Association of Socio-demographic and Decision Making Factors with the unmet need of family planning among Married Women in Madi Municipality, Chitwan, Nepal

Association of Socio-demographic and Decision Making Factors with the unmet need of family planning among Married Women in Madi Municipality, Chitwan, Nepal | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Association of Socio-demographic and Decision Making Factors with the unmet need of family planning among Married Women in Madi Municipality, Chitwan, Nepal Rochana Ghimire, Rajani Shah, Yojana Baral, Dinesh Kumar Malla, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4997097/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Sustainable Development Goal of Nepal targets universal access to family planning (FP) services and increasing the contraceptive prevalence rate to 75% by 2030. Despite continuous efforts from the government of Nepal in the FP sector, the prevalence of unmet need for FP is high. This study aimed to identify sociodemographic and decision-making factors associated with the unmet need for FP among married women of reproductive age. Methods This is a community-based cross-sectional study conducted in Madi municipality, Chitwan, Nepal. Face-to-face interviews were conducted with 218 married women of reproductive age using a semi-structured questionnaire. Descriptive statistics, chi-square tests and multivariable logistic regression were used to analyse the data. Results Nearly half (47%) were age group 25–34, 58% lived in nuclear families, 76% belonged to advantaged ethnic groups, majority of respondents (67%) and their husbands (75%) had at least secondary education. Most women (59%) were involved in agriculture, while most husbands (44%) were in foreign employment. Participants (91.3%) have heard about Depo-Provera. The overall unmet need for FP was 38%. Respondents whose husbands were involved in foreign employment were more likely [aOR: 4.408; CI: 2.068–9.399] to have an unmet need for FP than those employed within the country. The likelihood of the unmet need was higher [aOR: 3.212; CI: 1.368–8.135] among couples who did not discuss using FP methods compared to those who discussed three or more times. Women with up to two children [aOR: 5.212; CI: 1.163–23.363] and three or more children [aOR: 8.758; CI: 1.691–45.355] were more likely to have a higher unmet need for FP than women without a child. Conclusion A significant proportion of women had an unmet need for FP. Intervention should focus on addressing the FP needs of migrants and their spouses, promoting spousal discussion on FP and counselling on the treatment as well as side effects of contraceptives. Furthermore, empowering women would enable them in the decision-making process and in accessing FP services. Contraception Cross-sectional Factors associated Foreign employment Nepal Spousal communication Unmet need Background Sustainable Development Goal (SDG) of Nepal has focused on ensuring healthy lives and promoting well-being for all age groups. One of the targets of the SDGs of Nepal is ensuring universal access to sexual and reproductive health care services, including family planning (FP). It aims to increase the contraceptive prevalence rate (CPR) to 75% by 2030( 1 ). Globally, the CPR is 76%, and the prevalence of unmet need is 10%( 2 ), while in Nepal, a larger unmet need of 21% exists when CPR is 53%( 3 ). Nepal aims to achieve 74% of women aged 15–49 years having their family planning needs met by modern methods by 2022, with this target increasing to 80% by 2030. This aligns with Sustainable Development Goal (SDG) target 3.7.1( 4 ). Women with an unmet need for FP are those who are not currently using any contraceptive method but want to postpone childbirth for at least two years( 5 ). In Nepal, the unmet need declined by only 7% in a decade, from 28% in 2011 to 21% in 2022( 6 )( 4 ). Unwanted pregnancy is associated with higher unsafe abortion( 7 ). There are various ongoing efforts to address the unmet need of family planning. Both, government and private sector is working to make family planning accessible( 8 ). The government of Nepal is providing short-acting reversible contraceptive methods (male condoms, oral pills, and injectable) through primary health care centres (PHCCs), health posts and primary health care outreach clinics. Long-acting reversible contraceptive methods such as Intra Uterine Contraceptive Device (IUCD) and Implant are available in hospitals, PHCCs, and health posts through trained and skilled providers. Similarly, male and female sterilization are usually performed in mobile camps and hospitals. Clinics/centres, private hospitals/clinics, and pharmacies run by nongovernmental organizations are also providing quality FP services. Female community health volunteers (FCHVs) are responsible for raising awareness in the community regarding FP as well as distributing male condoms and oral contraceptive pills( 9 ). Despite the availability of FP services, the CPR for the modern FP method has remained stagnant (43%) since 2006, and a significant proportion of unmet needs exists( 3 ). The underlying reasons for the non-use of contraception among women with an unmet need for FP are a lack of awareness regarding the details of specific methods of contraception and the concept of fertility control, fear of side effects or health risks and the inconvenience of using contraceptives( 10 ). The unmet need for FP among married women is influenced by several factors, such as their age, caste/ethnicity, place of residence, education, occupation, education and occupation of husband, number of living children, number of living sons, approval of husband and spousal communication ( 11 – 14 ). Unlike previous studies on the unmet need for FP in Nepal( 11 – 14 ), this study was conducted in a semi urban setting of a newly formed municipality. There are a limited number of unmet need studies conducted in Nepal( 5 , 11 – 15 ). This study aimed to identify the socio-demographic and decision-making-related factors influencing the unmet need for FP among married women of reproductive age (MWRA). Methods Study area This study was conducted in the Madi Municipality of Chitwan District. In Chitwan, in addition to two pre-existing municipalities, village development committees were merged, and five new municipalities were gradually formed, including Madi. Madi was declared a municipality with 9 wards in 2014. It has nine public health facilities, including one hospital, three health posts, one community health care unit, and four urban health care centers. FP service is available at all the health facilities as well as from an FCHV of the respective ward. According to the record of household survey conducted by the municipality in 2017 [ Local Level Publication 2017 ], Madi Municipality has a total population of 43,402, of which 12,577 are females of reproductive age (15-49). It comprises a total of 8,649 households inhabiting 37 types of caste/ethnicity groups. The major caste/ethnicity are Brahmin, Chhetri, Chaudhary, Chepang, Damai, Gurung, Tamang, Bote, Magar, Kami and Sarki[13 (16). Study design and study participants This was a cross-sectional study conducted among MWRA (15-49 years) who were residents of Kalyanpur of Madi Municipality. Among the 12,577 female of reproductive age group we interviewed married women aged 15 to 49 years residing in the municipality(16), willing to participate in the study and provided informed consent. Sampling and sample size A multistage sampling technique was used in the study. Among the newly formed municipalities in Chitwan, Madi was selected purposively, being farthest in distance from Bharatpur – the district headquarters – that takes a two-hour drive. A ward was selected randomly using the lottery method. Then, a systematic sampling technique was used to select households for data collection. The selected ward (ward number 7) had a total of 978 households and 1,373 females in the reproductive age group [14]. The sample size for the study was calculated as follows: \(\:n=\frac{{Z}^{2}p\left(1-p\right)}{d²}\) = (1.96) 2 x 0.24 x 0.76/0.06 2 = 195 where n is the sample size, Z is the z score (set to 1.96 at the 95% confidence level), p is the prevalence of unmet need (24%) and d is the margin of error (6%). By considering a nonresponse rate of 10 percent, the final sample size (n)= 215 Then, the sampling interval was calculated as follows: Sampling Interval = total households/sample size = 978/215 = 4.54 Every fifth house was selected after random selection of a first house. A total of 218 MWRAs were included in the study to cover all the remaining houses in the ward. Study variables Dependent variable: The dependent variable was ‘ Unmet need for FP’ . Independent variables Independent variables include the age of the respondent, religion, caste/ethnicity, wealth index, educational status of the respondent, occupation of the respondent, educational status of the husband, occupation of the husband, number of living children, decision-maker, frequency of discussion, and approval of husband. Operational Definition Unmet need for FP Fecund women who desired to postpone birth for two or more years or stop childbearing altogether but were not currently using a contraceptive method, as well as pregnant women whose current pregnancy was unwanted/mistimed, were considered to have an unmet need for FP. The unmet need was categorized as ‘Yes’ (coded 1) and ‘No’ (coded 0)(17)(4). (1) Age of respondent: Completed years of life of respondent. It was classified into three categories: ‘≤24 years’, ‘25-34 years’ and ‘35 years & above’(18). (2) Religion: Religion followed by the respondents. It was classified into two categories: ‘Hindu’ and ‘Non-Hindu’ (Buddhist, Christian, and Muslim) (19)(20). (3) Caste/ethnicity : This was categorized as ‘Advantaged caste/ethnicity’ and ‘Disadvantaged caste/ethnicity’. So-called upper caste group, i.e., Brahmin & Chhetri and relatively advantaged Janajati were classified as ‘Advantaged caste/ethnicity’, whereas Dalits and Disadvantaged Janajati were classified as ‘Disadvantaged caste/ethnicity’[13, 17]. (4) Wealth index: A wealth index was created using a principal component analysis of a number of household assets. It was classified into ‘Poor’ and ‘Rich’. Household assets were considered for calculation of wealth index as adopted by Shah R, et al(21). (5) Educational status refers to completed years of schooling of the respondents and their husbands. It was measured in three categories – ‘no schooling’, ‘primary education’, ‘secondary education’ and ‘postsecondary or higher education’. Respondents who had completed any grades from 1 to 5 were classified as having ‘primary education’, respondents who had completed 9 th grade up to 12th grade were classified as having ‘secondary education’, and respondents with any completed education higher than 12th grade were classified as having ‘postsecondary or higher education’(6). (6) Occupation of respondent : Occupation of the respondent at the time of data collection was classified into three categories: ‘Housewife’, ‘Agriculture’ and ‘Employed within country’ (service/labor/business)’(22)(23). (7) Occupation of husband : Occupation of the respondent’s husband at the time of data collection. It was classified into three categories: ‘Agriculture’, ‘Foreign employment’, and ‘Employed within country’ (Service/Business/Labor) (22)(23). (8) Number of living children : The number of living children of the respondents. It was classified as ‘No child’, ‘Up to 2 children’, or ‘3 or more children’(24). (9) Decision maker : The individual who makes decisions regarding the use of the FP method. It was categorized as ‘By woman herself’ and ‘Husband and wife jointly’(25)(26). (10) Frequency of discussion: This variable assessed the number of discussions on FP that a couple had regarding family planning. It was measured as ‘Never’, ‘Once or twice’ and ‘Three or more times’(27) (11) Approval of husband: The variable assessed perceived approval of husband for using contraceptives. The response was categorized as ‘Approves’ and ‘Disapproves’. Data collection procedure Data were collected from June 30 to July 20, 2019. Data were collected using a structured questionnaire that was developed from relevant literature (3)(18)(27)(28) in the local Nepali language. The English version of questionnaire is available at [ Supplementary file- S1 ]. The questionnaire was pretested in a similar setting of another municipality (Kalika municipality) in Chitwan. The questionnaire was then customized based on the findings of the pretesting, which included the addition of a ‘skip’ label, deletion of vague words, and ‘reordering’ the questions to make it friendly to both the data collector and respondents. The final questionnaire consisted of variables related to socio-demographic characteristics, knowledge and practice of FP, and decision-making. Data were collected through face-to-face interviews by visiting women at their homes. A brief overview of the objectives of the present study was provided prior to the data collection among the women. The first house was selected by taking the community school as a landmark (29). A direction was randomly chosen by tossing a pen and following the direction of the point of the pen(30). Then, every fifth house was chosen until the required sample size was met. Additionally, two more eligible women were included from the remaining houses following the same procedure. Any fifth house where there was no eligible woman or was not available, the house just next to that was chosen as