.00

0.00

3.85

N=

475

29

58

35

43

80

82

29

54

39

26

OCP


50.59

10.00

40.00

70.59

50.00

87.50

52.94

20.00

44.44

38.89

12.50


35.88

80.00

40.00

23.53

50.00

3.13

29.41

50.00

37.04

38.89

87.50


2.35

10.00

0.00

0.00

0.00

3.13

0.00

0.00

0.00

11.11

0.00


1.18

0.00

0.00

0.00

0.00

0.00

0.00

10.00

3.70

0.00

0.00


1.18

0.00

0.00

0.00

0.00

0.00

11.76

0.00

0.00

0.00

0.00


4.71

0.00

13.33

0.00

0.00

0.00

5.88

10.00

7.41

11.11

0.00


1.18

0.00

0.00

0.00

0.00

0.00

0.00

0.00

7.41

0.00

0.00

Costs too much

0.59

0.00

0.00

0.00

0.00

3.13

0.00

0.00

0.00

0.00

0.00

Other

Change the method

1.18

0.00

6.67

0.00

0.00

0.00

0.00

10.00

0.00

0.00

0.00

method fail

0.59

0.00

0.00

5.88

0.00

0.00

0.00

0.00

0.00

0.00

0.00

not needed

0.59

0.00

0.00

0.00

0.00

3.13

0.00

0.00

0.00

0.00

0.00

N=

170

10

15

17

16

32

17

10

27

18

8

IUCD


31.37

0.00

42.86

80.00

33.33

25.00

18.18

37.50

26.67

14.29

0.00


61.76

100.00

52.38

20.00

66.67

68.75

72.73

62.50

60.00

71.43

80.00


0.98

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

20.00


0.98

0.00

0.00

0.00

0.00

6.25

0.00

0.00

0.00

0.00

0.00


0.98

0.00

0.00

0.00

0.00

0.00

0.00

0.00

6.67

0.00

0.00

Costs too much

Other

Menopause

2.94

0.00

4.76

0.00

0.00

0.00

0.00

0.00

6.67

14.29

0.00

method fail

0.98

0.00

0.00

0.00

0.00

0.00

9.09

0.00

0.00

0.00

0.00

N=

102

6

21

10

3

16

11

8

15

7

5

ECP


50.00

0.00

0.00

100.00


25.00

0.00

100.00

0.00


25.00

100.00

0.00

0.00

Costs too much

N=

4

0

0

1

0

1

2

0

0

0

0

Injectables


36.84

100.00

100.00

50.00

40.00

0.00

0.00

0.00

0.00


36.84

0.00

0.00

0.00

60.00

50.00

50.00

66.67

0.00


5.26

0.00

0.00

0.00

0.00

0.00

50.00

0.00

0.00


10.53

0.00

0.00

50.00

0.00

0.00

0.00

0.00

100.00


Costs too much

5.26

0.00

0.00

0.00

0.00

50.00

0.00

0.00

0.00

Other (Menopausal)

5.26

0.00

0.00

0.00

0.00

0.00

0.00

33.33

0.00

N=

19

0

3

1

0

2

5

2

2

3

1

LAM

Not specified

100.00

100.00

N=

1

0

1

0

0

0

0

0

0

0

0



93.84

88.64

60.00

100.00

100.00

98.33

71.43

100.00

100.00

81.82


0.68

0.00

20.00

0.00

0.00

0.83

0.00

0.00

0.00

0.00


1.37

4.55

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00



0.68

1.14

0.00

0.00

0.00

0.00

0.00

0.00

0.00

9.09


1.03

0.00

20.00

0.00

0.00

0.00

28.57

0.00

0.00

0.00


0.68

1.14

0.00

0.00

0.00

0.00

0.00

0.00

0.00

9.09

Other

Change the method

0.34

1.14

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

Hysterectomy

0.34

1.14

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

Menopause

0.68

2.27

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

not needed

0.34

0.00

0.00

0.00

0.00

0.83

0.00

0.00

0.00

0.00

N=

292

0

88

5

2

53

120

7

3

3

11

Traditional medicine


100.00

100.00

100.00

N=

3

0

0

0

0

0

2

0

0

1

0

Chapter 6: Current use of family planning methods and unmet need6.1 Current use of family planning methods

Table 6.1 shows that in Uttar Pradesh, 51% were using any method for avoiding or delaying the birth of a child. It was higher than state average in Lalitpur (69%), Gorakhpur (67%), Varanasi (66%) and Banda (62%).

The methods mix of modern methods shows that in Uttar Pradesh, Female sterilization was 19.21%. It was higher than state average in Lalitpur (39%), Varanasi (28.8%), Banda (28.7%) and Gorakhpur (27.5%).

