UP, Bihar numbers encouraging: 8.7% point rise in contraception use in 5 yrs, NFHS data shows

While 30 of 36 states/UTs have shown an increase in contraception use, experts point out that improvement in Uttar Pradesh and Bihar’s numbers have been particularly encouraging, given their large populations. In Bihar, Modern Contraceptive Prevalence Rate has almost doubled: from 23.3% in NFHS-4 to 44.4% in NFHS-5.

“The decrease in fertility is the function of three main factors: use of contraception, increase in age of marriage, and abortions,” Dr Niranjan Saggurti, director, Population Council of India, said. “In Bihar, age of marriage continues to remain low, with 43% girls married under the age of 18 in NFHS 4, which decreased marginally to 41% under the age of 18 in NFHS-5. But what has been successful is increase in modern contraceptive use. This points to push in family planning schemes by the state government. But what is most significant in Bihar’s case is the increase in education, which has translated into increased use of contraception and increased family planning.”

Saggurti points out that for UP, the good news has been that the age of marriage has increased. Twenty-one per cent women under the age of 18 were married, NFHS-4 had found, which has decreased by 5 percentage points in five years — 16 per cent girls under 18 were married in UP, the recent survey reported.

“UP has also shown a very good balanced contraception method mix, with a shift from sterilisation to reversible contraception,” Saggurti said.

In its contraception mix, 40% is now sterilisation and 60% is use of reversible contraceptive methods. In UP, contraception use has increased from 31.7 per cent in 2015-16 to 44.5 per cent in 2019-20. UP has also shown a marginal decrease in female sterilisation of 0.4 per cent. The date show Bihar (21%), Goa (35.3%), Dadra and Nagar Haveli and Daman and Diu (24%), Nagaland (24%) and Arunachal Pradesh (20.6%) have reported the highest increase in contraception use in NFHS-5 over NFHS 4. Rajasthan has also shown a significant increase in contraception use of 9 per cent.

Andhra Pradesh, Karnataka, Telangana, Tamil Nadu, Madhya Pradesh, Maharashtra, Himachal Pradesh, Puducherry, Rajasthan, Chhattisgarh, West Bengal, Haryana and Goa have 60 per cent or more contraception use.

Punjab and Ladakh have reported the highest decrease, while Meghalaya (22.5%) and Manipur (18.2%) have registered the lowest contraception use in the country.

“Data show women want smaller families. While the use of contraception has increased, indicating improving success of India’s family planning programme, women would have even less pregnancies if they had increased access to contraception and increased agency to make decisions,’’ Alok Vajpeyi, head of Knowledge Management at the Population Foundation of India, said.

Prof K. James, director, International Institute for Population Sciences, the Health Ministry’s partner organisation that carried out the survey, said if TFR correction occurs in four states — Bihar, UP, Madhya Pradesh and Rajasthan — it will put India on a definite course correction for population control.

“One of the most important contributing factors for decreasing TFR is the use of modern contraceptive methods,” James said. “Despite the fact that age of marriage of women has not increased significantly in the country, with some states having as much as 30-40 per cent women marrying under the age of 18, family planning programmes are showing results. Once countries attained 60 percent contraceptive use, they reach replacement levels.

“Family planning has been the most enhanced programme… because of continuing concerns of over-population. But what these results have shown is that it can be achieved with increased contraception…”