a sample, and then the next fifth house was selected. If there was more than one eligible woman in a house, one was randomly selected using the lottery method for interviews. Data were collected by the first (RG- BPH Student) and third author (YR- BPH Student) themselves. Data processing and analysis The data were entered and analysed using SPSS version 20 software. The frequency and percentage of data were calculated in descriptive analysis. Pearson’s chi-square test was used to assess the statistically significant association of the independent and dependent variables. Multicollinearity between independent variables was checked using variation inflation factor (VIF), taking the highest VIF value >3 into account (REF 1). The VIF value for any of the independent variables was not found >3. The variables that were significant at P value ≤0.1 were entered in multivariable analysis to ensure that potential predictors are included in the multivariable analysis(31). A P value <0.05 was considered to indicate statistical significance in multivariable analysis. Ethical considerations Ethical approval for the study was obtained from the Institutional Review Committee (IRC) of Shree Medical & Technical College (SMTC), Bharatpur, Chitwan (SMTC-IRC-2020720-2). Written informed consent was obtained from the respondents before initiating the interview using an informed consent form. Voluntary participation of the respondents was ensured throughout the study. The information collected was kept confidential and was used for research purposes only. Results In this study, we found that most women who were in fecund reported their status themselves. Among the seven pregnant women found during the survey, two had unwanted pregnancies. We interviewed 218 eligible women and overall unmet need for family planning is found to be 38%. All the women who we met provided consent for the data collection. Socio-demographic characteristics and relationship with unmet need of family planning of the respondents Nearly half of the respondents (47%) were aged 25-34 years, and 58% of the respondents were living in nuclear families. Approximately three-quarters (76%) of the respondents belonged to advantaged ethnic groups, and approximately 9 out of 10 were Hindus. The majority of the respondents (67%) and their husbands (75%) were educated at least to secondary and higher levels. The majority of women (59%) and their husbands (44%) were involved in agriculture and foreign employment, respectively. Two-thirds of the respondents had up to two children (Table 1). Among socio-demographic variables, husband’s occupation (p<0.001) showed a strong association in Pearson’s Chi-square test with unmet need for FP. Furthermore, spousal discussion on FP (p=0.025) and approval of husband (p=0.034) were also significantly associated . Table 1 Socio-demographic characteristics and association with unmet need for FP (n=218) Characteristics Total * Unmet need P value** Frequency (%) No Frequency(%) Yes Frequency(%) Age of respondent (Years) £ 24 51 (23.4) 30 (58.8) 21 (41.2) 0.517 25-34 102 (46.8) 61 (59.8) 41 40.2) 35 & above 65 (29.8) 44 (67.7) 21 (32.3) Religion Hindu 195 (89.4) 121 (62.1) 74 (37.9) 0.921 Non-Hindu 23 (10.6) 14 (60.9) 9 (39.1) Caste Advantaged 166 (76.1) 101 (60.8) 74 (37.9) 0.556 Disadvantaged 52 (41.7) 34 (65.4) 18 (34.6) Education of respondent No schooling 39 (17.9) 28 (71.8) 11 (28.2) 0.338 Primary 32 (14.7) 18 (56.2) 14 (43.8) Secondary /higher 147 (67.4) 89 (60.5) 58 (39.5) Education of husband No schooling 13 (6.0) 7 (53.8) 6 (46.2) 0.807 Primary 14 (18.8) 25 (61) 16 (39) Secondary/higher 164 (75.2) 103 (62.8) 61 (37.2) Occupation of respondent Housewife 59 (27.1) 36 (61.0) 23 (39.0) 0.531 Agriculture 128 (58.7) 77 (60.2) 51 (39.8) Employed within country 31 (14.2) 22 (71.0) 9 (29.0) Occupation of husband Agriculture 59 (27.1) 47 (79.7) 12 (20.3) Foreign employment 95 (43.6) 38 (40.0) 57 (60.0) <0.001 Employed within country 64 (29.4) 50 (78.1) 14 (21.9) Number of living children No child 19 (8.7) 16 (84.2) 3 (15.8) Up to 2 children 143 (65.5) 84 (54.7) 59 (41.3) 0.099 3 & more children 56 (25.7) 35 (62.5) 21 (37.5) Wealth Index Poorer 109 (50.0%) 74 (67.9) 35 (32.1) 0.07 Better 109 (50.0%) 61 (56.6) 48 (44.0) Decision maker on FP By women herself 29 (13.3) 16 (55.2) 13 (44.8) 0.421 Husband and wife jointly 189 (86.7) 119 (63.0) 70 (37.0) Spousal discussion on FP Never 36 (16.5) 16 (44.4) 20 (55.6) Once or twice 52 (23.9) 30 (57.7) 22 (42.3) 0.025 More often 130 (59.6) 89 (68.5) 41 (31.5) Approval of husband Approves 198 (90.8) 127 (64.1) 71 (35.9) 0.034 Disapproves 20 (9.2) 8 (40.0) 12 (60.0) *Yields column % equals to 100 **P value from Pearson chi -square test, Family Planning- FP Knowledge and practice of FP Depo-Provera was the most commonly (91%) heard FP method. Most of the respondents had knowledge about FP methods from health posts (60%) and FCHV (34%). Approximately half of the respondents (51%) used the FP method. Among the current users, 84% were using modern methods, while the remaining (16%) were following traditional methods of FP. Nearly 37% of the users had permanent FP, including vasectomy (31.3%) and Minilap (5.4%). Among nonusers, approximately 62% of the respondents reported husbands being abroad as a major reason for not using any FP methods (Table 2). Table 2 Knowledge and practice of FP (n=218) Characteristics Frequency Percent Heard method of FP* Depo-Provera 199 91.3 Pills 190 87.2 Condom 162 74.3 Implant 128 58.7 Vasectomy 111 50.9 Minilap 111 50.9 IUCD 109 50.0 Withdrawal 21 9.6 Calendar method 17 7.8 Source of knowledge on FP* Health post 131 60.1 Neighbors/Friends 81 37.2 FCHVs 73 33.5 Newspaper 36 16.5 Radio 22 10.1 Teachers 16 7.3 Television 15 6.9 Internet 8 3.7 Family member 3 1.4 Training 3 1.4 Current status of FP use Yes 112 51.4 No 106 48.6 Currently used FP method Vasectomy 35 31.3 Pills 23 20.5 Withdrawal 16 14.3 Depo-Provera 14 12.5 Condom 10 8.9 Mini lap 6 5.4 Implant 4 3.6 IUCD 2 1.8 Calendar method 2 1.8 Reasons for not using FP method*(#=106) Husband away 66 61.7 Breast feeding 16 15.0 Desire of child 11 10.3 Rare sex 10 9.3 Fear of side-effects 9 8.4 Poor health 3 2.8 * Multiple response, Female community health volunteers- FCHVs, Intrauterine contraceptive device- IUCD Results of multivariable logistic regression analysis Of the five variables included in multivariable logistic regression analysis, only three variables had a statistically significant association with unmet need for FP. The respondents whose husbands were involved in foreign employment were 4 times [aOR: 4.408; CI: 2.068-9.399] more likely to have unmet needs than those employed within the country. The couples who had no discussion on FP were 3 times [aOR: 3.212; CI: 1.368-8.135] more likely to have unmet needs than those who discussed three or more times. Similarly, women who had 3 or more children [aOR: 8.758; CI: 1.691-45.355] or up to 2 children [aOR: 5.212; CI: 1.163-23.363] were more likely to have unmet needs than women with no children (Table 3). Table 3 Multivariable logistic regression analysis (n=218) Characteristics Unadjusted OR (95% CI) P value (Crude) Adjusted OR (95% CI) P- value (adjusted) Occupation of husband Employed within country 1 1 Foreign employment 5.357 (2.605-11.01) <0.001 4.408 (2.068-9.399) <0.001 Agriculture 0.912 (0.383-2.172) 0.835 0.640 (0.248-1.650) 0.355 Spousal discussion on FP Three or more times 1 1 Never 2.713 (1.276-5.769) 0.009 3.212 (1.368-8.135) 0.014 Once or twice 1.592 (0.820-3.089) 0.169 1.840 (0.855-3.959) 0.119 Number of living children No child 1 1 Up to 2 children 0.313 (0.81-1.201) 0.090 5.212 (1.163-23.363) 0.031 3 & more children 1.17 (0.620-2.21) 0.627 8.758 (1.691-45.355) 0.010 Wealth Index Better 1 1 Poorer 0.601 (0.346-1.044) 0.71 0.610 (0.318-1.171) 0.138 Approval of husband Approves 1 1 Disapproves 2.683 (1.048-6.873) 0.040 2.257 (0.732-6.964) 0.157 Discussion This cross section study conducted in a newly formed municipality in the Chitwan district, Bagmati province, Nepal, interviewed 218 married women of reproductive age group. It explored various influencing factors for unmet need of family planning, including socio-demographic and decision making factors previously underrepresented in national studies. Unmet need for family planning was found to be 38 percent in this study, exceeding the national average of 21 percent in 2022 Nepal Demographic and Health Survey ( 4 ). This survey also indicated provincial disparities ranging from 16 to 28 percent ( 4 ), likely attributed to geographic, socio-cultural, socio-economic background throughout the Nepal. Population density, sampling strategies, ethnic group and other reasons could be the factors. Despite of the lower geographical coverage and heterogensou populations with a smaller sample size, we identified husband’s absence due to foreign employment, spousal discussion and number of living child significantly affected the unmet need of family planning. Despite a smaller sample size, we have been able to differentiate various similarities with other study from Nepal and other countries. Three primary factors- foreign employment, lack of spousal discussion, an number of children- emerged as significant influences on unmet need of family planning. As Nepal being labour force exporter for foreign employment( 32 ), major migrate to India and other countries( 33 ), seasonally migrated for works, higher among the Dalit( 34 ). Thus, couples living separately need to use contraceptives whenever husbands visit home( 33 ). Furthermore, couples living together has lower unmet that than those being separated as stated by national level studies from Nepal ( 35 , 36 ). Less time to prepare about family planning on husband’s arrival and communication gap is the factor for unused of it ( 37 ). Furthermore, conceptive use during the absences of husband was considered as challenges( 37 ). In this study we could not explore the sexual activity of women due to privacy reason. In present study, we reported discussion about FP is important about the couples. Studies from Nepal showed that communication is important for better use of family planning in rural areas( 38 ), joint decision making for contraceptives( 23 ). Consistent findings were reported from studies conducted in Botswana( 28 ), Cameroon( 30 ) and Ethiopia( 39 ), mini literature review by Fatemeh Najafi-Sharjabad et. Al. ( 40 ), Tanzania qualitative study( 41 ). As we reported, male are the major decision makers for family planning( 40 )( 41 ). All these collectively emphasize about the importance of discussion between couples. Number of the children among the couple was one of the factors in our study which was found consistent with studies from Nepal( 12 ),( 15 ), Ethiopia( 42 ), Burundi( 43 ). Unmet need of FP is greater among the women with higher number of children( 44 ), ( 12 ), ( 45 ). Women do not use FP as they find their family size complete( 45 ). Due to the fear factors, women consider abortion as an alternative than contraception( 45 )( 46 ). Consistently, in sub-Saharan Africa, women chose abortion as a method of limiting family size rather than use of contraception( 47 ). Fear of side effects and health concerns among women is the major reason for not using contraceptive in Nepal and around the globe( 11 )( 13 )( 30 )( 44 )( 46 ). Most of the non-user reporting fear of side effects have already used contraception and discontinued them( 48 ). While our findings align with several aspects of previous research, our study]s focus on newly formed municipality near Bharatpur metropolitan city offers a unique perspectives. Moreover, our findings contrast with those of previous studies in several key areas. As reported by secondary analysis of Nepal Demographic and health survey 2022, the total unmet need is 20.8%( 49 ) but we reported quite high. Similarly, the same study reported higher difference in urban 67.6 (66.1, 69.0)% Vs rural 32.4 (31.0, 33.9)% areas for unmet need of family planning( 49 ). We are here unable to differentiate between rural urban difference, however we claim the areas is semi-urban in nature. We also reported the difference between advantaged castes versus disadvantage caste is low in our study however the same secondary data analysis( 49 ) shows that difference is high. The main reason for this is the geographical coverage, population composition and socio-economic context, access to the major cities of our study. Adhering to the similar facts, we also observed difference in unmet among the multipara in NDHS( 49 ) is higher than our study. Furthermore, our study identified several discrepancies compared to previous research. A critical review of multiple rounds of Nepal's health survey reports( 6 )( 50 )( 49 ) reveals substantial changes in unmet needs and associated factors over time. These similarities and differences may be partly attributed to socio-economic factors. Strengths, Policy implication and Limitations The study has some strengths as well as limitations. It has underlined the factors associated with the unmet need for FP and the reasons behind not using FP methods. Data collection was performed by the first and third authors themselves using a pretested questionnaire prepared in the understandable Nepali language. There are lack of ground level studies in Nepal and in many low and middle income countries. Since Nepal recently transitioned to a federal structure, public health delivery has become a major responsibility of local governments. This study offers valuable policy-level insights by shedding light on the ground realities faced by local