The next method used by large number was condom/Nirodh. It was 12.6% in Uttar Pradesh and higher than state average in the districts of Bahraich (17.7%), Gorakhpur (14.8%), Lalitpur (14%) and Banda (13%).

Use of Oral contraceptive pill was 2.3% in Uttar Pradesh but it was higher in Bahraich (4%), Bareilly (3.15%), Banda (3%), Gorakhpur (2.8%) and Lalitpur (2.7%).

Use of IUCD/Copper T was 1.3% in Uttar Pradesh but it was higher in Ghaziabad (2.82%), Varanasi (2.67%) and Bareilly (1.82%).

Use of PPIUD was reported as 0.3% in Uttar Pradesh. It was not reported in the districts of Baharich and Gorakhpur but it was higher in Ghaziabad (1.33%).

Injectables use was 0.52% in Uttar Pradesh but it was higher in Ghaziabad (1.16%) and Bahraich (1%).

The prevalence of modern contraceptive methods in Uttar Pradesh was 36.44%. It was higher in Lalitpur (57.33%), Gorakhpur (46.67%), Banda (46%) and Varanasi (44.5%).

Use of traditional methods in Uttar Pradesh was 14.7%, which mainly included standard days (safe period method). Only few reported withdrawal method (except Sitapur district). Use of traditional methods was very high in Bahraich (27%), Varanasi (21%), Gorakhpur (20%) and Banda (16%).

Table 6.1: Distribution of respondents by current use of family planning methods

Particulars

Uttar Pradesh

District

Sitapur

Varanasi

Banda

Lalitpur

Bahr-aich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

%

%

%

%

%

%

%

%

%

%

%

Current use of contraceptives

Yes

51.16

28.52

66.00

62.33

69.50

59.50

66.83

34.22

45.3

36.65

43.02

No

48.84

71.48

34.00

37.67

30.50

40.50

33.17

65.78

54.7

63.35

56.98

N=All respondents

6012

603

600

600

600

600

600

602

602

603

602

Method currently used for delaying or avoiding pregnancy (Only yes responses)

Modern methods


19.21

11.94

28.83

28.67

39.00

8.50

27.50

5.98

18.11

12.60

11.13

Male sterilization

0.13

0.17

0.17

0.17

0.17

0.17

0.33

0.17

IUD

1.30

0.50

2.67

0.50

1.00

1.00

0.83

1.00

2.82

1.82

0.83

PPIUD

0.30

0.17

0.33

0.17

0.17

0.00

0.00

0.17

1.33

0.33

0.33

Injectables

0.52

0.17

0.67

0.50

0.17

1.00

0.33

0.66

1.16

0.17

0.33

OCP

2.33

1.00

1.50

3.00

2.67

4.00

2.83

1.33

2.66

3.15

1.16

Male Condom/Nirodh

12.59

9.12

10.17

13.00

14.17

17.67

14.83

10.47

12.62

10.45

13.46

Female Condom

ECP

0.07

0.17

0.17

0.17

0.17

Total mCPR

36.44

22.89

44.50

46.00

57.33

32.50

46.67

19.60

39.20

28.52

27.41

Traditional Methods

Std. Days/Cycle Beads

11.19

4.81

18.83

9.67

5.17

18.67

16.83

12.62

4.49

6.63

14.29

LAM

2.30

1.67

5.67

5.67

7.67

2.00

0.00

0.00

0.33

0.00

Rhythm Method

0.15

0.50

0.00

0.00

0.17

0.00

0.66

0.17

0.00

0.00

Withdrawal

0.75

0.67

0.83

1.17

0.50

1.00

0.66

0.83

0.66

1.16

Others Traditional Method

0.32

0.33

0.17

0.17

0.00

0.17

0.33

0.66

0.66

0.50

0.17

Total traditional

14.70

5.64

21.33

16.33

12.17

27.00

20.17

14.59

6.15

8.13

15.61

CPR (Any method)

51.09

28.52

66.00

62.33

69.50

59.50

66.83

34.16

45.35

36.65

43.02

The use of any method of family planning in urban areas across districts and state was higher than rural area except Banda where prevalence in rural area was higher and Lalitpur where prevalence was nearly equal. But prevalence of modern method use in urban area was much higher in urban area than in rural area except Banda where prevalence of modern methods in rural area is slightly higher than urban area.

