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FigureFigure3Contraceptive prevalence <strong>in</strong> states <strong>in</strong> India: 1992/93 to 2005/06per cent had higher education (Table 4). Contraceptiveuse <strong>in</strong>creased with <strong>in</strong>creas<strong>in</strong>g education. The effect ofeducation on contraceptive use, however, decreasedbetween 1992/92 <strong>and</strong> 2005/06. This is shown by adecrease over time <strong>in</strong> <strong>the</strong> odds ratios of contraceptive usefor all education levels compared with no education (Table6). Among more highly educated women <strong>the</strong> odds ratiosdecreased from 2.37 (95%CI: 1.97 - 2.86) <strong>in</strong> 1992/93to1.62 (95%CI: 1.42-1.82) <strong>in</strong> 2005/06. This decreaserepresents a strik<strong>in</strong>g <strong>in</strong>crease <strong>in</strong> contraceptive use amongwomen with no education, from 34 per cent <strong>in</strong> 1992/93to 52 per cent <strong>in</strong> 2005/06 (see Table 5). Fur<strong>the</strong>rmore, <strong>the</strong>proportion us<strong>in</strong>g sterilization among all users decreasedacross education groups over time, <strong>in</strong>dicat<strong>in</strong>g <strong>the</strong> spread ofspac<strong>in</strong>g methods. The use of sterilization among womenwith higher education was already low <strong>in</strong> 1992/93 <strong>and</strong>rema<strong>in</strong>ed about <strong>the</strong> same <strong>in</strong> 2005/06 (28.7% <strong>in</strong> 1992/93<strong>and</strong> 30.5% <strong>in</strong> 2005/06).EconomicTwo variables – employment 6 <strong>and</strong> wealth qu<strong>in</strong>tiles –were used to capture <strong>the</strong> <strong>in</strong>fluence of economic factorson contraceptive use. About 57 per cent of <strong>the</strong> womensurveyed <strong>in</strong> 2005/06 were not employed dur<strong>in</strong>g <strong>the</strong> 12months prior to <strong>the</strong> survey, 15 per cent were employed butreceived compensation <strong>in</strong> k<strong>in</strong>d <strong>and</strong> <strong>the</strong> rema<strong>in</strong><strong>in</strong>g 28 percent received compensation <strong>in</strong> cash for <strong>the</strong>ir employment.In comparison, only 12 per cent of women surveyed <strong>in</strong>1992/93 were employed dur<strong>in</strong>g <strong>the</strong> 12 months prior to <strong>the</strong>survey <strong>and</strong> received compensation <strong>in</strong> cash (see Table 4).Employed women who received cash were significantlymore likely to use contraception while unemployedwomen were significantly less likely to use contraception ascompared with those who were employed but paid <strong>in</strong> k<strong>in</strong>d.The difference between unemployed <strong>and</strong> those employedbut paid <strong>in</strong> k<strong>in</strong>d decreased over time but <strong>the</strong> effect of cashemployment on contraceptive use <strong>in</strong>creased. As shown <strong>in</strong>Table 6, <strong>the</strong> odds ratio for those employed <strong>and</strong> paid <strong>in</strong> cash<strong>in</strong>creased from 1.24 (95%CI: 1.14 – 1.35) <strong>in</strong> 1992/93to 1.45 (95%CI: 1.34 – 1.57) <strong>in</strong> 2005/06; <strong>and</strong> <strong>the</strong> oddsratios for those who were unemployed <strong>in</strong>creased from0.74 (95%CI: 0.69 – 0.80) to 0.91 (95%CI: 0.84 – 0.98).By 2005/06, 64 per cent of employed women work<strong>in</strong>gfor cash were us<strong>in</strong>g contraception compared with 54 percent of unemployed women <strong>and</strong> 53 per cent of employedwomen paid <strong>in</strong> k<strong>in</strong>d (Table 5).While <strong>the</strong> use of contraception among women from <strong>the</strong>lowest wealth qu<strong>in</strong>tile rose from 28 per cent <strong>in</strong> 1992/93 to42 per cent <strong>in</strong> 2005/06, wealth <strong>in</strong>equalities <strong>in</strong> contraceptiveuse persisted (Table 5). The use of contraception <strong>in</strong>creasedwith household wealth qu<strong>in</strong>tiles <strong>in</strong> all three years. Women<strong>in</strong> <strong>the</strong> highest wealth qu<strong>in</strong>tile were twice as likely to usecontraception as women <strong>in</strong> <strong>the</strong> lowest wealth qu<strong>in</strong>tile. Theodds ratio among <strong>the</strong> highest wealth qu<strong>in</strong>tile was 1.99(95%CI: 1.78-2.24) <strong>in</strong> 2005/06. The effect of wealth oncontraceptive use rema<strong>in</strong>ed relatively constant over time.Media exposureExposure to television, newspapers <strong>and</strong> radio was usedto show <strong>the</strong> effect of mass media on contraceptive use.The use of contraception among women exposed totelevision or newspapers was higher than among those notexposed to <strong>the</strong>se channels of communication. The odds140
of contraceptive use <strong>in</strong> 2005/06 among those exposedto television was 1.39 (95%CI: 1.32 – 1.47) <strong>and</strong> amongthose exposed to newspapers was 1.14 (95%CI: 1.05-1.23) <strong>in</strong> comparison to those not exposed to television ornewspapers (see Table 6). The effect of newspapers <strong>in</strong> partreflected <strong>the</strong> effect of education, while television is probablyeffective <strong>in</strong> all segments of <strong>the</strong> society. Exposure to radiodid not seem to have a significant effect on contraceptiveuse.O<strong>the</strong>r variables of <strong>in</strong>terestWhile <strong>the</strong> use of contraception <strong>in</strong> rural areas <strong>in</strong>creasedfrom 37 per cent <strong>in</strong> 1992/93 to 53 per cent <strong>in</strong> 2005/06,rural women rema<strong>in</strong>ed less likely to use contraception thanurban women <strong>in</strong> all three years. However, this differencecould be expla<strong>in</strong>ed by <strong>the</strong> difference <strong>in</strong> <strong>the</strong>ir o<strong>the</strong>rcharacteristics. This is shown by <strong>the</strong> fact that <strong>the</strong> oddsratio is nei<strong>the</strong>r statistically significant <strong>in</strong> 1998/99 (0.98;95%CI: 0.91-1.05) nor <strong>in</strong> 2005/06 (1.00; 95%CI: 0.93-1.08).Women who lived <strong>in</strong> non-nuclear households wereless likely to use contraception than those who lived <strong>in</strong>nuclear households. However, <strong>the</strong> odds ratios were notstatistically significant. While women who were contactedby a family plann<strong>in</strong>g worker <strong>in</strong> 1998/99 were more likelyto use contraception, <strong>the</strong> odds ratio was not statisticallysignificant. In 2005/06, women who were contacted by ahealth worker were less likely to use contraception thanthose who were not <strong>and</strong> <strong>the</strong> odds ratio was also significant.This contact, however, reflected contact for any healthproblem, <strong>in</strong>clud<strong>in</strong>g <strong>the</strong> health of children.Regional differences <strong>in</strong> contraceptiveuseAs mentioned previously, while <strong>the</strong> guidel<strong>in</strong>es for<strong>the</strong> services were uniform across states, <strong>the</strong> actualimplementation varied among states because of differences<strong>in</strong> <strong>the</strong> availability of human resources, as well as issuesrelated to governance. These differences <strong>in</strong> serviceenvironments along with <strong>the</strong> differences <strong>in</strong> <strong>the</strong> socialsett<strong>in</strong>gs of states are manifested <strong>in</strong> state-level variations <strong>in</strong>contraceptive prevalence. For example, <strong>the</strong> percentage ofcouples protected by contraception <strong>in</strong> 1972/73 varied from7 per cent among states with a poor social sett<strong>in</strong>g <strong>and</strong> weakprogramme effort to 21 per cent among states with a goodsocial sett<strong>in</strong>g <strong>and</strong> strong programme effort (Freedman <strong>and</strong>Berelson, 1976). These state-level differences cont<strong>in</strong>uetoday.Contraceptive use <strong>in</strong> 1992/93 varied from about 20 percent <strong>in</strong> Uttar Pradesh to 63 per cent <strong>in</strong> Kerala, <strong>and</strong> from 34per cent <strong>in</strong> Bihar to 71 per cent <strong>in</strong> West Bengal <strong>in</strong> 2005/06(for changes <strong>in</strong> contraceptive use among states over time,see Figure 3). In 1992/93, only one state had contraceptiveuse greater than 60 per cent; by 2005/06, this number<strong>in</strong>creased to 12 large <strong>and</strong> small states. Four of <strong>the</strong> largeH<strong>in</strong>di-speak<strong>in</strong>g states <strong>in</strong> <strong>the</strong> nor<strong>the</strong>rn part of <strong>the</strong> countrycont<strong>in</strong>ued to have lower use of contraception than states<strong>in</strong> <strong>the</strong> sou<strong>the</strong>rn part <strong>and</strong> many o<strong>the</strong>r large states. To study<strong>the</strong>se variations fur<strong>the</strong>r, we divided 29 Indian states <strong>in</strong>tofour regions: north 7 , south 8 , o<strong>the</strong>r large states 9 <strong>and</strong> smallstates10. These groups consisted of about 40.8 per cent,21.8 per cent, 33.7 per cent, <strong>and</strong> 3.7 per cent, respectively,of <strong>the</strong> weighted sample of women <strong>in</strong> 2005/06 (see Table4).The contraceptive gap between nor<strong>the</strong>rn <strong>and</strong> sou<strong>the</strong>rnstates narrowed between 1992/93 <strong>and</strong> 2005/06. Amongnor<strong>the</strong>rn states CPR <strong>in</strong>creased by approximately 18percentage po<strong>in</strong>ts, from 26 per cent <strong>in</strong> 1992/933 to 44 percent <strong>in</strong> 2005/06 (see Table 5). A similar <strong>in</strong>crease of about14 percentage po<strong>in</strong>ts dur<strong>in</strong>g this period was observed <strong>in</strong><strong>the</strong> sou<strong>the</strong>rn states. Interest<strong>in</strong>gly among all contraceptiveusers <strong>the</strong> percentage sterilized decreased <strong>in</strong> <strong>the</strong> nor<strong>the</strong>rnstates but <strong>in</strong>creased <strong>in</strong> <strong>the</strong> sou<strong>the</strong>rn states over <strong>the</strong> threesurveys, <strong>in</strong>dicat<strong>in</strong>g <strong>the</strong> use of more permanent methods <strong>in</strong><strong>the</strong> south <strong>and</strong> more spac<strong>in</strong>g methods <strong>in</strong> <strong>the</strong> north (Table5).Table 7 presents <strong>the</strong> crude <strong>and</strong> adjusted odds ratios ofcontraceptive use by region. The odds of contraceptive useamong women <strong>in</strong> o<strong>the</strong>r large states were not significantlydifferent than among those liv<strong>in</strong>g <strong>in</strong> <strong>the</strong> sou<strong>the</strong>rn states.The odds of contraceptive use among women <strong>in</strong> small stateswere slightly lower than among women <strong>in</strong> sou<strong>the</strong>rn states.The odds of contraceptive use among women <strong>in</strong> nor<strong>the</strong>rnstates were lowest among all regions <strong>in</strong> all survey years.However, <strong>the</strong> gap between <strong>the</strong> nor<strong>the</strong>rn <strong>and</strong> sou<strong>the</strong>rnstates narrowed over time. This is <strong>in</strong>dicated by an <strong>in</strong>crease<strong>in</strong> <strong>the</strong> crude odds ratio for <strong>the</strong> north region from 0.332(95%CI: 0.310 – 0.355) <strong>in</strong> 1992/93 to 0.425 (95%CI:0.396 – 0.455) <strong>in</strong> 2005/06. Interest<strong>in</strong>gly <strong>the</strong> odds ratio for<strong>the</strong> north region <strong>in</strong> 