authorities. By understanding these realities, local public health leaders can design appropriate policy interventions to address unmet needs in family planning. While the study was conducted in a newly developed urban area, the observed lifestyle patterns reflect those of a semi-urban setting. Consequently, the findings provide valuable insights applicable to both newly developed urban and semi-urban areas. The specific needs of couples with husband working abroad and families with two children can be leverage from policy level perspectives. With regard to limitations of the study, due to resource and time constraints, the study was limited to only one ward, and the findings may not be generalizable in all places of Nepal. However, the findings might reflect the situation of an unmet need for FP in other similar semi-urban settings. Being a quantitative study, the information might be limited. Being a small-scale study dealing in resource limited semi-urban setting with various socio-cultural issues, we could not explore whether the unmet need is for spacing or limiting. Similarly, we only relied on a small sample size in a ward of the municipality of semi-urban areas. Due to the relatively small sample size of 218, we were unable to employ advanced statistical modelling for exploring the relationships between predictor variables. Increasing the sample size would enhance the generalizability of family planning findings to broader populations, enabling the application of more sophisticated statistical models. Given Nepal's predominantly patriarchal society, like breastfeeding mothers, women living single or those whose sexual partner, exploring the decision-making process surrounding family planning was crucial. Furthermore, understanding who holds primary decision-making authority is vital and warrants further investigation through studies employing a gender lens. Furthermore, due to privacy reasons, we could not explore the sexual activities of migrants’ wives. Therefore, a more comprehensive study exploring more qualitative information is needed. Conclusion A high prevalence of unmet family planning (FP) needs was identified among married women in this study. Factors contributing to this included husbands working abroad, lack of communication about FP within couples, and families with three or more children. These findings inform policymakers to design targeted family planning based strategies. Interventions should focus on couples with migrant husbands by providing services during home visits and facilitating communication. Women empowerment and involvement of them in active discussion should be promoted through health education to couples. Additionally, programs should address concerns and raise awareness about additional childbearing for families with two children. Furthermore, the study emphasizes the importance of managing contraceptive side effects, promoting spousal discussions on FP, and empowering women in decision-making to address unmet needs and improve reproductive health outcomes. Abbreviations aOR Adjusted odds ratio CPR Contraceptive prevalence rate FCHV Female community health volunteer FP Family Planning IRC Institutional review committee IUCD Intrauterine contraceptive device MWRA Married women of reproductive age Declarations Acknowledgement We would like to thank Shree Medical and Technical College as well as Madi Municipality for their support during the study period. Availability of data and materials All the data associated with this study will be available freely upon request with the corresponding author. Authors’ Contributions RG conceptualized the design of the study, prepared tools, collected and analysed data, interpreted results, and drafted the manuscript. RS contributed to the design of the study, development of tools, analysis and interpretation of data, review of literature and drafting of the manuscript. YB contributed to the data collection, data analysis, review of literature and drafting of the manuscript. DKM contributed to data analysis, review of literature and drafting of the manuscript. All authors have read and approved the final version of the manuscript. KT finalized the final manuscript, supervision of works, review of literature, data analysis, submission of the manuscript, Data Availability Data will be available from the corresponding author on reasonable request. Ethical Approval and Consent to Participate Ethical approval was obtained from the Shree Medical and Technical College-Institutional Review Committee. Written informed consent was obtained from each respondent before data collection. Confidentiality of the information and privacy were maintained. Consent for Publication No individual details, images or video in form are included of the respondents. Competing Interests The authors declare that they have no competing interests. Funding Statement The study received no funding for research and publication. References National Planning Commission [NPC]. Nepal’s Sustainable Development Goals, Baseline Report [Internet]. National Planning Commission. 2017. Available from: https://www.npc.gov.np/images/category/SDGs_Baseline_Report_final_29_June-1(1).pdf United Nations, Department of Economic and Social Affairs PD (2019). Family Planning and the 2030 Agenda for Sustainable Development (Data Booklet). Family Planning and the 2030 Agenda for Sustainable Development: Data Booklet. (ST/ESA/ SER.A/429). 2019. Ministry of Health, Nepal; New ERA; ICF International. Nepal Demographic Health Survey (NDHS) Report 2016 [Internet]. 2016. Available from: https://www.dhsprogram.com/pubs/pdf/FR336/FR336.pdf Ministry of Health and Population(Nepal), New ERA, ICF. Nepal Demographic and Health Survey 2022Kathmandu, Nepal: Ministry of Health and Population [Nepal] [Internet]. 2023. Available from: www.DHSprogram.com. Mehata S, Paudel YR, Mehta R, Dariang M, Poudel P, Barnett S. Unmet need for family planning in nepal during the first two years postpartum. Biomed Res Int. 2014;2014. MOHP New ERA and ICF DHS Program. Nepal Demographic and Health Survey 2016 [Internet]. Kathmandu, Nepal; 2017. Available from: file:///D:/MNH at Bheri/Nepal-Demographic-Health-Survey-NDHS-2016-Final-Report.pdf Khatri RB, Poudel S, Ghimire PR. Factors associated with unsafe abortion practices in Nepal: Pooled analysis of the 2011 and 2016 Nepal Demographic and Health Surveys. PLoS One [Internet]. 2019;14(10):1–15. Available from: http://dx.doi.org/10.1371/journal.pone.0223385 Prata N. Making family planning accessible in resource-poor settings. Philos Trans R Soc B Biol Sci. 2009;364(1532):3093–9. Government of Nepal, Ministry of Health and Population, Department of Health Service Kathmandu N. Annual Report. Sedgh G, Hussain R. Reasons for Contraceptive Nonuse among Women Having Unmet Need for Contraception in Developing Countries. Stud Fam Plann. 2014;45(2):151–69. Bhusal CK, Bhattarai S. Factors Affecting Unmet Need of Family Planning Among Married Tharu Women of Dang District, Nepal. Int J Reprod Med. 2018;2018:1–9. Lamichhane K. Unmet Need for Family Planning among Currently Married Young Women in Nepal. J Dev Adm Stud. 2017;25(1–2):83–94. IS P, Budhathoki S. ¡ Original Article Unmet needs for family planning in Sunsari , eastern Nepal. Heal Renaiss. 2011;9(3):148–51. Kandel N. Unmet Need for Contraception and its Associated Factors among Married Women of Reproductive Age in Simichaur VDC of Gulmi District. Heal Prospect. 2012;11(March):11–4. Bhandari GP, Premarajan KC, Jha N, Yadav BK, Paudel IS, Nagesh S. Prevalence and determinants of unmet need for family planning in a district of eastern region of Nepal. Kathmandu Univ Med J. 2006;4 NO. 2(14):203–10. Municipality Madi. Household Survey Report. 2017. Ministry of Health and Population. Nepal Demographic and Health Survey 2006. Kathmandu, Nepal; 2006. Yadav D, Dhillon P. Assessing the impact of family planning advice on unmet need and contraceptive use among currently married women in Uttar Pradesh, India. PLoS One. 2015;10(3):1–16. Mishra SR, Joshi MP, Khanal V. Family planning knowledge and practice among people living with HIV in Nepal. PLoS One. 2014;9(2):1–8. Vohra R, Vohra A, Sharma S, Rathore M, Sharma B, Sharma M. Determinants of the unmet need for family planning among women of Jaipur, Rajasthan. Int J Adv Med Heal Res. 2014;1(1):20. Shah R, Rehfuess EA, Maskey MK, Fischer R, Bhandari PB, Delius M. Factors affecting institutional delivery in rural Chitwan district of Nepal : a community-based cross-sectional study. 2015;1–14. Igwegbe O, Ugboaja O, Monago N. Prevalence and determinants of unmet need for family planning in Nnewi , south-east Nigeria. Int J Med Med Sci. 2009;1(8):325–9. Sharan M, Valente TW. Spousal communication and family planning adoption: Effects of a radio drama serial in Nepal. Int Fam Plan Perspect. 2002;28(1):16–25. Pokharel R, Bhattarai G, Shrestha N, Onta S. Knowledge and utilization of family planning methods among people living with HIV in Kathmandu, Nepal. BMC Health Serv Res. 2018;18(1):1–12. Hameed W, Azmat SK, Ali M, Sheikh MI, Abbas G, Temmerman M, et al. Women’s empowerment and contraceptive use: The role of independent versus couples’ decision-making, from a lower middle income country perspective. PLoS One. 2014;9(8). Paudel YR, Acharya K. Fertility limiting intention and contraceptive use among currently married men in nepal: Evidence from Nepal demographic and health survey 2016. Biomed Res Int. 2018;2018. Antenane K. Planning and Reasons for Nonuse among Women with Unmet Need for Family Planning in Ethiopia. Calverton, Maryland USA: ORC Macro. 2002. Letamo G, Navaneetham K. Levels, trends and reasons for unmet need for family planning among married women in Botswana: A cross-sectional study. BMJ Open. 2015;5(3):1–11. Oye-Adeniran BA, Adewole IF, Umoh A V., Oladokun A, Ghadegsin A, Ekanem EE, et al. Community-based study of contraceptive behaviour in Nigeria. Afr J Reprod Health. 2006;10(2):90–104. Ajong AB, Njotang PN, Yakum MN, Essi MJ, Essiben F, Eko FE, et al. Determinants of unmet need for family planning among women in Urban Cameroon: A cross sectional survey in the Biyem-Assi Health District, Yaoundé. BMC Womens Health [Internet]. 2016;16(1):1–8. Available from: http://dx.doi.org/10.1186/s12905-016-0283-9 Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:1–8. Thapa N, Paudel M, Guragain AM, Thapa P, Puri R, Thapa P, et al. Status of migration and socio-reproductive impacts on migrants and their families left behind in Nepal. Migr Dev [Internet]. 2019;8(3):394–417. Available from: https://doi.org/10.1080/21632324.2019.1567097 Ban B, Karki S, Shrestha A, Hodgins S. Spousal separation and interpretation of contraceptive use and unmet need in Rural Nepal. Int Perspect Sex Reprod Health. 2012;38(1):43–7. Bam K, Thapa R, Newman MS, Bhatt LP, Bhatta SK. Sexual Behavior and Condom Use among Seasonal Dalit Migrant Laborers to India from Far West, Nepal: A Qualitative Study. PLoS One. 2013;8(9):1–10. Nepal Family Health Program II and New ERA. Family Planning, Maternal, Newborn and Child Health Situation in Rural Nepal: A Mid-term Survey for NFHP II. Kathmandu, Nepal: Nepal Family Health Program II and New ERA. 2010. Mehata S, Paudel YR, Dhungel A, Paudel M, Thapa J, Karki DK. Spousal Separation and Use of and Unmet Need for Contraception in Nepal: Results Based on a 2016 Survey. Sci World J. 2020;2020. Uprety S, Khatri R, Baral SC RS. Access to family planning services by Muslim communities in Nepal: Barriers and evidence gaps. Access to family planning services by migrant couples in Nepal: barriers and evidence gaps. A review of the literature. HERD International and Mott MacDonald. 2016. Cynthia F. Spousal communication and contraceptive use in rural Nepal: An event history analysis. Stud Fam Plann. 2011;42(2):83–92. Genet E, Abeje G, Ejigu T. Determinants of unmet need for family planning among currently married women in Dangila town administration, Awi Zone, Amhara regional state; A cross sectional study. Reprod Health [Internet]. 2015;12(1):1–5. Available from: https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-015-0038-3 Najafi-Sharjabad F, Zainiyah Syed Yahya S, Abdul Rahman H, Hanafiah Juni M, Abdul Manaf R. Barriers of modern contraceptive practices among Asian women: a mini literature review. Glob J Health Sci. 2013;5(5):181–92. Mosha I, Ruben R, Kakoko D. Family planning decisions, perceptions and gender dynamics among couples in Mwanza, Tanzania: A qualitative study. BMC Public Health. 2013;13(1). Duressa LT, Getahun A, Regassa T, Babure ZK, Tegegne Bidu K. Unmet Need for Family Planning and Related Factors among Currently Married Women in Sibu Sire District, 2016. J Women’s Heal Care. 2018;07(05):1–14. Nzokirishaka A, Itua I. Determinants of unmet need for family planning among married women of reproductive age in Burundi: a cross-sectional study. Contracept Reprod Med. 2018;3(1):1–13. Wulifan JK, Brenner S, Jahn A, De Allegri M. A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries. BMC Womens Health [Internet]. 2016;16(1). Available from: http://dx.doi.org/10.1186/s12905-015-0281-3 Khanal V, Joshi C, Neupane D, Karkee R. Practices and perceptions on contraception acceptance among clients availing safe abortion services in Nepal. Kathmandu Univ Med J. 2011;9(35):179–84. Otoide BVO, Oronsaye F OF. Why Nigerian Adolescents Seek Abortion. Int Fam Plan Perspect. 2001;27(2):77–81. Lauro D. Abortion and contraceptive use in sub-Saharan Africa: how women plan their families. Afr J Reprod Heal. 2011;March (1): Sedgh G, Ashford LS, Hussain R. Unmet need for contraception in developing countries: Examining women’s reasons for not using a method [Internet]. Guttmacher Institute. 