Spatial Heterogeneity and Socio-economic Correlates of Unmet Need for Spacing Contraception in India: Evidences from National Family Health Survey, 2015-16

Abstract Background:The high unmet need for contraception among women who wants to delay their subsequent births for two or more years (UNS) is a challenging issue in India. Therefore, the present study aims to display spatial heterogeneity and determine the associated factors underlying the UNS among the currently married women aged 15-49 years with a demand for spacing births in India.Methods:The present study used data from the National Family and Health Survey, 2015-16. Unmet need for spacing (UNS) used as outcomes and socio-cultural and demographic factors as explanatory variables. Among the comprehensive family planning, 16.7% (56742 women) of currently married women had demand for spacing births were used for analysis. Univariate, bivariate with chi-square significance test, spatial natural break technique, and multivariate logistic regression were used to accomplish the study objectives. Results:Almost 17% of women had demand spacing out of total demand for family planning in India. High unmet need for contraception found among them except the women with higher-level education and wealth status. District level spatial heterogeneity of UNS shows 248 districts had remarkably high unmet for spacing (68% and above). Results from multivariate logistic regression show that UNS's likelihood was noticeably high among the women with parity three or more (AOR: 1.42 [1.3-1.55]) compared to their counterparts. Similarly, 44% (AOR: 1.44[1.38-1.51]) more likely found among the OBC than General caste. Rural (AOR: 1.24[1.19-1.30]) women compared to urban, women living in South (AOR: 6.19 [5.76-6.65]), Central (AOR: 1.52 [1.43-1.61]), and West (AOR: 1.80 [1.68-1.92]) region compared to those from North had higher odds of UNS. Conclusion:Deal with the UNS in India requires scaling up women education, client choice-based services, campaign on benefits of spacing births and available contraception, and socio-economically backward group centric policies.