2005/06 decreased slightly from 0.425(95%CI: 0.396 – 0.455) to 0.406 (95%CI: 0.373 – 0.442)after adjust<strong>in</strong>g for each respondent’s demographic, social<strong>and</strong> economic characteristics. While <strong>the</strong> difference between<strong>the</strong> crude <strong>and</strong> adjusted odds ratio was not significantstatistically, this unexpected result could <strong>in</strong>dicate thatwomen <strong>in</strong> nor<strong>the</strong>rn states have made greater progress <strong>in</strong>terms of contraceptive use than what would be expectedon <strong>the</strong> basis of <strong>the</strong>ir characteristics. This programme <strong>and</strong>occurred despite stronger son preference <strong>in</strong> <strong>the</strong> northcompared with <strong>the</strong> south.To assess which demographic, social <strong>and</strong> economiccovariates are contribut<strong>in</strong>g to this unexpected phenomenon,separate logistic models were run for <strong>the</strong> north <strong>and</strong> southregions. Table 8 presents <strong>the</strong> odds ratios separately for141
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Family Pla
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ForewordThe Asia <
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Part 1Part 1Asia <
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Ensuring that <str
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of methods for all, in</str
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and undertake <str
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Report on the Regi
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SESSION 1: Changin
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that improving <st
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at a hospital would be offered post
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Bounkoung Phichit, Deputy M
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medicines
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Thus, while knowledge of modern met
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Hon. Mr. Malakai Tabar, Chairman, P
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curricula. If the
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dialogue as well as regional <stron
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BackgroundGlobal development effort
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TableTable1EventNational policyYear
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A third observation is that reporte
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TableTable2Current Contraceptive Pr
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Figure(-1.2), Cook Island</
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FigureTableTable3Trends in<
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Nam. Nearly all economies i
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2008 2009% Bilateral % Multilateral
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family planning wi
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IntroductionFamily
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The advent of the
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FigureFigure1Oceania and</s
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next 25 years, however, TFR fluctua
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FigureFigureFigure2Total fertility
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family planning pr
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esponsible for the
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that estimates of CPR for earlier p
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Figuremarried at an older age compa
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As previously mentioned most <stron
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FigureFigure945Relationship between
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The concept of “unmet need” has
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TableTable8Percentage of th
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FigureFigure4Total donor expenditur
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FigureFigureagain
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Impact of family plannin</s
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marketing of contr
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United States Agency for In
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200
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acceptable. From an NGO perspective
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FigureThis trend of limited donor f
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Figureto have the
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FigureFigure5Percentage change <str
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FigureFigure6Desire to limit childb
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coordination betwe
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the 1980s
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Policy Management.__________ (n.d.,
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218
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Population Activities (UNFPA) for a
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where family plannin</stron
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Thus an objective assessment of <st
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226
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Figureeconomic growth durin
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TableTable1TableTable2For spac<stro
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eflect a provider bias (e.g., <stro
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The Indonesian delegation was very
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than in ensur<stro