2016. Available from: https://www.guttmacher.org/sites/default/files/report_pdf/unmet-need-for-contraception-in-developing-countries-report.pdf Pratap SKC, Adhikari B, Pandey AR, Pandey M, Kakchapati S, Giri S, et al. Unmet need for family planning and associated factors among currently married women in Nepal: A further analysis of Nepal Demographic and Health Survey—2022. PLoS One [Internet]. 2024;19(5 May):1–14. Available from: http://dx.doi.org/10.1371/journal.pone.0303634 Ministry of Health and Population (MOHP)MOHP/Nepal, New ERA/Nepal, ICF International . Nepal Demographic and Health Survey [Internet]. 2011. Available from: https://dhsprogram.com/publications/publication-fr257-dhs-final-reports.cfm Additional Declarations No competing interests reported. Supplementary Files S1QuestionnaireinEnglish.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4997097","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":348293633,"identity":"6a0bacaa-8484-4728-9a8e-0e4151f21513","order_by":0,"name":"Rochana Ghimire","email":"","orcid":"","institution":"Shree Medical and Technical College","correspondingAuthor":false,"prefix":"","firstName":"Rochana","middleName":"","lastName":"Ghimire","suffix":""},{"id":348293634,"identity":"a4998efa-1097-4e37-9106-96607e0f20a7","order_by":1,"name":"Rajani Shah","email":"","orcid":"","institution":"Nepal Public Health Foundation","correspondingAuthor":false,"prefix":"","firstName":"Rajani","middleName":"","lastName":"Shah","suffix":""},{"id":348293635,"identity":"e5d91543-858c-404f-b27e-017a13b9d493","order_by":2,"name":"Yojana Baral","email":"","orcid":"","institution":"Shree Medical and Technical College","correspondingAuthor":false,"prefix":"","firstName":"Yojana","middleName":"","lastName":"Baral","suffix":""},{"id":348293636,"identity":"3a64d157-d11f-4b11-8e32-04e3561fcf58","order_by":3,"name":"Dinesh Kumar Malla","email":"","orcid":"","institution":"Birendra Multiple Campus, Tribhuvan University","correspondingAuthor":false,"prefix":"","firstName":"Dinesh","middleName":"Kumar","lastName":"Malla","suffix":""},{"id":348293638,"identity":"956fc54d-62d9-4135-b640-5cabd6fe094f","order_by":4,"name":"Kanchan Thapa","email":"data:image/png;base64,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","orcid":"","institution":"Noble Shivapuri Research Institute","correspondingAuthor":true,"prefix":"","firstName":"Kanchan","middleName":"","lastName":"Thapa","suffix":""}],"badges":[],"createdAt":"2024-08-29 10:59:25","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4997097/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4997097/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":87160204,"identity":"90d3a954-a805-4790-8add-549324245701","added_by":"auto","created_at":"2025-07-21 04:31:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1264311,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4997097/v1/01e27623-061e-4156-a46a-ceb1347fccfc.pdf"},{"id":65561401,"identity":"d89a35ea-76e3-4049-a3e8-d1b406c13f10","added_by":"auto","created_at":"2024-09-30 04:05:13","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":32634,"visible":true,"origin":"","legend":"","description":"","filename":"S1QuestionnaireinEnglish.docx","url":"https://assets-eu.researchsquare.com/files/rs-4997097/v1/8ccce4c5d03340df4a91f090.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Association of Socio-demographic and Decision Making Factors with the unmet need of family planning among Married Women in Madi Municipality, Chitwan, Nepal","fulltext":[{"header":"Background","content":"\u003cp\u003eSustainable Development Goal (SDG) of Nepal has focused on ensuring healthy lives and promoting well-being for all age groups. One of the targets of the SDGs of Nepal is ensuring universal access to sexual and reproductive health care services, including family planning (FP). It aims to increase the contraceptive prevalence rate (CPR) to 75% by 2030(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Globally, the CPR is 76%, and the prevalence of unmet need is 10%(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), while in Nepal, a larger unmet need of 21% exists when CPR is 53%(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Nepal aims to achieve 74% of women aged 15\u0026ndash;49 years having their family planning needs met by modern methods by 2022, with this target increasing to 80% by 2030. This aligns with Sustainable Development Goal (SDG) target 3.7.1(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Women with an unmet need for FP are those who are not currently using any contraceptive method but want to postpone childbirth for at least two years(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In Nepal, the unmet need declined by only 7% in a decade, from 28% in 2011 to 21% in 2022(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Unwanted pregnancy is associated with higher unsafe abortion(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere are various ongoing efforts to address the unmet need of family planning. Both, government and private sector is working to make family planning accessible(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The government of Nepal is providing short-acting reversible contraceptive methods (male condoms, oral pills, and injectable) through primary health care centres (PHCCs), health posts and primary health care outreach clinics. Long-acting reversible contraceptive methods such as Intra Uterine Contraceptive Device (IUCD) and Implant are available in hospitals, PHCCs, and health posts through trained and skilled providers. Similarly, male and female sterilization are usually performed in mobile camps and hospitals. Clinics/centres, private hospitals/clinics, and pharmacies run by nongovernmental organizations are also providing quality FP services. Female community health volunteers (FCHVs) are responsible for raising awareness in the community regarding FP as well as distributing male condoms and oral contraceptive pills(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Despite the availability of FP services, the CPR for the modern FP method has remained stagnant (43%) since 2006, and a significant proportion of unmet needs exists(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe underlying reasons for the non-use of contraception among women with an unmet need for FP are a lack of awareness regarding the details of specific methods of contraception and the concept of fertility control, fear of side effects or health risks and the inconvenience of using contraceptives(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe unmet need for FP among married women is influenced by several factors, such as their age, caste/ethnicity, place of residence, education, occupation, education and occupation of husband, number of living children, number of living sons, approval of husband and spousal communication (\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eUnlike previous studies on the unmet need for FP in Nepal(\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), this study was conducted in a semi urban setting of a newly formed municipality. There are a limited number of unmet need studies conducted in Nepal(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan additionalcitationids=\"CR12 CR13 CR14\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). This study aimed to identify the socio-demographic and decision-making-related factors influencing the unmet need for FP among married women of reproductive age (MWRA).\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy area\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThis study was conducted in\u0026nbsp;the\u0026nbsp;Madi Municipality of Chitwan District. In Chitwan, in addition to\u0026nbsp;two\u0026nbsp;pre-existing municipalities, village development committees were merged,\u0026nbsp;and five new municipalities were gradually formed,\u0026nbsp;including Madi. Madi was declared a municipality with 9 wards in 2014. It has nine public health facilities,\u0026nbsp;including one hospital, three health posts, one community health care unit, and four urban health care centers. FP service is available at all the health facilities as well as from\u0026nbsp;an\u0026nbsp;FCHV of the respective ward. According to the record of household survey conducted by the municipality in 2017\u0026nbsp;[\u003cem\u003eLocal Level Publication 2017\u003c/em\u003e], Madi Municipality has a total population of 43,402,\u0026nbsp;of which 12,577 are females of reproductive age (15-49). It comprises a total of 8,649 households inhabiting 37 types of caste/ethnicity groups. The major caste/ethnicity are Brahmin, Chhetri, Chaudhary, Chepang, Damai, Gurung, Tamang, Bote, Magar, Kami and Sarki[13\u0026nbsp;(16).\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eStudy design and study participants\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eThis was\u0026nbsp;a cross-sectional study\u0026nbsp;conducted among MWRA (15-49 years) who were residents of Kalyanpur of Madi Municipality. Among the 12,577 female of reproductive age group we interviewed married women aged 15 to 49 years residing in the municipality(16), willing to participate in the study and provided informed consent.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSampling and sample size\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eA multistage sampling technique was used in the study. Among the newly formed municipalities in Chitwan, Madi was selected purposively, being farthest in distance from Bharatpur \u0026ndash; the district headquarters \u0026ndash; that takes a two-hour drive. A ward was selected randomly using the lottery method. Then, a systematic sampling technique was used to select households for data collection. The selected ward (ward number 7) had a total of 978 households and 1,373 females in the reproductive age group [14]. The sample size for the study was calculated as follows:\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u0026nbsp;\u003cspan class=\"mathinline\"\u003e\\(\\:n=\\frac{{Z}^{2}p\\left(1-p\\right)}{d\u0026sup2;}\\)\u003c/span\u003e\u0026nbsp;\u003c/span\u003e = (1.96)\u003csup\u003e2\u003c/sup\u003e x 0.24 x 0.76/0.06\u003csup\u003e2\u003c/sup\u003e = 195\u003c/p\u003e\u003cp\u003ewhere n is the sample size, Z is the z score (set to 1.96 at\u0026nbsp;the\u0026nbsp;95% confidence level), p is the prevalence of unmet need (24%) and d is the margin of error (6%).\u003c/p\u003e\u003cp\u003eBy considering a\u0026nbsp;nonresponse\u0026nbsp;rate of 10 percent, the final sample size (n)= 215\u003c/p\u003e\u003cp\u003eThen, the sampling interval was calculated as\u0026nbsp;follows:\u003c/p\u003e\u003cp\u003eSampling Interval = total households/sample size = 978/215 = 4.54\u003c/p\u003e\u003cp\u003eEvery fifth house was selected after random selection of a first house. A total of 218 MWRAs were included in the study to cover all the remaining houses in the ward.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eStudy variables\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eDependent variable:\u003c/strong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eThe dependent variable was \u003cstrong\u003e\u0026lsquo;\u003c/strong\u003e\u003cem\u003eUnmet need\u0026nbsp;\u003c/em\u003e\u003cem\u003efor\u003c/em\u003e\u003cem\u003e\u0026nbsp;FP\u0026rsquo;\u003c/em\u003e.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eIndependent variables\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eIndependent variables include the age of the respondent, religion, caste/ethnicity, wealth index, educational status of the respondent, occupation of the respondent, educational status of the husband, occupation of the husband, number of living children, decision-maker, frequency of discussion, and approval of husband.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eOperational Definition\u003c/strong\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eUnmet need\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003efor\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;FP\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eFecund women who desired\u0026nbsp;to postpone birth for two or more years or stop\u0026nbsp;childbearing\u0026nbsp;altogether but were not currently using a contraceptive method, as well as pregnant women whose current pregnancy was unwanted/mistimed, were considered to have\u0026nbsp;an\u0026nbsp;unmet need\u0026nbsp;for\u0026nbsp;FP.\u0026nbsp;The unmet need was categorized as \u0026lsquo;Yes\u0026rsquo; (coded 1) and \u0026lsquo;No\u0026rsquo; (coded 0)(17)(4).\u003c/p\u003e\u003cp\u003e\u003cem\u003e(1) Age of respondent:\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eCompleted years of life of respondent. It was classified into three categories:\u0026nbsp;\u0026lsquo;\u0026le;24 years\u0026rsquo;, \u0026lsquo;25-34 years\u0026rsquo; and \u0026lsquo;35 years \u0026amp; above\u0026rsquo;(18).\u003c/p\u003e\u003cp\u003e\u003cem\u003e(2) Religion:\u003c/em\u003e Religion followed by the respondents. It was classified into two categories: \u0026lsquo;Hindu\u0026rsquo; and \u0026lsquo;Non-Hindu\u0026rsquo; (Buddhist, Christian, and Muslim) (19)(20).\u003c/p\u003e\u003cp\u003e\u003cem\u003e(3) Caste/ethnicity\u003c/em\u003e:\u0026nbsp;This\u0026nbsp;was categorized as \u0026lsquo;Advantaged caste/ethnicity\u0026rsquo; and \u0026lsquo;Disadvantaged caste/ethnicity\u0026rsquo;. So-called upper caste group, i.e., Brahmin \u0026amp; Chhetri and relatively advantaged Janajati were classified as \u0026lsquo;Advantaged caste/ethnicity\u0026rsquo;,\u0026nbsp;whereas Dalits and Disadvantaged Janajati were classified as \u0026lsquo;Disadvantaged caste/ethnicity\u0026rsquo;[13, 17].