Table 6.1a: Current use of contraceptives by residence

Urban

Rural

Total

Current use of contraceptives

%

%

%

Sitapur

34.44

26.00

28.52

Bahriach

65.00

57.14

59.50

Bareilly

42.22

34.28

36.65

Gorakhpur

75.56

63.10

66.83

Varanasi

72.22

63.33

66.00

Ghaziabad

52.78

42.18

45.35

Banda

55.56

65.24

62.33

Etah

38.67

32.30

34.22

Kanpur Dehat

40.33

44.18

43.02

Lalitpur

70.17

69.05

69.50

Uttar Pradesh

54.72

49.64

51.16

Table 6.1b: Current use of contraceptive methods by residence

District

Current use of contraceptive methods (%)

Any Method

Any modern method


Male Sterilization

IUD

Urban

Rural

Total

Urban

Rural

Total

Urban

Rural

Urban

Rural

Urban

Rural

Sitapur

34.44

26.00

28.52

29.44

20.09

22.89

10.56

12.53

0.00

0.00

1.11

0.24

Bahriach

65.00

57.14

59.50

41.67

28.57

32.50

8.33

8.57

0.56

0.00

1.67

0.71

Bareilly

42.22

34.28

36.65

36.11

25.30

28.52

10.00

13.71

0.00

0.00

3.33

1.18

Gorakhpur

75.56

63.10

66.83

62.78

39.76

46.67

31.67

25.71

0.56

0.00

2.22

0.24

Varanasi

72.22

63.10

65.83

47.78

43.10

44.50

23.33

31.19

0.56

0.00

5.00

1.67

Ghaziabad

52.78

42.18

45.35

46.67

36.02

39.20

17.78

18.25

0.56

0.24

3.89

2.37

Banda

55.56

65.24

62.33

45.56

46.19

46.00

23.89

30.71

0.56

0.00

0.56

0.48

Etah

38.67

32.30

34.22

21.55

18.76

19.60

4.97

6.41

0.00

0.00

0.55

1.19

Kanpur Dehat

40.33

44.18

43.02

30.94

25.89

27.41

7.18

12.83

0.55

0.00

1.66

0.48

Lalitpur

70.56

69.05

69.50

59.44

56.43

57.33

30.00

42.86

0.00

0.24

1.67

0.71

Uttar Pradesh

54.72

49.62

51.15

42.18

33.99

36.44

16.76

20.26

0.33

0.05

2.16

0.93

District

Current use of contraceptive methods (%)

PPIUD

Injectables

Oral Pills

Male Condom/Nirodh

ECP

Urban

Rural

Urban

Rural

Urban

Rural

Urban

Rural

Urban

Rural

Sitapur

0.56

0.00

0.00

0.24

1.67

0.71

15.56

6.38

0.00

0.00

Bahriach

0.00

0.00

1.11

0.95

6.67

2.86

23.33

15.24

0.00

0.24

Bareilly

1.11

0.00

0.56

0.00

6.11

1.89

15.00

8.51

0.00

0.00

Gorakhpur

0.00

0.00

0.56

0.24

4.44

2.14

23.33

11.19

0.00

0.24

Varanasi

0.56

0.24

1.11

0.48

2.78

0.95

13.89

8.57

0.56

0.00

Ghaziabad

3.33

0.47

0.00

1.66

5.56

1.42

15.56

11.37

0.00

0.24

Banda

0.00

0.24

0.00

0.71

2.22

3.33

18.33

10.71

0.00

0.00

Etah

0.00

0.24

0.55

0.71

1.10

1.43

14.36

8.79

0.00

0.00

Kanpur Dehat

0.00

0.48

0.55

0.24

3.31

0.24

17.68

11.64

0.00

0.00

Lalitpur

0.00

0.24

0.56

0.00

3.33

2.38

23.89

10.00

0.00

0.00

Uttar Pradesh

0.55

0.19

0.50

0.52

3.72

1.73

18.09

10.24

0.06

0.07

6.2 Current use of any family planning method by background characteristics

Table 6.2 shows that by religion, 87% of Hindu and 13% of Muslim used any method of family planning. The use of any method among Muslims was higher in Bahraich (32%), Sitapur (23%) and Bareilly (22%).

By caste, use of any method in Uttar Pradesh was highest among OBC (53%) followed by scheduled caste and general (23% each). Use of any method among OBC was higher in Bareilly (77%) followed by Etah (65.5%) and Varanasi (61%). Use of any method among scheduled caste was higher in Sitapur (49%).

Be education, use of any method in Uttar Pradesh) was highest among Illiterate (45%) followed by those who had studied between class 5-8 (24%) and class 9-12 years (19%). Use among those educated upto graduate and higher was low (9%). This is similar across districts.

By parity, use of any method in Uttar Pradesh was highest among those women who had 3-4 children (47%) followed by those having 2 children (29%) and one child (9%). It was 15% among women having 5 or more children and negligible in women with no children.