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in-country <strong
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(Ministry of Healt
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242
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FigureTrends and p
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TableTable3Unmet need for contracep
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TableTable5TableTable6TableTable725
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TableTable8TableTable9Malaysia, abo
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previously mentioned is based on fo
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TableTable16births and</str
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FigureFigure3TRF54.5Scatter plots o
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ReferencesAng, Eng Suan (2007). Stu
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Demographic data sheet: population
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population size, with just 336,000
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NuptialityIn Myanmar nuptiality is
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FigureIn Myanmar, birth-spac<strong
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Scope of coverage and</stro
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FigureIn Myanmar, out of six select
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equirements. The Min</stron
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according to <stro
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Adolescent sexual and</stro
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FigureHIV/AIDS. An HIV-positive wom
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National Population PolicyMyanmar i
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Linkages with o<st
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TableTable4Achievements of Myanmar
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monitoring <strong
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Nay Pyi Taw, 26 October 2010.53 Sit
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TableTableA296
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dispense and adm<s
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(1) I am against a
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FigureFigureFigure3Use of modern co
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FigureFigure7Traditional method use
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Figureprojection, and</stro
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Figure 11 summarizes the</s
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correlating <stron
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Figurethe use of c
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FigureFigure15Sexual behaviour <str
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track the distribu
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Figureservices, which should <stron
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FigureFigureFigure18 Population <st
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National Statistics Office, <strong
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TableTable11326
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TableTable19Laws and</stron
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worker and hours w
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334
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336
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includin</
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TableTable1Contraceptive prevalence
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These results suggest that about 70
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2 The (period) TFR is the</
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346
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FigureThe existence of traditional
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Guinea case by <st
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The establishment of provin
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provide family plannin</str
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Figurelegal requirement nor a condi
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FigureTableTable5TableTable6Figure4
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modern method and
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married or in unio
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Figureolder. Both the</stro
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TableTable15The immediate past Nati
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out that the “ne
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Commodity securitySupply cha<strong
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is able to achieve. In Papua New Gu
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Qualitative assessments by a number
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increasin<
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service delivery poin</stro
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Population: Views from Men
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1545-1730Day 2: December 9Session 2
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Day 3, December 10Session 50830-100
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15Mr. Tong Sithen1
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54Ms. Shadiya IbrahimAssistant Repr
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93Mr. Melkie AntonProject OfficerUn
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131Dr. John P. SkibiakDirectorRepro
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International <str
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