\u003c/p\u003e\u003cp\u003e\u003cem\u003e(4) Wealth index:\u0026nbsp;\u003c/em\u003eA wealth index was created using a principal component analysis of a number of household assets. It was classified into \u0026lsquo;Poor\u0026rsquo; and \u0026lsquo;Rich\u0026rsquo;. Household assets were considered for calculation of wealth index as adopted by Shah R, et al(21).\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cem\u003e(5) Educational status\u003c/em\u003e refers to completed years of schooling of the respondents and their husbands. It was measured in three categories \u0026ndash; \u0026lsquo;no schooling\u0026rsquo;, \u0026lsquo;primary education\u0026rsquo;, \u0026lsquo;secondary education\u0026rsquo; and \u0026lsquo;postsecondary or higher education\u0026rsquo;. Respondents who had completed any grades from 1 to 5 were classified as having \u0026lsquo;primary education\u0026rsquo;, respondents who had completed 9\u003csup\u003eth\u003c/sup\u003e grade up to 12th grade were classified as having \u0026lsquo;secondary education\u0026rsquo;, and respondents with any completed education higher than 12th grade were classified as having \u0026lsquo;postsecondary or higher education\u0026rsquo;(6).\u003c/p\u003e\u003cp\u003e\u003cem\u003e(6) Occupation of respondent\u003c/em\u003e: Occupation of the respondent at the time of data collection was classified into three categories: \u0026lsquo;Housewife\u0026rsquo;, \u0026lsquo;Agriculture\u0026rsquo; and \u0026lsquo;Employed within country\u0026rsquo;\u0026nbsp;(service/labor/business)\u0026rsquo;(22)(23).\u003c/p\u003e\u003cp\u003e\u003cem\u003e(7) Occupation of husband\u003cstrong\u003e:\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eOccupation of the respondent\u0026rsquo;s husband at the time of data collection. It was classified into three categories: \u0026lsquo;Agriculture\u0026rsquo;, \u0026lsquo;Foreign employment\u0026rsquo;, and \u0026lsquo;Employed within country\u0026rsquo;\u0026nbsp;(Service/Business/Labor)\u0026nbsp;(22)(23).\u003c/p\u003e\u003cp\u003e\u003cem\u003e(8) Number of living children\u003c/em\u003e: The number of living children of the respondents. It was classified as \u0026lsquo;No child\u0026rsquo;, \u0026lsquo;Up to 2 children\u0026rsquo;,\u0026nbsp;or\u0026nbsp;\u0026lsquo;3\u0026nbsp;or\u0026nbsp;more children\u0026rsquo;(24).\u003c/p\u003e\u003cp\u003e\u003cem\u003e(9) Decision maker\u003c/em\u003e: The individual who makes\u0026nbsp;decisions\u0026nbsp;regarding the use of\u0026nbsp;the\u0026nbsp;FP method. It was categorized as \u0026lsquo;By woman herself\u0026rsquo; and \u0026lsquo;Husband and wife jointly\u0026rsquo;(25)(26).\u003c/p\u003e\u003cp\u003e\u003cem\u003e(10)\u0026nbsp;\u003c/em\u003e\u003cem\u003eFrequency of discussion:\u003c/em\u003e This variable assessed the number of discussions on FP that a couple had regarding family planning. It was measured as \u0026lsquo;Never\u0026rsquo;, \u0026lsquo;Once or twice\u0026rsquo; and \u0026lsquo;Three or more times\u0026rsquo;(27)\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003cem\u003e(11) Approval of husband:\u003c/em\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe variable assessed perceived approval of husband for using contraceptives.\u0026nbsp;The response was categorized as \u0026lsquo;Approves\u0026rsquo; and \u0026lsquo;Disapproves\u0026rsquo;.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eData collection procedure\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eData\u0026nbsp;were\u0026nbsp;collected from June 30 to July 20, 2019.\u0026nbsp;Data\u0026nbsp;were\u0026nbsp;collected using a structured questionnaire\u0026nbsp;that\u0026nbsp;was developed from relevant literature\u0026nbsp;(3)(18)(27)(28)\u0026nbsp;in\u0026nbsp;the\u0026nbsp;local Nepali language. The English version of questionnaire is available at [\u003cem\u003eSupplementary file- S1\u003c/em\u003e]. The questionnaire was pretested in a similar setting of another municipality (Kalika municipality) in Chitwan. The questionnaire was then customized based on\u0026nbsp;the\u0026nbsp;findings of the\u0026nbsp;pretesting,\u0026nbsp;which included the addition of\u0026nbsp;a\u0026nbsp;\u0026lsquo;skip\u0026rsquo; label, deletion of vague words, and\u0026nbsp;\u0026lsquo;reordering\u0026rsquo;\u0026nbsp;the questions to make it friendly to both\u0026nbsp;the\u0026nbsp;data collector and respondents. The final questionnaire consisted of variables related to socio-demographic characteristics, knowledge and practice of FP, and decision-making.\u003c/p\u003e\u003cp\u003eData were collected through face-to-face interviews by visiting women at their homes. \u0026nbsp;A brief overview of the objectives of the present study was provided prior to the data collection among the women. The first house was selected by taking the community school as a landmark (29). A direction was randomly chosen by tossing a pen and following the direction of the point of the pen(30). Then, every fifth house was chosen until the required sample size was met. Additionally, two more eligible women were included from the remaining houses following the same procedure. Any fifth house where there was no eligible woman or was not available, the house just next to that was chosen as a sample, and then the next fifth house was selected. If there was more than one eligible woman in a house, one was randomly selected using the lottery method for interviews. Data were collected by the first (RG- BPH Student) and third author (YR- BPH Student) themselves.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eData processing and analysis\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eThe data\u0026nbsp;were\u0026nbsp;entered and analysed using SPSS version 20 software.\u0026nbsp;The frequency\u0026nbsp;and percentage of data were calculated in descriptive analysis. Pearson\u0026rsquo;s\u0026nbsp;chi-square test was used to assess\u0026nbsp;the\u0026nbsp;statistically significant association of the independent and dependent variables. Multicollinearity between independent variables was checked using variation inflation factor (VIF), taking the highest VIF value \u0026gt;3 into account (REF 1). The VIF value for any of the independent variables was not found \u0026gt;3. The variables that were significant at P value \u0026le;0.1 were entered in multivariable analysis to ensure that potential predictors are included in the multivariable analysis(31).\u0026nbsp;A\u0026nbsp;P value \u0026lt;0.05 was considered to indicate statistical significance in multivariable analysis.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eEthical\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003econsiderations\u003c/strong\u003e\u003c/p\u003e\u003cp\u003eEthical approval for the study was obtained from the Institutional Review Committee (IRC) of Shree Medical \u0026amp; Technical College (SMTC), Bharatpur, Chitwan (SMTC-IRC-2020720-2). Written informed consent was obtained from the respondents before initiating the interview using an informed consent form. Voluntary participation of the respondents was ensured throughout the study. The information collected was kept confidential and was used for research purposes only.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eIn this study, we found that most women who were in fecund reported their status themselves. Among the seven pregnant women found during the survey, two had unwanted pregnancies. We interviewed 218 eligible women and overall unmet need for family planning is found to be 38%. All the women who we met provided consent for the data collection.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSocio-demographic\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;characteristics and relationship with unmet need of family planning of the respondents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNearly half of the respondents (47%) were\u0026nbsp;aged\u0026nbsp;25-34 years, and 58% of the respondents were living in nuclear\u0026nbsp;families. Approximately\u0026nbsp;three-quarters\u0026nbsp;(76%) of the respondents belonged to advantaged ethnic\u0026nbsp;groups, and\u0026nbsp;approximately\u0026nbsp;9 out of 10 were Hindus.\u0026nbsp;The majority\u0026nbsp;of the respondents (67%) and their husbands (75%) were educated at least to secondary\u0026nbsp;and\u0026nbsp;higher\u0026nbsp;levels. The majority\u0026nbsp;of women (59%) and their husbands (44%) were involved in agriculture and foreign employment,\u0026nbsp;respectively. Two-thirds\u0026nbsp;of the respondents had up to two children (Table 1). Among socio-demographic variables, husband\u0026rsquo;s occupation (p\u0026lt;0.001) showed a strong association in Pearson\u0026rsquo;s Chi-square test with unmet need\u0026nbsp;for\u0026nbsp;FP. Furthermore, spousal discussion on FP (p=0.025) and approval of husband (p=0.034) were also significantly associated\u003cs\u003e.\u0026nbsp;\u003c/s\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003eSocio-demographic characteristics and association with unmet need\u0026nbsp;for\u0026nbsp;FP\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e(n=218)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal *\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 218px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnmet need\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYes\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge of respondent (Years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u0026pound; 24\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e51 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e30 (58.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e21 (41.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.517\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e25-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e102 (46.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e61 (59.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e41 40.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e35 \u0026amp; above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e65 (29.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e44 (67.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e21 (32.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eHindu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e195 (89.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e121 (62.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e74 (37.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.921\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eNon-Hindu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e23 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e14 (60.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e9 (39.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCaste\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eAdvantaged\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e166 (76.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e101 (60.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e74 (37.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.556\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eDisadvantaged\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e52 (41.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e34 (65.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e18 (34.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation of respondent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eNo schooling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e39 (17.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e28 (71.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e11 (28.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.338\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003ePrimary\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e32 (14.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e18 (56.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e14 (43.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eSecondary /higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e147 (67.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e89 (60.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e58 (39.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation of husband\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eNo schooling\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e13 (6.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e7 (53.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e6 (46.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.807\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e14 (18.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e25 (61)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e16 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eSecondary/higher\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e164 (75.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e103 (62.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e61 (37.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of respondent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eHousewife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e59 (27.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e36 (61.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e23 (39.