Table 6.2: Distribution of currently married women using contraceptives by their background characteristics (F9 by B3, B5, B6, B14)

Particulars

Uttar Pradesh

District

Sitapur

Varanasi

Banda

Lalitpur

Bahraich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

Religion of respondent

Hindu

87.2

76.7

87.9

95.7

93.3

67.8

92.3

95.6

87.5

77.8

91.1

Muslim

12.8

23.3

12.1

4.3

6.7

32.2

7.7

4.4

12.5

22.2

8.9

Total

3076

172

396

374

417

357

401

206

273

221

259

Caste

Schedule caste (SC)

22.6

49.2

16.4

23.2

27.5

17.8

27.6

8.1

24.7

12.2

22.5

Schedule tribe (ST)

1.3

0.0

6.6

0.3

0.8

0.4

1.9

0.0

0.0

0.0

0.4

Other backward caste (OBC)

53.4

22.7

60.6

52.5

46.8

59.5

50.3

65.5

39.7

77.3

57.6

General

22.6

28.0

16.4

24.0

24.9

22.3

20.3

26.4

35.6

10.5

19.5

Total except Muslims

2683

132

348

358

389

242

370

197

239

172

236

Educational level of respondent

Illiterate

45.1

48.3

34.1

49.7

46.8

62.5

39.9

41.3

27.8

62.9

40.2

1 - 4 years

3.8

0.6

6.1

5.9

4.6

4.2

4.5

1.0

1.8

3.2

1.5

5 - 8 years

23.7

28.5

22.5

25.4

28.1

15.1

24.9

23.8

28.9

17.2

23.2

9 - 12 years

18.6

15.1

27.5

10.7

14.4

12.3

18.2

22.8

31.5

11.3

24.3

Graduate & above

8.8

7.6

9.8

8.3

6.2

5.9

12.5

11.2

9.9

5.4

10.8

Total

3076

172

396

374

417

357

401

206

273

221

259

Parity of children

Not given any birth

0.2

0.0

0.8

0.3

0.7

0.0

0.0

0.0

0.0

0.0

0.0

1

8.9

5.8

10.6

8.6

10.3

10.9

9.2

4.9

8.1

8.1

8.5

2

28.7

24.4

31.3

24.6

33.3

23.5

35.7

27.2

30.8

22.6

26.3

3 - 4

47.3

48.3

47.2

46.5

45.8

45.7

42.6

54.9

50.9

48.9

48.6

5 & above

14.9

21.5

10.1

20.1

9.8

19.9

12.5

13.1

10.3

20.4

16.6

Total

3076

172

396

374

417

357

401

206

273

221

259

6.3Current use of family planning methods by background characteristics

Table 6.3 shows that use of sterilization (male and female) in Uttar Pradesh was 38.8%, which was contributed by 96% Hindu and 4% Muslims. Similar was the case with other modern and traditional methods except ECP, which was used more by Muslims than Hindu.

By caste, female sterilization was higher in OBC (52%) followed by scheduled caste (25%) and general (21.5%) but male sterilization was higher in general category (57%). Copper T was higher in OBC (51%) followed by general (39%) whereas PPIUCD was higher in OBC (62%) followed by Schedule caste (25%). Similar was the situation with other methods by caste. Generally, the method use was higher in OBC followed by general and then scheduled caste. Use of methods by scheduled Tribe was very low.

By education, female sterilization was higher among illiterate (54%) followed by those who have studied upto 5-8 years (26%) whereas male sterilization was equal among illiterate and those who have studied upto graduate and above (37.5%). Use of IUCD (31%) and PPIUCD (39%) was more among those who have studied upto 9-12 years followed by those who have studied upto 5-8 years. Similarly, use of other methods was higher among illiterates followed by those who have studied 5-12 years.

By parity, sterilization use was higher among those with 3-4 children whereas use of copper T was higher among those have 2 children followed by those having 3-4 children.

Use of injectables and OCP was higher among those with 3-4 children followed by those having 2 children whereas condom use was 57% among those having 1-2 children. Use of spacing methods was higher among women with low parity. None of the women, who had no surviving children, was using any contraceptive.

