Is unmet need for family planning still a concern in India: situation, trends and determinants with special focus to Odisha

Background: India is harnessing a hard and strenuous path since the launch of National family planning program which was later integrated into Reproductive, Maternal, Newborn, Child and Adolescent health (RMNCH+A) strategy. In this context Odisha, geographically located at the southeastern coast of the country with a population of 42 million is selected for the research study. Odisha has significantly high Maternal Mortality Ratio (MMR) of 180per 100000 live births (SRS 2014-2016) and Infant Mortality Rate (IMR) of 44 per 1000 live births (SRS 2016), Under 5 Mortality Rate (U5MR) 49 (National Family Health Survey (NFHS) IV, 2015-16). Objective: The research paper aims to study the use of modern limiting, spacing and traditional methods of contraceptives in association with age, education, place of residence, wealth status among tribal and non-tribal population of Odisha. It also attempts to study the factors associated with the current use of modern methods of contraceptives among tribal and non-tribal women. A district wise trend for modern use of contraceptives among tribal and non-tribal women is mapped using ArcGIS. The reason behind lack of contraceptive usage is studied in terms of barriers, opposition to use, knowledge, fear and complications related to contraceptive usage. Methods: The NFHS IV (2015-16) data published by Ministry of Health and Family Welfare (MoHFW) is used for the study. The data on family planning is accessed from woman questionnaire of the survey with a sample size of 33,721 women of Odisha. The data is analyzed using SPSS by applying binary logistic regression method. Results: It is found that use of modern contraceptives increases significantly with education, wealth index, among the young couples of both tribal and non-tribal married women. Use of contraceptive has reduced with increasing number of births of daughters among tribal and non-tribal showing a significant preference towards the birth of son. Unmet need for tribal and non-tribal married women is analyzed for High Priority Districts (HPS’s). It was found that unmet need for limiting and spacing is high among the tribal women in Gajapathi, Koraput, Nuapada and Rayapada (HPD’s). Conclusion: The finding of research study will contribute to identify the various socio cultural, demographic and community-based interventions which can significantly improve the contraceptive usage among married couples of Odisha.