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.531\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eAgriculture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e128 (58.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e77 (60.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e51 (39.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eEmployed within country\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e31 (14.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e22 (71.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e9 (29.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of husband\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eAgriculture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e59 (27.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e47 (79.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e12 (20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eForeign employment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e95 (43.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e38 (40.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e57 (60.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eEmployed within country\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e64 (29.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e50 (78.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e14 (21.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of living children\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eNo child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e19 (8.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e16 (84.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e3 (15.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eUp to 2 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e143 (65.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e84 (54.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e59 (41.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.099\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e3 \u0026amp; more children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e56 (25.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e35 (62.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e21 (37.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWealth Index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003ePoorer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e109 (50.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e74 (67.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e35 (32.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eBetter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e109 (50.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e61 (56.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e48 (44.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDecision maker on FP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eBy women herself\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e29 (13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e16 (55.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e13 (44.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.421\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eHusband and wife jointly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e189 (86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e119 (63.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e70 (37.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpousal discussion on FP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e36 (16.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e16 (44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e20 (55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eOnce or twice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e52 (23.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e30 (57.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e22 (42.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eMore often\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e130 (59.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e89 (68.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e41 (31.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\" style=\"width: 624px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eApproval of husband\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eApproves\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e198 (90.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e127 (64.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e71 (35.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 152px;\"\u003e\n \u003cp\u003eDisapproves\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 184px;\"\u003e\n \u003cp\u003e20 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 117px;\"\u003e\n \u003cp\u003e8 (40.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003e12 (60.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e*Yields column % equals to 100 **P value from Pearson\u0026nbsp;\u003c/em\u003e\u003cem\u003echi\u003c/em\u003e\u003cem\u003e-square test,\u003c/em\u003e Family Planning- FP \u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge and practice of FP\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDepo-Provera was the most commonly (91%) heard FP method. Most of the respondents had\u0026nbsp;knowledge\u0026nbsp;about FP methods from health\u0026nbsp;posts\u0026nbsp;(60%) and FCHV (34%).\u0026nbsp;Approximately\u0026nbsp;half of the respondents (51%) used\u0026nbsp;the\u0026nbsp;FP method. Among the current users, 84% were using modern methods, while the remaining (16%) were following traditional methods of FP. Nearly 37% of the users had permanent FP,\u0026nbsp;including vasectomy (31.3%) and Minilap (5.4%). Among\u0026nbsp;nonusers, approximately\u0026nbsp;62% of the respondents reported husbands being abroad as a major reason for not using any FP methods (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u0026nbsp;\u003c/strong\u003eKnowledge and practice of FP (n=218)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"546\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercent\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHeard method of FP*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eDepo-Provera\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e199\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e91.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003ePills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e87.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eCondom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e74.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eImplant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e58.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eVasectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e50.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eMinilap\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e50.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eIUCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e50.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eWithdrawal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eCalendar method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource of knowledge on FP*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eHealth post\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e60.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eNeighbors/Friends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e37.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eFCHVs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e33.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eNewspaper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e16.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eRadio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e10.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eTeachers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e7.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eTelevision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eInternet\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eFamily member\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eTraining\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCurrent status of FP use\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e51.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCurrently used FP method\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eVasectomy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e31.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003ePills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e20.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eWithdrawal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e14.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eDepo-Provera\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e12.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eCondom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eMini lap\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e5.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eImplant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eIUCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eCalendar method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReasons for not using FP method*(#=106)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eHusband away\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e61.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eBreast feeding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e15.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eDesire of child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eRare sex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003eFear of side-effects\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e8.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43.0403%;\"\u003e\n \u003cp\u003ePoor health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.022%;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28.9377%;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*\u003cem\u003eMultiple response, Female community health volunteers- FCHVs, Intrauterine contraceptive device- IUCD\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults of multivariable logistic regression analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf the five variables included in multivariable logistic regression analysis, only three variables had\u0026nbsp;a\u0026nbsp;statistically significant association with unmet need\u0026nbsp;for\u0026nbsp;FP. The respondents whose husbands were involved in foreign employment were 4 times [aOR: 4.408; CI:\u0026nbsp;2.068-9.399] more likely to have unmet\u0026nbsp;needs\u0026nbsp;than those employed within\u0026nbsp;the\u0026nbsp;country. The\u0026nbsp;couples\u0026nbsp;who had no discussion on FP were 3 times\u0026nbsp;[aOR: 3.212; CI:\u0026nbsp;1.368-8.135]\u0026nbsp;more likely to have unmet\u0026nbsp;needs\u0026nbsp;than\u0026nbsp;those\u0026nbsp;who discussed three or more times. Similarly, women who had 3\u0026nbsp;or\u0026nbsp;more children\u0026nbsp;[aOR: 8.758; CI:\u0026nbsp;1.691-45.355] or up to 2 children\u0026nbsp;[aOR: 5.212; CI:\u0026nbsp;1.163-23.363]\u0026nbsp;were more likely to have unmet\u0026nbsp;needs\u0026nbsp;than women\u0026nbsp;with\u0026nbsp;no\u0026nbsp;children\u0026nbsp;(Table 3).\u003cstrong\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003eMultivariable logistic regression analysis (n=218)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"898\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnadjusted OR (95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value (Crude)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdjusted OR\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(95% CI)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP- value (adjusted)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 898px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation of husband\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 261px;\"\u003e\n \u003cp\u003eEmployed within country\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 175px;\"\u003e\n \u003cp\u003e\u0026nbsp;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eForeign employment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u0026nbsp;5.357 (2.605-11.01)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e4.408 (2.068-9.399)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eAgriculture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.912 (0.383-2.172)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.835\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.640 (0.248-1.650)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e0.355\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 898px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSpousal discussion on FP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eThree or more times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u0026nbsp;2.713 (1.276-5.769)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e3.212 (1.368-8.135)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eOnce or twice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u0026nbsp;1.592 (0.820-3.089)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e1.840 (0.855-3.959)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e0.119\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\" style=\"width: 