Table 6.3: Distribution of current users of contraceptives by method used and background characteristics (F10 by B3, B5, B6, B14)

Name of State/ district

Background characteristics

Total

Sterilization (F)

Sterilization (M)

IUCD

PPIUCD

Injectables

OCP

Male condoms / Nirodh

ECP

Standard days (safe period)

LAM

Other traditional methods

%

%

%

%

%

%

%

%

%

%

%

%

Uttar Pradesh

Total

51.2

37.5

0.3

2.5

0.6

1.0

4.6

24.6

0.1

21.9

4.5

0.7

Uttar Pradesh

Religion

Uttar Pradesh

Hindu

87.2

95.8

87.5

91.0

88.9

83.9

78.6

77.4

25.0

86.0

83.3

87.8

Uttar Pradesh

Muslim

12.8

4.2

12.5

9.0

11.1

16.1

21.4

22.6

75.0

14.0

16.7

12.2

Uttar Pradesh

Total

3076

1155

8

78

18

31

140

757

4

673

138

74

Uttar Pradesh

Caste

Uttar Pradesh

Schedule caste (SC)

22.6

24.8

14.3

9.9

25.0

19.2

19.1

19.3

0.0

23.0

28.7

23.1

Uttar Pradesh

Schedule tribe (ST)

1.3

1.5

0.0

0.0

0.0

0.0

0.9

0.7

0.0

1.7

2.6

1.5

Uttar Pradesh

Other backward caste (OBC)

53.4

52.2

28.6

50.7

62.5

50.0

49.1

52.6

100.0

59.1

53.9

43.1

Uttar Pradesh

General

22.6

21.5

57.1

39.4

12.5

30.8

30.9

27.5

0.0

16.2

14.8

32.3

Uttar Pradesh

Total

2683

1107

7

71

16

26

110

586

1

579

115

65

Uttar Pradesh

Education

Uttar Pradesh

Illiterate

45.1

53.9

37.5

24.4

11.1

48.4

40.7

30.4

25.0

51.3

47.8

35.1

Uttar Pradesh

1 - 4 years

3.8

4.8

12.5

5.1

5.6

3.2

4.3

2.9

0.0

3.0

4.3

1.4

Uttar Pradesh

5 - 8 years

23.7

25.9

0.0

24.4

22.2

16.1

22.1

24.6

50.0

20.1

22.5

24.3

Uttar Pradesh

9 - 12 years

18.6

13.2

12.5

30.8

38.9

22.6

20.0

24.8

25.0

18.1

17.4

24.3

Uttar Pradesh

Graduate & above

8.8

2.3

37.5

15.4

22.2

9.7

12.9

17.3

0.0

7.6

8.0

14.9

Uttar Pradesh

Total

3076

1155

8

78

18

31

140

757

4

673

138

74

Uttar Pradesh

Parity

Uttar Pradesh

None

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

Uttar Pradesh

1

8.9

0.9

0.0

7.7

5.6

3.2

11.4

17.9

0.0

9.6

24.6

10.8

Uttar Pradesh

2

28.7

21.7

25.0

41.0

66.7

29.0

26.4

38.7

50.0

26.9

31.9

28.4

Uttar Pradesh

3 - 4

47.3

59.2

62.5

39.7

27.8

48.4

44.3

34.0

25.0

46.5

34.8

50.0

Uttar Pradesh

5 & above

14.9

18.2

12.5

11.5

0.0

19.4

17.9

9.4

25.0

17.0

8.7

10.8

Uttar Pradesh

Total except those who have not given birth

3069

1155

8

78

18

31

140

754

4

669

138

74

6.4 Place of sterilization and quality of care and whether packet of condom/oral contraceptive pills was shown

Place of sterilization was mostly Govt. facility (90.4%). Private facility was used by 9.5% and only 0.1% got it done at NGO facility (only Sitapur). Similar was the trend in the districts under study.

Age at the time of sterilization of males was between 25-35 years and females were between 26-35 years.

The quality of care received was mentioned bad or not so good largely in Sitapur, Bahraich, Banda and Lalitpur. In addition, 2% regretted after getting sterilization in Uttar Pradesh which was highest in Kanpur Dehat (5.9%) and Etah (5.6%).

Table 6.4: Distribution of sterilization users by quality of sterilization services

Particulars

Uttar Pradesh

District

Sitapur

Varanasi

Banda

Lalitpur

Bahraich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

%

%

%

%

%

%

%

%

%

%

%

Place where sterilization was done (male or female)

Govt. facility

90.4

91.7

88.5

98.8

97.4

90.4

83.7

66.7

83.8

86.8

91.2

Private facility

9.5

6.9

11.5

1.2

2.6

9.6

16.3

33.3

16.2

13.2

8.8

NGO facility

0.1

1.4

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

N=sterilization users (male and female)

1163

72

174

173

235

52

166

36

111

76

68

Age at the time of sterilization (in years)

