Journal of Public Health

, Volume 27, Issue 5, pp 637–648 | Cite as

Contraceptive use and unmet need for family planning among women with at least one child in rural Uttar Pradesh: the role of wealth and gender composition of children

  • Bal Govind ChauhanEmail author
  • R. Nagarajan
Original Article



Family planning has long been recognised as an effective public health intervention to reduce fertility and unwanted births. This study examines the effect of household wealth and gender composition of children on contraceptive use and unmet need for family planning.

Subject and methods

Our study is based on primary data collected from 460 respondents in the rural areas of the Rae Bareli district of Uttar Pradesh between September 2016 and February 2017. The representative sample comprised 460 currently married women who had at least one living child below 10 years of age. Current use of contraception and an unmet need for family planning were the outcomes variables. Descriptive statistics, a concentration curve and index for inequality, and multivariate techniques were used to examine the association between predictor and outcome variables.


Our study showed low prevalence and substantial socio-economic differentials in contraceptive use. An unmet need for family planning was concentrated among the poor and the use of contraception was found to be more frequent among affluent women. Household wealth and gender composition of children were significantly associated with contraceptive use and unmet need for family planning.


There are substantial differentials in contraceptive use and unmet need for family planning in rural Uttar Pradesh. In addition to promoting family planning, there is a need to create an atmosphere to reduce son preference, increase the acceptance of girl babies and remove economic inequalities.


Contraceptive use Unmet need for family planning Wealth Gender composition of children Uttar Pradesh 



All the authors are grateful to all anonymous reviewers for their constructive comments in improving the manuscript.

Authors’ contributions

All authors contributed equally to preparing the manuscript.


No funding was received to conduct this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict interest.

Consent for publication

Not applicable.

Availability of data

The datasets generated and/or analyzed during the current study are not publicly available because this study was based on primary data collected during the course of the first author’s doctoral thesis. It can, however, be made available on reasonable request.


