A mixed methods study on reversible contraceptive use determinants in Bihar, Madhya Pradesh and Rajasthan

A mixed methods study on reversible contraceptive use determinants in Bihar, Madhya Pradesh and Rajasthan | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 12 May 2026 V1 Latest version Share on A mixed methods study on reversible contraceptive use determinants in Bihar, Madhya Pradesh and Rajasthan Authors : Madhu Gupta [email protected] , Saswati Das [email protected] , Aritrik Das [email protected] , Yukti Bhandari 0000-0002-8771-3171 [email protected] , Sanjay Kumar [email protected] , Kiranjit Kaur [email protected] , Pawna Kaushal [email protected] , … Show All … , Neena Singla [email protected] , Rimpi Singla [email protected] , Tarundeep Singh [email protected] , Bharti Joshi [email protected] , Madhur Verma [email protected] , Bimla Upadhyay [email protected] , Shivendra Singh [email protected] , Sreejit E M [email protected] , and Deepa Prasad [email protected] Show Fewer Authors Info & Affiliations https://doi.org/10.22541/authorea.15003062/v1 15 views 8 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Introduction Although India has expanded contraceptive choices, uptake of reversible methods remains low in Bihar, Madhya Pradesh, and Rajasthan. Sociocultural barriers, provider bias, and systemic gaps constrain informed use. This study explored determinants of reversible contraceptive uptake through a mixed-methods approach. Methods A sequential explanatory mixed-methods design was adopted. Quantitative analysis utilized NFHS-5 (2019–21) data on 521,352 currently married women aged 15–49 years, applying multivariable logistic regression to assess determinants of reversible contraceptive use. Subsequently, qualitative inquiry was conducted in selected districts of Bihar, Madhya Pradesh, and Rajasthan through 93 in-depth interviews, 6 focus group discussions, and 9 mystery client assessments (total n = 150). Thematic analysis was guided by grounded theory, and findings were triangulated across methods. Results Quantitative analysis revealed younger age (20–24 years), secondary or higher education, higher wealth quintile, women’s autonomy, exposure to family planning messages, and counseling during pregnancy as significant predictors of reversible contraceptive use. Muslim women were more likely to adopt short-acting reversible methods compared to Hindus, reflecting religious constraints on sterilization. Qualitative findings reinforced these patterns, highlighting myths, misconceptions, son preference, early marriage, limited autonomy, and provider bias as barriers. Service gaps included stockouts, inadequate counseling, and poor privacy, particularly in Bihar and Madhya Pradesh. Facilitators included supportive family members, community outreach, and proactive frontline workers. Discussion Improving reversible contraceptive uptake requires tackling sociocultural barriers, engaging men and family elders, enhancing counseling quality, and ensuring consistent method availability. Integrated community and health-system interventions are essential for equitable family planning access in underserved states. Supplementary Material File (supplementary tables.docx) supplementary tables Download 39.51 KB Information & Authors Information Version history V1 Version 1 12 May 2026 Keywords MATERNITY SERVICES MEDICAL EDUCATION ANTENATAL CARE CONTRACEPTION: METHODS DELIVERY: ASSISTED VAGINAL DELIVERY: PERINEAL CARE EARLY PREGNANCY CLINICAL GUIDELINES BIOINFORMATICS DIAGNOSTIC META-ANALYSIS EPIDEMIOLOGY: INFECTIOUS DISEASES HEALTH SERVICES RESEARCH MEDICAL EDUCATION META-ANALYSIS QUALITATIVE RESEARCH RANDOMISED CONTROLLED TRIALS CARCINOMA OF THE OVARY: BASIC SCIENCE GYNAECOLOGICAL SURGERY: GYNAECOLOGICAL CANCER CARCINOMA OF THE CERVIX: DIAGNOSIS CARCINOMA OF THE ENDOMETRIUM: DIAGNOSIS CARCINOMA OF THE OVARY: DIAGNOSIS CIN: DIAGNOSIS CYTOLOGY: ENDOMETRIAL EPIDEMIOLOGY: GYNAECOLOGICAL CANCER CONTRACEPTION: EPIDEMIOLOGY CONTRACEPTION: METHODS EPIDEMIOLOGY: CONTRACEPTION HEALTH SERVICES RESEARCH QUALITATIVE RESEARCH CARCINOMA OF THE OVARY: BASIC SCIENCE ADENOMYOSIS: BASIC SCIENCE GYNAECOLOGICAL SURGERY: GYNAECOLOGICAL CANCER CARCINOMA OF THE CERVIX: DIAGNOSIS CARCINOMA OF THE ENDOMETRIUM: DIAGNOSIS CARCINOMA OF THE OVARY: DIAGNOSIS CIN: DIAGNOSIS CYTOLOGY: ENDOMETRIAL EPIDEMIOLOGY: GYNAECOLOGICAL CANCER ANTENATAL CARE CONTRACEPTION: METHODS DELIVERY: ASSISTED VAGINAL DELIVERY: PERINEAL CARE EARLY PREGNANCY CLINICAL GUIDELINES MATERNITY SERVICES MEDICAL EDUCATION BIOINFORMATICS DIAGNOSTIC META-ANALYSIS EPIDEMIOLOGY: INFECTIOUS DISEASES HEALTH SERVICES RESEARCH MEDICAL EDUCATION META-ANALYSIS QUALITATIVE RESEARCH RANDOMISED CONTROLLED TRIALS Authors Affiliations Madhu Gupta [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Saswati Das [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Aritrik Das [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Yukti Bhandari 0000-0002-8771-3171 [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Sanjay Kumar [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Kiranjit Kaur [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Pawna Kaushal [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Neena Singla [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Rimpi Singla [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Tarundeep Singh [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Bharti Joshi [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Madhur Verma [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Bimla Upadhyay [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Shivendra Singh [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Sreejit E M [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Deepa Prasad [email protected] Postgraduate Institute of Medical Education and Research, India View all articles by this author Metrics & Citations Metrics Article Usage 15 views 8 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Madhu Gupta, Saswati Das, Aritrik Das, et al. A mixed methods study on reversible contraceptive use determinants in Bihar, Madhya Pradesh and Rajasthan. Authorea . 12 May 2026. DOI: https://doi.org/10.22541/authorea.15003062/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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