898px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of living children\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eNo child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u0026nbsp;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eUp to 2 children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e0.313 (0.81-1.201)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e5.212 (1.163-23.363)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003e3 \u0026amp; more children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u0026nbsp;1.17 (0.620-2.21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.627\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e8.758 (1.691-45.355)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWealth Index\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eBetter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u0026nbsp;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003ePoorer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e0.601 (0.346-1.044)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e0.610 (0.318-1.171)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eApproval of husband\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eApproves\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e\u0026nbsp;1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 237px;\"\u003e\n \u003cp\u003eDisapproves\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 199px;\"\u003e\n \u003cp\u003e2.683 (1.048-6.873)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 98px;\"\u003e\n \u003cp\u003e\u0026nbsp;0.040\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 206px;\"\u003e\n \u003cp\u003e2.257 (0.732-6.964)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 157px;\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis cross section study conducted in a newly formed municipality in the Chitwan district, Bagmati province, Nepal, interviewed 218 married women of reproductive age group. It explored various influencing factors for unmet need of family planning, including socio-demographic and decision making factors previously underrepresented in national studies. Unmet need for family planning was found to be 38 percent in this study, exceeding the national average of 21 percent in 2022 Nepal Demographic and Health Survey (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). This survey also indicated provincial disparities ranging from 16 to 28 percent (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), likely attributed to geographic, socio-cultural, socio-economic background throughout the Nepal. Population density, sampling strategies, ethnic group and other reasons could be the factors. Despite of the lower geographical coverage and heterogensou populations with a smaller sample size, we identified husband\u0026rsquo;s absence due to foreign employment, spousal discussion and number of living child significantly affected the unmet need of family planning.\u003c/p\u003e \u003cp\u003eDespite a smaller sample size, we have been able to differentiate various similarities with other study from Nepal and other countries. Three primary factors- foreign employment, lack of spousal discussion, an number of children- emerged as significant influences on unmet need of family planning. As Nepal being labour force exporter for foreign employment(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e), major migrate to India and other countries(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e), seasonally migrated for works, higher among the Dalit(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Thus, couples living separately need to use contraceptives whenever husbands visit home(\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Furthermore, couples living together has lower unmet that than those being separated as stated by national level studies from Nepal (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Less time to prepare about family planning on husband\u0026rsquo;s arrival and communication gap is the factor for unused of it (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Furthermore, conceptive use during the absences of husband was considered as challenges(\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). In this study we could not explore the sexual activity of women due to privacy reason. In present study, we reported discussion about FP is important about the couples. Studies from Nepal showed that communication is important for better use of family planning in rural areas(\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e), joint decision making for contraceptives(\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Consistent findings were reported from studies conducted in Botswana(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), Cameroon(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) and Ethiopia(\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e), mini literature review by \u003cem\u003eFatemeh Najafi-Sharjabad et. Al.\u003c/em\u003e(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e), Tanzania qualitative study(\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). As we reported, male are the major decision makers for family planning(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)(\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). All these collectively emphasize about the importance of discussion between couples.\u003c/p\u003e \u003cp\u003eNumber of the children among the couple was one of the factors in our study which was found consistent with studies from Nepal(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e),(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), Ethiopia(\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e), Burundi(\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). Unmet need of FP is greater among the women with higher number of children(\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e), (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e), (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Women do not use FP as they find their family size complete(\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). Due to the fear factors, women consider abortion as an alternative than contraception(\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e)(\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). Consistently, in sub-Saharan Africa, women chose abortion as a method of limiting family size rather than use of contraception(\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e). Fear of side effects and health concerns among women is the major reason for not using contraceptive in Nepal and around the globe(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)(\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e)(\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e). Most of the non-user reporting fear of side effects have already used contraception and discontinued them(\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWhile our findings align with several aspects of previous research, our study]s focus on newly formed municipality near Bharatpur metropolitan city offers a unique perspectives. Moreover, our findings contrast with those of previous studies in several key areas. As reported by secondary analysis of Nepal Demographic and health survey 2022, the total unmet need is 20.8%(\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) but we reported quite high. Similarly, the same study reported higher difference in urban 67.6 (66.1, 69.0)% Vs rural 32.4 (31.0, 33.9)% areas for unmet need of family planning(\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e). We are here unable to differentiate between rural urban difference, however we claim the areas is semi-urban in nature. We also reported the difference between advantaged castes versus disadvantage caste is low in our study however the same secondary data analysis(\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) shows that difference is high. The main reason for this is the geographical coverage, population composition and socio-economic context, access to the major cities of our study. Adhering to the similar facts, we also observed difference in unmet among the multipara in NDHS(\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) is higher than our study. Furthermore, our study identified several discrepancies compared to previous research. A critical review of multiple rounds of Nepal's health survey reports(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)(\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e)(\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e) reveals substantial changes in unmet needs and associated factors over time. These similarities and differences may be partly attributed to socio-economic factors.\u003c/p\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eStrengths, Policy implication and Limitations\u003c/h2\u003e \u003cp\u003eThe study has some strengths as well as limitations. It has underlined the factors associated with the unmet need for FP and the reasons behind not using FP methods. Data collection was performed by the first and third authors themselves using a pretested questionnaire prepared in the understandable Nepali language. There are lack of ground level studies in Nepal and in many low and middle income countries. Since Nepal recently transitioned to a federal structure, public health delivery has become a major responsibility of local governments. This study offers valuable policy-level insights by shedding light on the ground realities faced by local authorities. By understanding these realities, local public health leaders can design appropriate policy interventions to address unmet needs in family planning. While the study was conducted in a newly developed urban area, the observed lifestyle patterns reflect those of a semi-urban setting. Consequently, the findings provide valuable insights applicable to both newly developed urban and semi-urban areas. The specific needs of couples with husband working abroad and families with two children can be leverage from policy level perspectives.\u003c/p\u003e \u003cp\u003eWith regard to limitations of the study, due to resource and time constraints, the study was limited to only one ward, and the findings may not be generalizable in all places of Nepal. However, the findings might reflect the situation of an unmet need for FP in other similar semi-urban settings. Being a quantitative study, the information might be limited. Being a small-scale study dealing in resource limited semi-urban setting with various socio-cultural issues, we could not explore whether the unmet need is for spacing or limiting. Similarly, we only relied on a small sample size in a ward of the municipality of semi-urban areas. Due to the relatively small sample size of 218, we were unable to employ advanced statistical modelling for exploring the relationships between predictor variables. Increasing the sample size would enhance the generalizability of family planning findings to broader populations, enabling the application of more sophisticated statistical models. Given Nepal's predominantly patriarchal society, like breastfeeding mothers, women living single or those whose sexual partner, exploring the decision-making process surrounding family planning was crucial. Furthermore, understanding who holds primary decision-making authority is vital and warrants further investigation through studies employing a gender lens. Furthermore, due to privacy reasons, we could not explore the sexual activities of migrants\u0026rsquo; wives. Therefore, a more comprehensive study exploring more qualitative information is needed.