Male sterilization

25-30

50.0

100.0

100.0

100.0

0.0

0.0

0.0

100.0

31-35

37.5

0.0

0.0

0.0

100.0

0.0

100.0

0.0

36-40

12.5

0.0

0.0

0.0

0.0

100.0

0.0

0.0

N=Male sterilization users

8

1

1

1

1

1

2

1

Female sterilization

40

1.0

1.4

1.2

0.0

0.0

0.0

1.8

0.0

0.9

2.6

4.5

N=Female sterilization users

1155

72

173

172

234

51

165

36

109

76

67

Quality of care received during operation and thereafter

Very good

48.9

47.2

46.0

42.8

46.8

34.6

52.4

63.9

58.6

51.3

57.4

All right

46.4

40.3

51.1

50.9

47.7

57.7

45.8

30.6

38.7

44.7

41.2

Not so good

4.5

11.1

2.9

6.4

5.5

5.8

1.8

5.6

2.7

3.9

1.5

Bad

0.2

1.4

0.0

0.0

0.0

1.9

0.0

0.0

0.0

0.0

0.0


1163

72

174

173

235

52

166

36

111

76

68

Feel regret after getting sterilization

Yes

2.1

2.8

2.3

2.3

0.4

3.8

1.2

5.6

0.0

3.9

5.9

No

97.9

97.2

97.7

97.7

99.6

96.2

98.8

94.4

100.0

96.1

94.1


1163

72

174

173

235

52

166

36

111

76

68

6.5 Packet of Oral pills/Condom shown

Only 21% of users of condom or Oral contraceptive pills could show the packet of these contraceptives reported to have used by them. It was higher in Lalitpur (36%), Banda (31%) and Bahraich (27%).

Table 6.5: Distribution of users of condom/oral pill by whether packet of condom or Oral contraceptive pills shown

Particulars

Uttar Pradesh

District

Sitapur

Varanasi

Banda

Lalitpur

Bahraich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

%

%

%

%

%

%

%

%

%

%

%

Packet of condom or oral pill shown

Shown

21.3

18.0

20.0

31.3

35.6

26.9

13.2

11.3

21.7

17.1

10.2

Not shown

78.7

82.0

80.0

68.8

64.4

73.1

86.8

88.7

78.3

82.9

89.8

N=users of condom/oral pill

897

61

70

96

101

130

106

71

92

82

88

6.6Knowledge of sources of obtaining family planning methods

PPIUCD: Only 45% respondents reported sources of obtaining PPIUCD but 42% reported correctly as Govt. or private facility.

IUCD/Copper T: Nearly 92% reported sources of obtaining IUCD and 90% reported correctly the source as Govt. facility, private facility or ANM.

Oral Contraceptive pills (OCP): About 37% women knew of availability of OCP from Govt. facility, 27.5% knew its availability from Private facility and 26% from medical store. Only 5% mentioned its availability from ASHA and ANM. Nearly 17% in Sitapur and 11% in Bareilly mentioned its availability from general store, which is incorrect.

Injectable contraceptive: Nearly 25% in Uttar Pradesh mentioned its availability from Govt. facility, which is wrong. This misunderstanding was common in most of the districts except Sitapur, Etah and Bareilly.

Condom/Nirodh: The knowledge of sources of availability of condom was very good though its availability with ASHA and ANM was known to only 18% and 12%, respectively (higher in Varanasi).

ECP: Knowledge about availability of ECP from Govt. or private facility was very low (3% each). Its availability from medical store was known to 11% in Uttar Pradesh (higher in Varanasi-22% and Gorakhpur-20%). Its availability with ANM was mentioned by very few in Varanasi and Etah.

Table 6.6: Distribution of current users of contraceptives by knowledge of sources of obtaining contraceptive methods

