Transcript FAMILY PLANNING AND QUALITY OF CARE

National Family Health Survey-2
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
National Family Health Survey-2
Trends in Knowledge of
Contraceptive Methods
95
99
95
Percent
99
40
29
Any method
Any modern method
NFHS-1
National Family Health Survey-2
Any traditional method
NFHS-2
Currently married women
Which modern methods are most
familiar to married women?
95
99
Female
sterilization
88
Male sterilization
57
Pill
55
Condom
IUD
44
97
75
64
NFHS-1
59
NFHS-2
Percent
National Family Health Survey-2
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
National Family Health Survey-2
Family Planning and
Quality of Care
• Knowledge
• Use
• Source
• Informed Choice and Follow-Up
• Unmet Need for Family Planning
National Family Health Survey-2
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
3
Any method
National Family Health Survey-2
NFHS-2
2
Modern spacing methods
Family Planning Methods Used
Not using any
method
76%
Female
Sterilization
19%
Traditional
methods
2%
Pill
1%
IUD
0.5%
Condom
0.7%
Male
sterilization
1%
National Family Health Survey-2
Urban-Rural Differences
in Contraceptive Use
39
Percent
23
27
18
7
2
Any method
Female sterilization
Urban
National Family Health Survey-2
Rural
Modern spacing
methods
Trends In Contraceptive Use
by Residence
Female Sterilization
All Other Methods
TOTAL
NFHS-1
NFHS-2
17
6
19
5
URBAN
NFHS-1
28
NFHS-2
27
15
12
RURAL
NFHS-1
NFHS-2
16
18
National Family Health Survey-2
4
5
Percent
Contraceptive Use by Region and
State
INDIA
34
Jharkhand
21
North Bihar Plain
20
BIHAR
19
South Bihar Plain
17
Female Sterilization
National Family Health Survey-2
7
3
2
2
2
Modern Spacing Methods
Percent
Contraceptive Use by State
68
Himachal Pradesh
52
Tamil Nadu
48
INDIA
44
Madhya Pradesh
40
Rajasthan
28
Uttar Pradesh
25
Bihar
Meghalaya
National Family Health Survey-2
20
Percent
Does use of contraception vary by
number of sons?
Percent
For women with 2 children:
38
21
11
No sons
National Family Health Survey-2
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
National Family Health Survey-2
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
National Family Health Survey-2
Preferred method for women who intend
to use contraception in the future
Female
sterilization
68
25
Pill
Condom
1
IUD
1
Rhythm/Safe
period
1
Male sterilization
1
National Family Health Survey-2
Percent
Family Planning and
Quality of Care
• Knowledge
• Use
• Source
• Informed Choice and Follow-Up
• Unmet Need for Family Planning
National Family Health Survey-2
Where do women get their modern
contraceptive methods?
Public medical sector
77%
Private medical sector
18%
Shop/Other
4%
Don’t know/
Missing
1%
NGO/Trust
0.4%
National Family Health Survey-2
Where do users get specific
contraceptive methods?
Female
sterilization
Male sterilization
IUD
Percent
0
16
0
83
22
3
49
49
Pill
Condom
National Family Health Survey-2
78
20
16
11
23
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
National Family Health Survey-2
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”
National Family Health Survey-2
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
National Family Health Survey-2
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%)
National Family Health Survey-2
Family Planning and
Quality of Care
• Knowledge
• Use
• Source
• Informed Choice and Follow-Up
• Unmet Need for Family Planning
National Family Health Survey-2
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
National Family Health Survey-2
Unmet Need for Family Planning
NFHS-1
Percent
NFHS-2
25
14
13
For spacing
National Family Health Survey-2
11
25
12
For limiting
For both
Unmet Need by Region and State
Jharkhand
North Bihar Plain
BIHAR
South Bihar Plain
21
24
25
28
Percent
National Family Health Survey-2
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
National Family Health Survey-2