Trends In Contraceptive Use Some Experiences From India and Her Neighbouring Countries

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Trends In Contraceptive Use Some Experiences From India and Her Neighbouring Countries Sudeshna Ghosh, Associate Professor, Economics Department. Scottish Church College, India,* * Presentation at the 4th World Conference on Women s Studies, 03rd - 05th May, 2018, Colombo, Sri Lanka

Introduction Among the South Asian developing countries, the need for small families and drive for healthy birth spacing has progressively augmented. In order to obtain the desired child bearing preference patterns, the women of these countries need to apply knowledge of proper contraceptive use to avoid unwanted pregnancies. Analysis of data on trends in contraceptive use in the developing countries is essential for proper planning for better health care services and efficient allocation of budgetary resources along gendered path of development.

Motivation This paper utilizes contraceptive data sets from the United Nations, Department of Economic and Social Affairs Population Division, Fertility and Family Planning Section, to examine the trend and pattern of contraceptive use in the countries of Bangladesh, India, Nepal, Pakistan and Sri Lanka during the period 1970 to 2018. Further the paper tries to analyse the reasons for variation in use of contraceptives across these countries, particularly from the viewpoint of meeting the Millennium Development Goals. Last, the paper develops a statistical model to discuss the causality association across economic growth, fertility behaviour and contraceptive use in these set of countries.

Data Description and Methods Variables Description Source Total Fertility Rate Contraceptive Prevalence Method Gross Domestic Product It s the average number of children that would be born to a woman if she were to pass through all her childbearing years conforming to the age-specific fertility rates of a given year. Contraceptive prevalence is defined as the percentage of women currently using any method of contraception among all women of reproductive age (i.e., those aged 15 to 45 years, unless otherwise stated) who are married or in a union. Sum of gross value added by all resident producers in the economy. Period: 1970-2018. Source: World Development Indicators, World Bank. Period : 1970-2018. Source: United Nations, Department of Economic and Social Affairs, Population Division, Fertility and Family Planning Section Period :1970-2018. Source: World Development Indicators, World Bank.

Behaviour across contraceptive prevalence and fertility trends, country comparison

Overview The Millennium Development Goals, Bangladesh Progress Report (2008) opines that the fertility rates among the adolescent in Bangladesh will show further declining trend if the accessibility to higher education is enhanced. There is a need for awareness towards the importance of safe motherhood and reproductive health behaviour. there is a strong need to introduce family education in India and Nepal before adolescents and young women enter into the family making process. Misconceptions need to be done away with only through the spread of education. Pakistan still needs to put in arduous efforts to meet the Millennium Development Goal s (5) target of 2.1 births per woman. Sri Lanka has attained substantial accomplishment in diminishing maternal mortality. However strong supervision by health authorities is necessary to accomplish the target of the Millennium Development Goal (5). The regional disparities need urgent attention.

Literature Review Barro (1991) observe that the growth in the quantity of human capital per capita is likely to increase higher rates of investment in human capital and as well as physical capital, this will lead to higher per capita economic growth. The preference of households in having few but educated children will augment human capital formation and will ultimately raise the productivity of the nation. Becker (1993) opines that accumulation of human capital augments technological progress and enhances economic growth. The classical theories of fertility evolution proposes that one of the prerequisites of fertility falling of is the shifting economic value of children.

Literature Review Caldwell (1976) in his wealth flow theory opines that with rise in economic growth the direction of wealth flow changes from upward (children to parents ) to a downward direction (parents to children). So preference pattern moves towards having fewer children. Seetharam, (2002) observe that improved services of awareness, decline in child mortality accompanied by rising income levels have led to augmenting demand for contraceptives in most South Asian countries

Literature Review Kohler s (2012) opines that the different channels by which population affects economic outcomes includes natural resource, the demography from changes in population age groups and outcomes of population size on innovation. Doran (2012) opine that labour force participation among the female population explain significantly the variation in fertility.

Literature Review Trends in Contraceptive use A Graphical Exposition Growth Rate in the use of contraceptives, India

Literature Review Trends in Contraceptive use A Graphical Exposition Growth Rate in the use of contraceptives, Nepal Growth Rate in the use of contraceptives, Pakistan

Econometric Methodology The current study has used the Auto Regressive Distributive Lag (ARDL) method to cointegration to develop the long run association across the concerned set of variables. Stationarity Test Unit root testing is done to confirm that the underlying condition of the ARDL is satisfied before the bounds testing to cointegration can be followed. Here the test for stationarity is done using the Augmented Dickey Fuller (ADF) and Philip-Perron (PP) tests to obtain the order of integration.

