Advertisement

China Population and Development Studies

, Volume 1, Issue 1, pp 67–82 | Cite as

Trends and Determinants of Contraceptive Method Choice in China

  • Min QinEmail author
  • Sabu S. Padmadas
  • Jane Falkingham
Open Access
Article
  • 4 Downloads

Abstract

Contraception promotion is a crucial component of the family planning programme in China. Since the mid-1990s, state strategy has gradually shifted from demographic targets towards a client-centred, informed choice approach. Data for this study are drawn from six national Population and Family Planning surveys conducted during 1982–2006. Data from all six surveys are used for describing the trends in contraception use and changes in method mix over the last three decades. Data for individuals taken from the 2001 and 2006 surveys are applied to investigate the effect of changing strategies on parity-specific methods choices. Both individual and community level data from the 2006 survey are then used to examine the determinants of informed choice. Multilevel logistic regression models are fitted for each of the two outcomes. The results show that contraceptive prevalence rate among married women of reproductive age in China was over 70% in the 1980s and reached 80% in the 1990s, with the method mix dominated by sterilization and IUD. A shift towards increase in condom use and a decrease in sterilization was observed among new users between 1996–2001 and 2001–2006. The multilevel analysis shows that between 1996–2001 and 2001–2006, the proportion of users choosing methods “highly recommended” by providers of family planning services declined significantly. The provision of a mix of contraceptives by the community plays a positive role for informed choice. Although the historical top-down approach towards promoting long-acting methods has weakened over time, institutional forces continue to influence the method choices made by individuals. Enhancing community contraception provision and providing adequate counselling could benefit informed choice of contraception method and this, in turn, could contribute to improving women’s reproductive health.

Key words

Family Planning Informed choices China 

Notes

Acknowledgement

This research is supported by ESRC (ES/J50016111). The authors thank the editors and anonymous reviewers, whose comments improved this artic1e a great deal.