Particulars

Uttar Pradesh

Sitapur

Varanasi

Banda

Lalitpur

Bahraich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

%

%

%

%

%

%

%

%

%

%

%

Using any FP method to delay the pregnancy or avoid getting pregnant

Yes

51.2

28.5

66

62.3

69.5

59.5

66.8

34.2

45.3

36.7

43

No

48.8

71.5

34

37.7

30.5

40.5

33.2

65.8

54.7

63.3

57

Total

6012

603

600

600

600

600

600

602

602

603

602

Sources of obtaining family planning methods

PPIUCD

Govt. facility

22.0

30.2

45.7

21.4

13.9

27.5

40.9

1.0

3.7

10.0

3.9

Private facility

19.7

22.1

43.9

20.6

10.3

24.9

39.2

1.9

3.7

3.6

2.3

Medical store

0.6

4.7

2.0

0.0

0.0

0.0

0.2

0.0

0.0

0.0

0.4

General store

0.1

2.3

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

ASHA

0.2

0.0

1.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.4

ANM

2.5

0.6

5.3

2.4

0.0

5.6

6.2

0.5

0.0

0.0

0.4

IUCD

Govt. facility

45.3

48.8

73.2

57.0

39.3

55.2

60.3

7.8

22.0

43.0

12.7

Private facility

38.3

33.7

68.7

44.7

31.7

43.1

56.4

9.2

20.1

28.1

13.1

Medical store

1.7

2.3

5.3

1.3

0.0

0.8

1.5

0.5

1.1

2.3

1.2

General store

0.1

0.6

0.3

0.0

0.0

0.0

0.0

0.0

0.0

0.9

0.0

ASHA

0.7

0.0

4.0

0.5

0.2

0.6

0.0

0.0

0.0

0.0

0.4

ANM

5.6

5.2

11.9

4.8

6.5

7.0

8.0

1.5

0.0

2.3

1.9

OCP

Govt. facility

37.0

41.9

58.3

49.5

37.6

44.8

44.4

5.8

14.7

33.5

11.2

Private facility

27.5

15.7

44.2

39.3

28.1

34.5

36.9

2.9

11.7

22.2

8.1

Medical store

25.7

37.8

28.3

31.8

18.7

28.6

31.2

8.3

22.0

39.4

9.3

General store

2.2

16.9

1.3

0.3

0.0

0.3

0.5

0.0

2.2

10.9

0.0

ASHA

4.6

9.9

18.2

1.9

2.9

1.7

3.5

1.9

0.4

2.7

1.5

ANM

4.5

9.3

13.9

2.7

1.7

3.4

7.2

1.5

0.0

2.3

0.0

Injection

Govt. facility

25.2

0.0

33.6

46.8

35.7

35.3

35.7

1.5

11.7

0.5

5.0

Private facility

29.1

23.8

45.7

38.8

28.1

32.5

40.6

4.9

11.0

34.4

6.6

Medical store

4.8

9.9

12.1

1.1

0.0

3.6

8.0

0.5

4.4

9.5

0.4

General store

0.3

1.2

0.3

0.3

0.0

0.0

0.7

0.5

0.4

0.5

0.0

ASHA

0.6

0.0

2.0

0.5

0.2

0.3

0.7

0.5

0.0

0.0

0.4

ANM

2.0

1.2

7.8

2.4

0.7

0.6

2.7

0.5

0.0

0.0

1.2

Others

0.2

2.9

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

Condom/Nirodh

Govt. facility

33.7

43.6

55.1

40.6

32.6

44.5

36.4

4.9

12.5

35.3

10.8

Private facility

25.4

20.9

43.2

34.8

25.7

34.5

28.9

3.9

9.5

14.9

12.4

Medical store

47.1

52.3

77.5

52.7

36.0

50.7

59.6

15.0

26.4

58.4

20.1

General store

16.6

16.3

27.5

17.9

13.7

25.2

20.2

2.4

7.0

19.0

5.0

ASHA

18.2

8.7

41.7

20.6

18.2

25.2

25.2

2.9

2.6

6.3

3.1

ANM

11.6

7.6

30.6

12.8

12.0

13.4

14.7

0.5

0.0

4.5

2.3

ECP

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

Govt. facility

2.9

8.1

11.4

1.3

0.7

2.8

2.0

0.0

0.4

0.9

0.8

Private facility

3.4

8.1

11.4

2.9

0.7

3.9

3.7

0.5

0.4

0.0

0.8

Medical store

10.6

7.0

22.0

9.9

3.6

12.9

20.2

2.4

5.5

7.7

4.2

General store

0.1

0.0

0.0

0.0

0.0

0.0

0.2

0.5

0.0

0.0

0.0

ASHA

0.1

0.0

0.5

0.0

0.0

0.0

0.0

0.0

0.0

0.0

0.0

ANM

0.4

0.6

2.3

0.0

0.0

0.0

0.0

0.5

0.0

0.0

0.0

6.7 Duration of use of current method

The duration of use of current method is 1-3 years (32%) followed by 4-6 years (20%) whereas 29% have been using for more than 6 years in Uttar Pradesh. The method use for less than one year is 19% in Uttar Pradesh. It is higher in Bahraich (31%) but lower in Sitapur (10.5%) and Bareilly (10.9%). The overall use by about half of users is during last 3 years.

