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Family Planning Use among Urban Poor Women from Six Cities of Uttar Pradesh, India


Family planning has widespread positive impacts for population health and well-being; contraceptive use not only decreases unintended pregnancies and reduces infant and maternal mortality and morbidity, but it is critical to the achievement of Millennium Development Goals. This study uses baseline, representative data from six cities in Uttar Pradesh, India to examine family planning use among the urban poor. Data were collected from about 3,000 currently married women in each city (Allahabad, Agra, Varanasi, Aligarh, Gorakhpur, and Moradabad) for a total sample size of 17,643 women. Participating women were asked about their fertility desires, family planning use, and reproductive health. The survey over-sampled slum residents; this permits in-depth analyses of the urban poor and their family planning use behaviors. Bivariate and multivariate analyses are used to examine the role of wealth and education on family planning use and unmet need for family planning. Across all of the cities, about 50% of women report modern method use. Women in slum areas generally report less family planning use and among those women who use, slum women are more likely to be sterilized than to use other methods, including condoms and hormonal methods. Across all cities, there is a higher unmet need for family planning to limit childbearing than for spacing births. Poorer women are more likely to have an unmet need than richer women in both the slum and non-slum samples; this effect is attenuated when education is included in the analysis. Programs seeking to target the urban poor in Uttar Pradesh and elsewhere in India may be better served to identify the less educated women and target these women with appropriate family planning messages and methods that meet their current and future fertility desire needs.

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  1. 1.

    While not all women (including currently pregnant women) with an unmet need will use family planning if available,19 unmet need serves as a programmatic indicator of who could be targeted with family planning methods and services.

  2. 2.

    In some calculations of unmet need, women who are not using FP and are unsure of future childbearing or unsure of the timing of future childbearing are considered to have an unmet need; in this analysis, these women are not considered to have an unmet need since their fertility intentions are not firm. In addition, some calculations consider amenorrhoeic women who report their last pregnancy as mistimed or unwanted and are not using FP to have an unmet need for FP; we examine these women’s current intentions and FP use and classify them accordingly rather than incorporating their last pregnancy intentions in the calculation. Differences in unmet need estimates including the above referenced women as having an unmet need would lead to greater unmet need by 0.0–0.4% across the cities.

  3. 3.

    In non-slum models that removed education in these two cities, wealth remained non-significant and likewise for models that removed wealth, education remained non-significant (not shown). Thus, it is not thought that multicollinearity is affecting these findings.


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This project was approved by the Futures Group India Institutional Review Board (in-country approval) as well as by the Institutional Review Boards at The University of North Carolina at Chapel Hill and the International Center for Research on Women (ICRW). Funding for this project comes from the Bill & Melinda Gates Foundation. The authors would like to thank Lisa Calhoun for her helpful insights into this paper.

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Correspondence to Ilene S. Speizer.

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Speizer, I.S., Nanda, P., Achyut, P. et al. Family Planning Use among Urban Poor Women from Six Cities of Uttar Pradesh, India. J Urban Health 89, 639–658 (2012).

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  • Slum
  • Uttar Pradesh
  • India
  • Family planning
  • Unmet need
  • Urban poor