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eA high prevalence of unmet family planning (FP) needs was identified among married women in this study. Factors contributing to this included husbands working abroad, lack of communication about FP within couples, and families with three or more children. These findings inform policymakers to design targeted family planning based strategies. Interventions should focus on couples with migrant husbands by providing services during home visits and facilitating communication. Women empowerment and involvement of them in active discussion should be promoted through health education to couples. Additionally, programs should address concerns and raise awareness about additional childbearing for families with two children. Furthermore, the study emphasizes the importance of managing contraceptive side effects, promoting spousal discussions on FP, and empowering women in decision-making to address unmet needs and improve reproductive health outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\" width=\"392\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.2755%;\"\u003e\n \u003cp\u003eaOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.7245%;\"\u003e\n \u003cp\u003eAdjusted odds ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.2755%;\"\u003e\n \u003cp\u003eCPR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.7245%;\"\u003e\n \u003cp\u003eContraceptive prevalence rate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.2755%;\"\u003e\n \u003cp\u003eFCHV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.7245%;\"\u003e\n \u003cp\u003eFemale community health volunteer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.2755%;\"\u003e\n \u003cp\u003eFP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.7245%;\"\u003e\n \u003cp\u003eFamily Planning\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.2755%;\"\u003e\n \u003cp\u003eIRC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.7245%;\"\u003e\n \u003cp\u003eInstitutional review committee\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.2755%;\"\u003e\n \u003cp\u003eIUCD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.7245%;\"\u003e\n \u003cp\u003eIntrauterine contraceptive device\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 26.2755%;\"\u003e\n \u003cp\u003eMWRA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73.7245%;\"\u003e\n \u003cp\u003eMarried women of reproductive age\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank Shree Medical and Technical College as well as Madi Municipality for their support during the study period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the data associated with this study will be available freely upon request with the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eRG conceptualized the design of the study, prepared tools, collected and analysed data, interpreted results, and drafted the manuscript. RS contributed\u0026nbsp;to\u0026nbsp;the design of the study, development of tools, analysis and interpretation of data, review of literature and drafting of the manuscript. YB contributed\u0026nbsp;to\u0026nbsp;the data collection, data analysis, review of literature and drafting of the manuscript. DKM contributed\u0026nbsp;to\u0026nbsp;data analysis, review of literature and drafting of the manuscript. All authors have read and approved the final version of the manuscript. KT finalized the final manuscript, supervision of works, review of literature, data analysis, submission of the manuscript,\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAvailability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData will be available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from\u0026nbsp;the\u0026nbsp;Shree Medical and Technical College-Institutional Review Committee. Written informed consent was obtained from each respondent before data collection. Confidentiality of the information and privacy were maintained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo individual details, images or video in form are included of the respondents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study received no funding for research and publication.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eNational Planning Commission [NPC]. Nepal\u0026rsquo;s Sustainable Development Goals, Baseline Report [Internet]. National Planning Commission. 2017. 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Annual Report. \u003c/li\u003e\n\u003cli\u003eSedgh G, Hussain R. Reasons for Contraceptive Nonuse among Women Having Unmet Need for Contraception in Developing Countries. Stud Fam Plann. 2014;45(2):151\u0026ndash;69. \u003c/li\u003e\n\u003cli\u003eBhusal CK, Bhattarai S. Factors Affecting Unmet Need of Family Planning Among Married Tharu Women of Dang District, Nepal. Int J Reprod Med. 2018;2018:1\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eLamichhane K. Unmet Need for Family Planning among Currently Married Young Women in Nepal. J Dev Adm Stud. 2017;25(1\u0026ndash;2):83\u0026ndash;94. \u003c/li\u003e\n\u003cli\u003eIS P, Budhathoki S. \u0026iexcl; Original Article Unmet needs for family planning in Sunsari , eastern Nepal. Heal Renaiss. 2011;9(3):148\u0026ndash;51. \u003c/li\u003e\n\u003cli\u003eKandel N. Unmet Need for Contraception and its Associated Factors among Married Women of Reproductive Age in Simichaur VDC of Gulmi District. 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Knowledge and utilization of family planning methods among people living with HIV in Kathmandu, Nepal. BMC Health Serv Res. 2018;18(1):1\u0026ndash;12. \u003c/li\u003e\n\u003cli\u003eHameed W, Azmat SK, Ali M, Sheikh MI, Abbas G, Temmerman M, et al. Women\u0026rsquo;s empowerment and contraceptive use: The role of independent versus couples\u0026rsquo; decision-making, from a lower middle income country perspective. PLoS One. 2014;9(8). \u003c/li\u003e\n\u003cli\u003ePaudel YR, Acharya K. Fertility limiting intention and contraceptive use among currently married men in nepal: Evidence from Nepal demographic and health survey 2016. Biomed Res Int. 2018;2018. \u003c/li\u003e\n\u003cli\u003eAntenane K. Planning and Reasons for Nonuse among Women with Unmet Need for Family Planning in Ethiopia. Calverton, Maryland USA: ORC Macro. 2002. \u003c/li\u003e\n\u003cli\u003eLetamo G, Navaneetham K. Levels, trends and reasons for unmet need for family planning among married women in Botswana: A cross-sectional study. BMJ Open. 2015;5(3):1\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eOye-Adeniran BA, Adewole IF, Umoh A V., Oladokun A, Ghadegsin A, Ekanem EE, et al. Community-based study of contraceptive behaviour in Nigeria. Afr J Reprod Health. 2006;10(2):90\u0026ndash;104. \u003c/li\u003e\n\u003cli\u003eAjong AB, Njotang PN, Yakum MN, Essi MJ, Essiben F, Eko FE, et al. Determinants of unmet need for family planning among women in Urban Cameroon: A cross sectional survey in the Biyem-Assi Health District, Yaound\u0026eacute;. BMC Womens Health [Internet]. 2016;16(1):1\u0026ndash;8. Available from: http://dx.doi.org/10.1186/s12905-016-0283-9\u003c/li\u003e\n\u003cli\u003eBursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3:1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eThapa N, Paudel M, Guragain AM, Thapa P, Puri R, Thapa P, et al. Status of migration and socio-reproductive impacts on migrants and their families left behind in Nepal. Migr Dev [Internet]. 2019;8(3):394\u0026ndash;417. Available from: https://doi.org/10.1080/21632324.2019.1567097\u003c/li\u003e\n\u003cli\u003eBan B, Karki S, Shrestha A, Hodgins S. Spousal separation and interpretation of contraceptive use and unmet need in Rural Nepal. Int Perspect Sex Reprod Health. 2012;38(1):43\u0026ndash;7. \u003c/li\u003e\n\u003cli\u003eBam K, Thapa R, Newman MS, Bhatt LP, Bhatta SK. Sexual Behavior and Condom Use among Seasonal Dalit Migrant Laborers to India from Far West, Nepal: A Qualitative Study. PLoS One. 2013;8(9):1\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eNepal Family Health Program II and New ERA. Family Planning, Maternal, Newborn and Child Health Situation in Rural Nepal: A Mid-term Survey for NFHP II. Kathmandu, Nepal: Nepal Family Health Program II and New ERA. 2010. \u003c/li\u003e\n\u003cli\u003eMehata S, Paudel YR, Dhungel A, Paudel M, Thapa J, Karki DK. Spousal Separation and Use of and Unmet Need for Contraception in Nepal: Results Based on a 2016 Survey. Sci World J. 2020;2020. \u003c/li\u003e\n\u003cli\u003eUprety S, Khatri R, Baral SC RS. Access to family planning services by Muslim communities in Nepal: Barriers and evidence gaps. Access to family planning services by migrant couples in Nepal: barriers and evidence gaps. A review of the literature. HERD International and Mott MacDonald. 2016. \u003c/li\u003e\n\u003cli\u003eCynthia F. Spousal communication and contraceptive use in rural Nepal: An event history analysis. Stud Fam Plann. 2011;42(2):83\u0026ndash;92. \u003c/li\u003e\n\u003cli\u003eGenet E, Abeje G, Ejigu T. Determinants of unmet need for family planning among currently married women in Dangila town administration, Awi Zone, Amhara regional state; A cross sectional study. Reprod Health [Internet]. 2015;12(1):1\u0026ndash;5. Available from: https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-015-0038-3\u003c/li\u003e\n\u003cli\u003eNajafi-Sharjabad F, Zainiyah Syed Yahya S, Abdul Rahman H, Hanafiah Juni M, Abdul Manaf R. Barriers of modern contraceptive practices among Asian women: a mini literature review. Glob J Health Sci. 2013;5(5):181\u0026ndash;92. \u003c/li\u003e\n\u003cli\u003eMosha I, Ruben R, Kakoko D. Family planning decisions, perceptions and gender dynamics among couples in Mwanza, Tanzania: A qualitative study. BMC Public Health. 2013;13(1). \u003c/li\u003e\n\u003cli\u003eDuressa LT, Getahun A, Regassa T, Babure ZK, Tegegne Bidu K. Unmet Need for Family Planning and Related Factors among Currently Married Women in Sibu Sire District, 2016. J Women\u0026rsquo;s Heal Care. 2018;07(05):1\u0026ndash;14. \u003c/li\u003e\n\u003cli\u003eNzokirishaka A, Itua I. Determinants of unmet need for family planning among married women of reproductive age in Burundi: a cross-sectional study. Contracept Reprod Med. 2018;3(1):1\u0026ndash;13. \u003c/li\u003e\n\u003cli\u003eWulifan JK, Brenner S, Jahn A, De Allegri M. A scoping review on determinants of unmet need for family planning among women of reproductive age in low and middle income countries. BMC Womens Health [Internet]. 2016;16(1). Available from: http://dx.doi.org/10.1186/s12905-015-0281-3\u003c/li\u003e\n\u003cli\u003eKhanal V, Joshi C, Neupane D, Karkee R. Practices and perceptions on contraception acceptance among clients availing safe abortion services in Nepal. Kathmandu Univ Med J. 2011;9(35):179\u0026ndash;84. \u003c/li\u003e\n\u003cli\u003eOtoide BVO, Oronsaye F OF. Why Nigerian Adolescents Seek Abortion. Int Fam Plan Perspect. 2001;27(2):77\u0026ndash;81. \u003c/li\u003e\n\u003cli\u003eLauro D. Abortion and contraceptive use in sub-Saharan Africa: how women plan their families. Afr J Reprod Heal. 2011;March (1): \u003c/li\u003e\n\u003cli\u003eSedgh G, Ashford LS, Hussain R. Unmet need for contraception in developing countries: Examining women\u0026rsquo;s reasons for not using a method [Internet]. Guttmacher Institute. 2016. Available from: https://www.guttmacher.org/sites/default/files/report_pdf/unmet-need-for-contraception-in-developing-countries-report.pdf\u003c/li\u003e\n\u003cli\u003ePratap SKC, Adhikari B, Pandey AR, Pandey M, Kakchapati S, Giri S, et al. Unmet need for family planning and associated factors among currently married women in Nepal: A further analysis of Nepal Demographic and Health Survey\u0026mdash;2022. PLoS One [Internet]. 2024;19(5 May):1\u0026ndash;14. Available from: http://dx.doi.org/10.1371/journal.pone.0303634\u003c/li\u003e\n\u003cli\u003eMinistry of Health and Population (MOHP)MOHP/Nepal, New ERA/Nepal, ICF International . Nepal Demographic and Health Survey [Internet]. 2011. Available from: https://dhsprogram.com/publications/publication-fr257-dhs-final-reports.cfm\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Contraception, Cross-sectional, Factors associated, Foreign employment, Nepal, Spousal communication, Unmet need","lastPublishedDoi":"10.21203/rs.3.rs-4997097/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4997097/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSustainable Development Goal of Nepal targets universal access to family planning (FP) services and increasing the contraceptive prevalence rate to 75% by 2030. Despite continuous efforts from the government of Nepal in the FP sector, the prevalence of unmet need for FP is high. This study aimed to identify sociodemographic and decision-making factors associated with the unmet need for FP among married women of reproductive age.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis is a community-based cross-sectional study conducted in Madi municipality, Chitwan, Nepal. Face-to-face interviews were conducted with 218 married women of reproductive age using a semi-structured questionnaire. Descriptive statistics, chi-square tests and multivariable logistic regression were used to analyse the data.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eNearly half (47%) were age group 25\u0026ndash;34, 58% lived in nuclear families, 76% belonged to advantaged ethnic groups, majority of respondents (67%) and their husbands (75%) had at least secondary education. Most women (59%) were involved in agriculture, while most husbands (44%) were in foreign employment. Participants (91.3%) have heard about Depo-Provera. The overall unmet need for FP was 38%. Respondents whose husbands were involved in foreign employment were more likely [aOR: 4.408; CI: 2.068\u0026ndash;9.399] to have an unmet need for FP than those employed within the country. The likelihood of the unmet need was higher [aOR: 3.212; CI: 1.368\u0026ndash;8.135] among couples who did not discuss using FP methods compared to those who discussed three or more times. Women with up to two children [aOR: 5.212; CI: 1.163\u0026ndash;23.363] and three or more children [aOR: 8.758; CI: 1.691\u0026ndash;45.355] were more likely to have a higher unmet need for FP than women without a child.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eA significant proportion of women had an unmet need for FP. Intervention should focus on addressing the FP needs of migrants and their spouses, promoting spousal discussion on FP and counselling on the treatment as well as side effects of contraceptives. Furthermore, empowering women would enable them in the decision-making process and in accessing FP services.\u003c/p\u003e","manuscriptTitle":"Association of Socio-demographic and Decision Making Factors with the unmet need of family planning among Married Women in Madi Municipality, Chitwan, Nepal","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-30 04:05:08","doi":"10.21203/rs.3.rs-4997097/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e1698c54-3566-4867-9ba8-c646889c5073","owner":[],"postedDate":"September 30th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-21T04:23:45+00:00","versionOfRecord":[],"versionCreatedAt":"2024-09-30 04:05:08","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4997097","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4997097","identity":"rs-4997097","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}