Table 6.7: Distribution of current users of contraceptives by duration of use

Particulars

Uttar Pradesh

Sitapur

Varanasi

Banda

Lalitpur

Bahraich

Gorakhpur

Etah

Ghaziabad

Bareilly

Kanpur Dehat

%

%

%

%

%

%

%

%

%

%

%

Duration of use of FP methods(in years)

Less than 1 year

19.2

10.5

15.9

20.9

21.1

31.1

21.2

21.8

12.5

10.9

17.8

1 - 3 years

32.1

37.8

37.4

25.7

28.3

29.4

28.2

36.4

35.9

35.3

35.5

4 - 6 years

20.0

24.4

17.4

19.5

17.5

17.1

21.4

20.9

20.1

25.3

22.4

7 - 9 years

11.9

11.6

14.1

12.8

11.3

12.6

11.0

8.7

11.7

14.9

9.3

10 years & above

16.7

15.7

15.2

21.1

21.8

9.8

18.2

12.1

19.8

13.6

15.1

Total Contraceptive users

3076

172

396

374

417

357

401

206

273

221

259

6.8 Any payments made for obtaining the method and which method

About 37% of respondents in Uttar Pradesh reported to have paid money for obtaining family planning method (higher in Ghaziabad and Sitapur-43% each, Bahriach-67% and Etah-63%). The method paid was largely condom (80%) followed by OCP (8%) which shows that these users were purchasing it from market. The payment for IUCD was mentioned by 8% (higher in Ghaziabad-50%) whereas 4% mentioned payment for injectables (not in Govt. programme). Few users of PPIUCD in Etah and Ghaziabad also mentioned payment for PPIUCD (Table 6.8).

Payment for ECP was reported by 36 moths)

.

B21

B18.1

What is the sex of your youngest child?

Male

Female

1

2

B19

For how long you have exclusively breastfed (meaning nothing else was given to the child other than breastmilk) the child?

Number of months

Still exclusively breastfeeding

Never breastfed the child

1 .

2

3

B20

When did your last menstrual period start?

Days ago_____

Months ago____

Menopausal/

hysterectomy

Before last birth

Never menstruated

No response

1 .

2 .

3

4

5

99

B21

Did you ever had a pregnancy(ies) that miscarried, was aborted, or ended in a stillbirth?

Spontaneous abortion

Induced abortion

Stillbirth

None of them

1

2

3

4

B22

What was your age when you had pregnancy (which may have resulted into live birth or stillbirth) the last time?

Age (in years)

____

B23

Are you currently pregnant?

Yes

No

1

2

A1

B24

How many months pregnant are you?

Number of months

.

B25

Now I have some questions about the future.

Would you like to have a/another child or would you prefer not to have any / any more children?

Have a/another child

No more/prefer no children

Says she cant get pregnant

Undecided / Dont know

No response

1

2

3

98

99

F27

B26

How long would you like to wait from now before the birth of a/another child?

If you select months or years, you will enter a number for x on the next screen.

(If yes in B25 Sa)

Months

Years

Soon/now

Says she cant get pregnant

Other

Dont know

No response

1

2

3

4

96

98

99

B27

Now I would like to ask a question about your last live birth.

At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any / any more children at all?

Then

Later

Not at all

No response

1

2

3

99

B28

Now I would like to ask a question about your current pregnancy.

At the time you became pregnant, did you want to become pregnant then, did you want to wait until later, or did you not want to have any / any more children at all?

Then

Later

Not at all

No response

1

2

3

99

A. Interaction with ASHA

A1

Do you know ASHA in your village/ community?

Yes

No

1

2

A5

A2

During pregnancy, did any ASHA visit you at home to talk to you about your pregnancy and child birth?

Yes

No

1

2

A5

A3

How many times did an ASHA visit you at home during this pregnancy?

Number of times

..

A4

When did ASHA contact you for the last time?

Less than 1 month before

Between 1-2 months

2-3 months before

More than 3 months before

1

2

3

4

A5

During this pregnancy or after the birth of child (last birth), did you receive any counselling / advice on family planning?

Yes

No

1

2

A9

A6

Who gave you advice on family planning?

ASHA

ANM

AWW

Others (specify).

1

2

3

96

A7

Where did you get the information on FP methods?

Home

Sub-center

PHC

Village Health & Nutrition Day

Others (specify)

1

2

3

4

96

A8

During this pregnancy or after the birth of the child, which of these family planning methods were discussed?

(multiple response possible)


Male Sterilization

IUCD/LOOP

PPIUCD

Pills

Condom/Nirodh

Implants

Female Condom

Injectables

Traditional method

Others (specify)

1

2

3

4

5

6

7

8

9

10

96

A9

In the last 12 months, were you visited by an anganwadi worker, ASHA, or other community health worker who talked to you about family planning?

Yes

No

1

2

A10

In the last 12 months, have you visited a health facility or camp for care for yourself or your children?

Yes

No

1

2

A11

If yes, did any staff member at the health facility speak to you about family planning methods?

Yes

No

1

2

F. FAMILY PLANNING

F1

Have you ever used anything or tried in any way to delay or avoid getting pregnant?

Yes

No

1

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