  1. Arnold F (1987) The effect of sex preference on fertility and family planning: Empirical evidence. Population Bulletin of the United Nations, (23–24):44–55Google Scholar
  2. Arnold F, Choe MK, Roy TK (1998) Son preference, the family-building process and child mortality in India. Popul Stud 52(3):301–315CrossRefGoogle Scholar
  3. Barros AJ, Ronsmans C, Axelson H, Loaiza E, Bertoldi AD, França GV, Bryce J, Boerma JT, Victora CG (2012) Equity in maternal, newborn, and child health interventions in countdown to 2015: a retrospective review of survey data from 54 countries. Lancet 379(9822):1225–1233. CrossRefPubMedGoogle Scholar
  4. Boerma JT, Bryce J, Kinfu Y, Axelson H, Victora CG (2008) Mind the gap: equity and trends in coverage of maternal, newborn, and child health services in 54 countdown countries. Lancet 371(9620):1259–1267. CrossRefPubMedGoogle Scholar
  5. Bongaarts J, Cleland J, Townsend JW, Bertrand JT, Gupta MD (2012) Family planning programs for the 21st century. Population Council, New YorkGoogle Scholar
  6. Chaurasia AR, Singh R (2014) Forty years of planned family planning efforts in India. J Fam Welf 60(2):1–16Google Scholar
  7. Currie J (2009) Healthy, wealthy, and wise: socioeconomic status, poor health in childhood, and human capital development. J Econ Lit 47(1):87–122CrossRefGoogle Scholar
  8. DeRose LF, Ezeh AC (2010) Decision-making patterns and contraceptive use: evidence from Uganda. Popul Res Policy Rev 29(3):423–439CrossRefGoogle Scholar
  9. Dwivedi SN (1992) Contribution of some socio-economic variables towards explaining the level of adoption of various family planning devices in India during 1987. Demograp Ind 21(2):239–245Google Scholar
  10. Fanslow J, Whitehead A, Silva M, Robinson E (2008) Contraceptive use and associations with intimate partner violence among a population-based sample of New Zealand women. Aust N Z J Obstet Gynaecol 48(1):83–89. CrossRefPubMedGoogle Scholar
  11. Filmer D, Pritchett LH (2001) Estimating wealth effects without expenditure data—or tears: an application to educational enrollments in states of India. Demography 38(1):115–132PubMedGoogle Scholar
  12. Gakidou E, Vayena E (2007) Use of modern contraceptive by the poor is falling behind. PLoS Med 4(2):e31.
  13. Gold RB (2009) Family planning and health care reform: the benefits and challenges of prioritizing prevention. Guttmacher Policy Rev 12(1):19–24Google Scholar
  14. Government of Uttar Pradesh (2000) Uttar Pradesh Population Policy-2000. Department of Healthand Family Welfare, LucknowGoogle Scholar
  15. Gulati SC (1996) Contraceptive methods use and choice in Kerala and Uttar Pradesh: multinomial logit analysis of NFHS data. Demograp Ind 25(2):205–220Google Scholar
  16. Hussain R, Fikree FF, Berendes HW (2000) The role of son preference in reproductive behavior in Pakistan. Bull World Health Organ 78(3):379–388PubMedPubMedCentralGoogle Scholar
  17. International Institute for Population Sciences (2010) District level household and facility survey (DLHS-3), 2007–08. India, IIPS, MumbaiGoogle Scholar
  18. Islam MR, Islam MA, Banowary B (2009) Determinants of exposure to mass media family planning messages among indigenous people in Bangladesh: a study on the Garo. J Biosoc Sci 41(2):221–229CrossRefPubMedGoogle Scholar
  19. Jayaraman A, Mishra V, Arnold F (2009) The relationship of family size and composition to fertility desires, contraceptive adoption and method choice in South Asia. Int Perspect Sex Reprod Health 35(1):29–38. CrossRefPubMedGoogle Scholar
  20. Kakwani N, Wagstaff A, Van DE (1997) Socioeconomic 447 inequalities in health: measurement, computation, and statistical inference. J Econ 77(1):87–103. CrossRefGoogle Scholar
  21. Kanitkar T, Murthy BN (1983) Factors associated with contraceptive in Bihar and Rajasthan: findings from recent sample surveys. Dynamics of population and family welfare. Himalaya Publishing House, Delhi Google Scholar
  22. Kesarwani R, Yadav A (2012) Role of gender in contraceptive use among currently married women in Uttar Pradesh and Bihar. Res Human Soc Sci 2(2):34–45Google Scholar
  23. Khan S, Mishra V, Arnold F, Abderrahim N (2007) Contraceptive trends in developing countries. Macro International Inc. DHS Comparative Reports, 16.
  24. Kiragu K, Galiwango MK, Mulira HM, Sekatawa E (1996) Promoting reproductive health in Uganda: evaluation of a national IEC program. IEC Field Report Number 7, The Johns Hopkins School of Public Health, Center for Communication Programs, BaltimoreGoogle Scholar
  25. Kish L (1949) A procedure for objective respondent selection within the household. J Am Stat Assoc 44(247):380–387CrossRefGoogle Scholar
  26. Kulkarni MS (2003) Exposure to mass media and its impact on the use of family planning methods by women in Goa. Health Populat Perspect Issues 26(2):87–93Google Scholar
  27. Kulkarni S, Choe MK (1998) Wanted and unwanted fertility in selected states of India, report#6, National Family Health Survey. In: International Institute for Population Sciences. Mumbai and East West Centre, Honolulu Google Scholar
