National Family Health Survey-2. Bihar FAMILY PLANNING AND QUALITY OF CARE

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1998-99 Bihar FAMILY PLANNING AND QUALITY OF CARE

Family Planning and Quality of Care Knowledge Use Source Informed Choice and Follow-Up Unmet Need for Family Planning

Trends in Knowledge of Contraceptive Methods 95 99 95 99 Percent 29 40 Any method Any modern method Any traditional method NFHS-1 NFHS-2 Currently married women

Which modern methods are most familiar to married women? Female sterilization Male sterilization 88 95 99 97 Pill 57 75 Condom 55 64 IUD 44 59 NFHS-1 NFHS-2 Percent Currently married women

Family Planning Messages and the Media About 40 percent of women have heard or seen family planning messages in the past few months Urban exposure: 72% any media 62% TV Rural exposure: 36% any media 16% TV

Family Planning and Quality of Care Knowledge Use Source Informed Choice and Follow-Up Unmet Need for Family Planning

Has contraceptive use among married women increased since the last survey? Percent Share of female sterilization in contraceptive use has increased from 75% to 78% over the six-year period. 23 25 NFHS-1 NFHS-2 3 2 Any method Modern spacing methods

Family Planning Methods Used Not using any method 76% Female Sterilization 19% Traditional methods 2% Pill 1% IUD 0.5% Male sterilization 1% Condom 0.7%

Urban-Rural Differences in Contraceptive Use 39 Percent 23 27 18 7 2 Any method Female sterilization Modern spacing methods Urban Rural

Trends In Contraceptive Use by Residence TOTAL Female Sterilization All Other Methods Percent NFHS-1 NFHS-2 URBAN 17 19 6 5 NFHS-1 NFHS-2 RURAL 28 27 12 15 NFHS-1 NFHS-2 16 18 4 5

Contraceptive Use by Region and State INDIA 34 7 Jharkhand 21 3 North Bihar Plain 20 2 BIHAR 19 2 South Bihar Plain 17 2 Female Sterilization Modern Spacing Methods Percent

Contraceptive Use by State Himachal Pradesh 68 Tamil Nadu INDIA Madhya Pradesh Rajasthan 52 48 44 40 Uttar Pradesh Bihar 25 28 Meghalaya 20 Percent

Does use of contraception vary by number of sons? For women with 2 children: Percent 38 21 11 No sons 1 son 2 sons

Sterilization Facts: Bihar Median age at sterilization for women is about 28 years, more than two years older than the all-india figure of 26 years Two-thirds (68%) of sterilizations occurred before the wife was 30 years old Male sterilization is 3%, representing a decline from 7% in the ten years preceding the survey

Do women not currently using contraception intend to use a method in the future? 57% of women not currently using contraception intend to use a method in the future 28% of these nonusers intend to use a method within the next 12 months

Preferred method for women who intend to use contraception in the future Female sterilization 68 Pill 25 Condom 1 IUD Rhythm/Safe period Male sterilization 1 1 1 Percent

Family Planning and Quality of Care Knowledge Use Source Informed Choice and Follow-Up Unmet Need for Family Planning

Where do women get their modern contraceptive methods? Public medical sector 77% Private medical sector 18% Shop/Other 4% NGO/Trust 0.4% Don t know/ Missing 1%

Where do users get specific contraceptive methods? Female sterilization 0 16 83 Percent Male sterilization 0 22 78 IUD 3 49 49 Pill Condom 20 16 23 11 56 55 Shop/Other Private medical sector Public medical sector

Family Planning and Quality of Care Knowledge Use Source Informed Choice and Follow-Up Unmet Need for Family Planning

Do motivators tell women about other contraceptive methods? 15% of users motivated by someone else were told by motivator about another method of FP In the public medical sector, 21% of current users were informed, compared to 15% in private medical sector or by someone else

Are women told about side effects at the time of accepting their method? Only 16% of women using a modern method were told about side effects by a health worker, less than the all-india average of 22% 19% of urban users were similarly informed, compared to 15% of rural users

Follow-Up After Accepting Method 77% of users of modern methods received follow-up after accepting their method Follow-up was slightly higher for acceptors of sterilization (78%)

Family Planning and Quality of Care Knowledge Use Source Informed Choice and Follow-Up Unmet Need for Family Planning

Defining Unmet Need for Family Planning Proportion of currently married women who wish to either: have no more children or wait at least two years before the next child but are not using contraception These women are considered to have an unmet need for family planning

Unmet Need for Family Planning Percent NFHS-1 NFHS-2 25 25 14 13 11 12 For spacing For limiting For both

Unmet Need by Region and State Jharkhand 21 North Bihar Plain 24 BIHAR 25 South Bihar Plain 28 Percent

Impact of Satisfying Unmet Need Currently, programmes are meeting only about half of the total demand for family planning Contraceptive prevalence would increase from current level of 25% to a new level of 49% if all unmet need for contraception were satisfied