References

  1. Brown, J., Li, B. and Padmadas, S. S. (2010). A multilevel analysis of the effects of a reproductive health programme that encouraged informed choice of contraceptive method rather than use of officially preferred methods, China 2003–2005. Population Studies, 64 (2): 105–115.CrossRefGoogle Scholar
  2. Bongaarts, J., and S. Sinding. (2011). Population policy in transition in the developing world. Science, 333:574–575.CrossRefGoogle Scholar
  3. Bruce, J. (1990). Fundamental elements of the quality of care: a simple framework. Studies in Family Planning, 21(2): 61–91.CrossRefGoogle Scholar
  4. Gu, B. C., Wang, F., Guo, Z. G., and Zhang E. L. (2007). China’s local and national fertility policies at the end of the twentieth century. Population and Development Review, 33(1): 129–147.CrossRefGoogle Scholar
  5. Hardee, W.K., Xie, Z. M. and Gu, B. C. (2004). Family planning and women’s lives in rural China. International Family Planning Perspectives. 30 (2): 68–76.CrossRefGoogle Scholar
  6. Jain, A. K. (1989. Fertility reduction and the quality of family planning services. Studies in Family Planning 20(1): 1–16.CrossRefGoogle Scholar
  7. Kaufman, J., Zhang, E. L. and Xie, Z. M. (2006). Quality of care in China: scaling up a pilot project into a national reform program. Studies in Family Planning 37 (1): 17–28.CrossRefGoogle Scholar
  8. Khan, H. R. and Shaw, J. E. (2011). Multilevel logistic regression analysis applied to binary contraceptive prevalence data. Journal of Data Science. 9, 93–110.Google Scholar
  9. Li, J. M (2009). Fertility revolution in China. Population Research, 33(1): 1–9.Google Scholar
  10. Liu, Y. R. (2004). Contraception use among married women in China. Chinese Journal of Family Planning. 5:260–262.Google Scholar
  11. Magadi, M. A. and Curtis, S. L. (2003). Trends and determinants of contraceptive method choice in Kenya. Studies in Family Planning 34(3): 149–159.CrossRefGoogle Scholar
  12. Mason, K. O., Smith, H. L. (2000) Husbands’ versus wives’ fertility goals and contraceptive use: The influence of gender context in five Asian countries. Demography, 37: 299–312.CrossRefGoogle Scholar
  13. National Population and Family Planning Commission (NPFPC) edit. (2007). History of China Population and Family Planning. China Population Press: Beijing.Google Scholar
  14. Philips, J. F., Simmons, R., Koening, M. A., and Chakraborty, J. (1988). Determinants of reproductive change in a traditional society: evidence from Matlab, Bangladesh. Studies in Family Planning. 19(6): 313–334.CrossRefGoogle Scholar
  15. Qin, M (2016). Evolution of family planning policy and its impact on population change in China. PhD thesis. University of Southampton, Social Sciences: Social Statistics & Demography.Google Scholar
  16. Rasbash, J., Steele, F., Browne, W. and Goldstein, H. (2009). A user’s guide to MLwiN. Version 2, Centre for Multilevel Modelling, University of Bristol, UK.Google Scholar
  17. Ross, J., Hardee, K., Mumford, E., and Eid, S. (2001). Contraceptive method choice in developing countries. International Family Planning Perspectives, 28(1): 32–40.CrossRefGoogle Scholar
  18. Ren, Q. and Zheng, X. Y. (2006). Behaviour change of Chinese married women on contraception use: 1988–2001. Chinese Journal of Population Science 3: 28–38.Google Scholar
  19. Reng, N., Su, P., Guang, H. T., Wu, C. J., Zhou, J. L., Su, N., Liao, J. Y. and Xiong, C. L. 2003. Analysis on influencing factor for informed choice of family planning among rural women. Chinese Journal Public Health 19 (11): 1288–1289.Google Scholar
  20. Seiber, E. E. Bertrand, J. T. and Sullivan, T. M. (2007). Changes in contraceptive method mix in developing countries. International Family Planning Perspectives. 33(3): 117–123.CrossRefGoogle Scholar
  21. Steele, F., Curtis, S. L. and Choe, M. K. (1999). The impact of family planning service provision on contraceptive use dynamics in Morocco, Studies in Family Planning, 30 (1): 28–42.CrossRefGoogle Scholar
  22. Stephenson, R. and Tsui, A. O. (2002). Contextual influences on reproductive health service use in Uttar Pradesh, India, Studies in Family Planning, 33(4): 309–320.CrossRefGoogle Scholar
  23. Tsui, A. O. and D. Bogue. (1978). Declining World Fertility: Trends, Causes and Implications. Population Bulletin, 33(4): 2–56.Google Scholar
  24. The Johns Hopkins School of Public Health. (1989). Informed choice-. Report of the cooperating agencies task force. Baltimore, ML: Johns Hopkin Press.Google Scholar
  25. Wang, C. (2012a). History of the Chinese Family Planning program: 1970–2010. Contraception, 85, 563–569.CrossRefGoogle Scholar
  26. Wang, C. (2012b). Trends in contraceptive use and determinants of choice in China: 1980–2010. Contraception, 85: 570–579.CrossRefGoogle Scholar
  27. World Health Organization (WHO). (2014). Ensuring human rights in the provision of contraceptive information and services Guidance and recommendations. WHO, Luxembourg.Google Scholar
  28. Wu, J. Q. (2008). Counselling about informed choice of contraception. Chinese Journal of Family Planning 3:132–136.Google Scholar
  29. Wu, S. C. (2008). Side effect of contraceptives and informed choice of contraception. Journal of Obstetrics and Gynecology. 24(3): 143–44.Google Scholar
  30. Xie, Z. M. (2011) Focusing on quality of care in the Family Planning Programme. http://ssc.undp.org/content/ssc/library/solutions/partners/gssdAcademy/Volume 19 Experiences_ in_Addressing_Population_and_Reproductive_Health_Challenges.html Accessed 28 February 2017.Google Scholar
  31. Zhang, Y. Z. (2007). Factors influence contraceptive informed choice among rural women in Henan Province. Population Research, 31(4): 89–96.Google Scholar

Copyright information

© China Population and Development Research Center 2015

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors and Affiliations

  1. 1.China Population and Development Research CenterESRC Center for Population Change, University of SouthamptonBeijingChina
  2. 2.Centre for Global Health, Population, Poverty & Policy, China Research Centre and Department of Social Statistics and DemographyUniversity of SouthamptonUK
  3. 3.ESRC Centre for Population Change and China Research CentreUniversity of SouthamptonUK

Personalised recommendations