  28. Majumder N, Ram F (2015) Contraceptive use among poor and non-poor in Asian countries: a comparative study. Soc Sci Spectrum 1(2):87–105Google Scholar
  29. Ministry of Health and Family Welfare (MOHFW) (2000) National Population Policy - 2000. Department of Family Welfare, New DelhiGoogle Scholar
  30. Mohanty SK, Pathak PK (2009) Rich–poor gap in utilization of reproductive and child health services in India, 1992–2005. J Biosoc Sci 41(3):381–398CrossRefPubMedGoogle Scholar
  31. Monteith RS, Anderson JE, Pineda MA, Santiso R, Oberle M (1985) Contraceptive use and fertility in Guatemala. Stud Fam Plan 16(5):279–288CrossRefGoogle Scholar
  32. Navaneetham K, Dharmalingam A (2002) Utilization of maternal health care services in southern India. Soc Sci Med 55(10):1849–1869CrossRefPubMedGoogle Scholar
  33. Nketiah-Amponsah E, Arthur E, Abuosi A (2012) Correlates of contraceptive use among Ghanaian women of reproductive age (15-49 years). Afr J Reprod Health 16(3):154–169Google Scholar
  34. O’Donnell O, Doorslaer van E, Wagstaff A, Lindelow M (2008) Analyzing health equity using household survey data: a guide to techniques and their implementation. Washington: World Bank.
  35. Olaleye DO, Bankole A (1992) The impact of mass 490 media on family planning promotion in Ghana. Paper Presented at the Annual Meeting of the Population Association of America, DenuerGoogle Scholar
  36. Pachauri S (2004) Expanding contraceptive choice in India: issues and evidence. J Fam Welf 50(SI):13–25.
  37. Pandey A, Singh KK (2015) Contraceptive use before first pregnancy by women in India (2005– 2006): determinants and differentials. BMC Public Health 15(1):1316CrossRefPubMedPubMedCentralGoogle Scholar
  38. Pathak PK, Mohanty SK (2010) Does the safe-motherhood programme reach the poor in Uttar Pradesh, India? Asian Popul Stud 6(2):173–191. CrossRefGoogle Scholar
  39. Patrikar SR, Basannar DR, Sharma MS (2014) Women empowerment and use of contraceptive. MedJ Armed Forces Ind 70(3):253–256CrossRefGoogle Scholar
  40. Rahman M, Akbar J, Phillips JF, Becker S (1992) Contraceptive use in Matlab, Bangladesh: the role of gender preference. Stud Fam Plan 23(4):229–242CrossRefGoogle Scholar
  41. Rahman MM, Akter S, Mondal MNI (2008) Contraceptive use among married women in Chuadanga District, Bangladesh. Middle East J Family Med 6(2):22–27Google Scholar
  42. Rahman MM, Mostofa MG, Hoque MA (2014) Women’s household decision-making autonomy and contraceptive behavior among Bangladeshi women. Sex Reprod Healthcare 5(1):9–15CrossRefGoogle Scholar
  43. Rai AK, Chauhan BG (2014) Inequality in utilization of maternal health care services among teenage married women in Uttar Pradesh: evidences form NFHS-3. Glob J Multidiscip Stud 3(10):71–89Google Scholar
  44. Rajaretnam T, Deshpande RV (1994) The effect of sex preference on contraceptive use and fertility in rural South India. Int Fam Plan Perspect 20(3):88–95CrossRefGoogle Scholar
  45. Rajpurohit AC, Kesarwani P, Srivastava VK (2014) Contraceptive 511 use by the rural women of Uttar Pradesh-a socio-demographic study. Ind J Comm Health 26(2):139–144Google Scholar
  46. Renuka R, Jeyarathnam M (2016) Women's autonomy and family planning practices among married women in Coimbatore. Asian J Nurs Educ Res 6(2):214CrossRefGoogle Scholar
  47. Sahoo H (2007) Determinants of contraceptive use in Orissa: an analysis of National Family Health Survey III. Health Populat Prospect Issues 30(3):208–221Google Scholar
  48. Sharma RK, Rani M (2009) Contraceptive use among tribal women of Central India: experiences among DLHS-RCH–II survey. Res Pract Soc Sci 5(1):44–66Google Scholar
  49. Singh MN, Joshi N (2017) Dynamics of contraceptive use among schedule caste women in Uttar Pradesh. Int J Reprod, Contrac, Obstet Gynecol 3(3):566–574Google Scholar
  50. Singh SK, Yadava KN (1997) Women’s status and fertility regulation in rural eastern Uttar Pradesh. In: Gupta K, Pandey A (eds) Population and development in Uttar Pradesh. B.R. Publishing Council, New Delhi, pp 217–233Google Scholar
  51. Speizer IS, Nanda P, Achyut P, Pillai G, Guilkey D (2012) Family planning use among urban poor women from six cities of Uttar Pradesh. India J Urban Health 89:639–658CrossRefPubMedGoogle Scholar
  52. Wang W, Wang S, Pullum T, Ametepi P (2012) How family planning supply and the service environment affect contraceptive use: findings from four east African countries. DHS analytical studies no. 26. ICF International, CalvertonGoogle Scholar
  53. Woldemicael G (2009) Women’s autonomy and reproductive preferences in Eritrea. J Biosoc Sci 41(2):161–181CrossRefPubMedGoogle Scholar
  54. World Population Data Sheet (2009) Washington: Population Reference 534 Bureau. Available from:

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.International Institute for Population SciencesMumbaiIndia
  2. 2.Department of Development StudiesInternational Institute for Population SciencesMumbaiIndia

Personalised recommendations