Here the ARDL method is applied for three model specification,in each case, fertility rates, Gross Domestic Product and contraceptives are used as dependent variables. p1 TFR t = α 0TFR + i=1 β 1iTFR TFR t i + i=0 β 2iTFR GDP t i + p3 i=0 β 3iTFR CONT t i +σ 1TFR TFR t i +σ 2TFR GDP t i +σ 3TFR CONT t i +ε 1t...(1) p2 p1 GDP t =α 0GDP + i=1 β 1iGDP GDP t i + i=0 β 2iGDP TFR t i + p3 i=0 β 3iGDP CONT t i +σ 1GDP GDP t i +σ 2GDP TFR t i +σ 3GDP CONT t i +ε 2t...(2) p2 p1 i=1 CONT t =α 0CONT + β 1iCONT CONT t i p2 p3 + i=0 β 2iCONT GDP t i + i=0 β 3iCONT TFR t i +σ 1CONT CONT t i +σ 2CONT GDP+σ 3CONT TFR t i +ε 3t...(3

Results, Unit Root Tests Variables at Level Bangladesh India ADF PP ADF PP TFR 0.61-1.77-3.76-0.27 GDP -3.70-7.12-1.38-1.77 CONT -7.23-29.32-15.84-36.21 Variables at First Difference Bangladesh India ADF PP ADF PP TFR -6.79-32.01-5.56-29.53 GDP -4.77-27.01-7.84-36.85 CONT -0.22-10.72-0.89-0.32

Results, Unit Root Tests Variables at Level Nepal Pakistan ADF PP ADF PP TFR -6.47-31.21 2.39 0.60 GDP -2.77-6.24-1.44-7.31 CONT -8.37-26.01-0.79 0.39 Variables at First Difference Nepal Pakistan ADF PP ADF PP TFR -1.33-2.72-7.33-52.01 GDP -9.48-52.01-5.43-32.43 CONT -1.43-4.61-8.14-27.99

Results, Unit Root Tests Variables at Level Sri Lanka Since none of the variables are of order ADF PP I(k) where k>1, the bounds testing TFR -6.3-28.72 procedure for GDP -2.77-6.24 cointegration is applicable CONT -18.68-19.94 Variables at First Difference Sri Lanka Note: Critical values -4.19; - ADF PP TFR 6.47 1.21 GDP -8.18-51.39 CONT -1.55-2.76 3.52 for ADF statistics, at 1%and 5% levels of significance respectively. Critical values -25.06;-19.42 for PP statistics, at 1%and 5% levels of significance respectively.

Bound Testing and Granger Causality: Key Findings The bound test show that the cointegration is present at 5%level of significance when total fertility rates (TFR) are dependent variable (based on equation 1) for all the countries under study except for Pakistan. The existence of a long run relation implies that there must be a Granger causation in at least one direction among the variables. Bidirectional Granger causality exists between economic growth and fertility rate for India. There is unidirectional causality from contraceptives towards fertility rate behaviour. Bangladesh shows in the short run unidirectional causality from TFR to GDP. For Sri Lanka there is bidirectional causality across TFR and GDP. There is unidirectional causality from GDP and CONT towards fertility rate for Nepal.

Results of granger Causality Test: Country: India Dependent F statistics (Probability) Variable TFR GDP CONT ECT t-1 (t statistics) TFR -0.084* -0.016* -0.34* GDP -0.58* 0.32-0.12* CONT -0.92-0.03 0.11 Country: Bangladesh Dependent F statistics (Probability) Variable TFR GDP CONT ECT t-1 (t statistics) TFR -0.03 0.02-0.35* GDP -0.26* 0.23-0.12 CONT -0.75-0.081 0.31 Country: Nepal Dependent F statistics (Probability) Variable TFR GDP CONT ECT t-1 (t statistics) TFR -0.04* -0.27* -0.32* GDP -0.23 0.091 0.29 CONT 0.078 0.045-0.11* Country: Sri Lanka Dependent F statistics (Probability) Variable TFR GDP CONT ECT t-1 (t statistics) TFR -0.011* -0.091* -0.79* GDP -0.60* 0.31-0.54* CONT 0.11 0.22* -0.22*

2 3 4 5 6 7 2 3 4 5 6 Scatter plot across contraceptives and fertiliy behaviour Bangladesh 0 20 40 60 contraceptive use Scatter plots across contraceptives and fertility behaviour Nepal fertility rates fertility rates 3 4 5 6 7 2 3 4 5 6 Scatter plots across contraceptives and fertility behaviour India 10 20 30 40 50 60 contraceptive use Scatter plots across contraceptives and fertility behaviour Pakistan 0 10 20 30 40 contraceptive use fertility rates 2 3 4 5 6 Scatter plots across contraceptives and fertility behaviour Sri Lanka 30 40 50 60 70 contraceptive use 0 10 20 30 40 50 contraceptive use

Conclusion. This paper, restructures the discussion on economic growth affects, the trends in contraceptive use and fertility affects along logical and quantifiable dimensions. After observing the trend analysis for the countries India, Bangladesh, Nepal, Pakistan and Sri Lanka, the paper proceeds with econometric study of causality analysis of the variables namely, economic growth, contraceptive use and fertility behaviour. The paper utilizes the bounds testing methods to obtain the long run relation across fertility rate, contraceptive use behaviour and economic growth among India and neighbouring countries over 1970 to 2018. The findings from the current study is important in improving the quality of life among the women of South Asian countries against the backdrop of the millennium development Goal. Policies to reduce the fertility rate and education on use of contraceptives not only reduces women s health risks especially in the rural areas but also ensures better nutrition, and education among the fewer children in the early period of childhood development

4th World Conference on Women s Studies 2018 Women s Studies: Gendered scholarship activism, and storytelling for a sustainable planet