Migration and family planning in the state with highest total fertility rate in India
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RESEARCH ARTICLE
Open Access
Migration and family planning in the state with highest total fertility rate in India Bidhubhusan Mahapatra* , Niranjan Saggurti, Raman Mishra, Monika Walia and Saradiya Mukherjee
Abstract Background: This study examined the relationship between male out-migration and family planning (FP) behaviour of women in rural Bihar. Methods: Data was collected from 937 currently married women aged 15–34 years from two districts of Bihar, namely Nawada and Gopalganj. Respondents were selected through a multi-stage systematic sampling and were recruited from both low and high male out-migration blocks. Differences in FP outcomes—use of modern contraceptive methods, intention to use contraceptives in next 12 months and access to FP services—were assessed by volume of migration, husband’s migration status, frequency of return, and duration of husband’s stay at home during visits. Results: Women with migrant husbands were about 50% less likely to use modern contraceptive methods. Further, the odds of using modern contraceptives was about half among women with migrant husbands if they resided in high out-migration areas (HMA) than low out-migration areas (LMA) (15% vs 29%, AOR: 0·50, p = 0·017). A higher proportion of women with migrant husbands, specifically from HMA, reported greater intention of using contraceptives in next 12 months than their counterparts (37% vs 23%, AOR: 1·83, p = 0·015). Similarly, access to FP services was negatively associated with the volume of male out-migration, specifically for women with migrant husbands. Conclusions: The migratory environment as well as the migration of husbands affect contraceptive use and access to FP services among women. Given that a significant proportion of married males leave their home states for work, it is imperative that FP programs in migration affected areas plan and implement migration-centric FP implementation strategies. Keywords: Migration, Family planning, Contraceptive, Bihar
Background India launched its family planning (FP) program in 1952 [1–3], starting with birth control programs and later expanding to include mother and child health, nutrition and family welfare. Since then, several modifications have been made to the program to minimize the growth rate of the ever-increasing population [1]. However, even after more than 60 years of the program, its impact remains non-uniform, and India is yet to achieve the replacement level fertility, and unmet need for * Correspondence: [email protected]; [email protected] Population Council, B86, 2nd Floor, New Delhi 110024, India
contraception remain high [3, 4]. The Government of India in 2012, articulated its commitment to contribute towards an additional 48 million new users of contraceptive by 2020, comprising 40% of the global goal of 120 million [5]. To reach this goal, the required annual rate of increase in modern contraceptive prevalence rate (mCPR) in 2012 was estimated to be almost twice the current growth rate of 1% [5]. Concomitant to the national program, the
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