부산대학교 도서관

Background: Despite six decades of official family planning programme, the use of modern contraceptive method remained low in India. The discontinuation of modern spacing method (DMSM) has also increased from 42.3% in 2005−06 to 43.6% during 2015–16. Discontinuation rate is higher for Injectable (51%), followed by condom (47%), pill (42%) and lowest in IUD (26%). Methods: Data from NFHS-4 (2015–16) comprising of 601,509 households, 699,686 women and a sample of 119,548 episode of modern spacing method was used for the analysis. Multiple decrement life table has used to estimate 12-month discontinuation rate of modern spacing methods (DMSM). Moran's I statistics, Bivariate LISA cluster map has used to understand the spatial correlates and clustering the DMSM. OLS model and impact analysis has used to assess the significant associated covariates with discontinuation. Result: The 12-month DMSM in India is 43.5%; largely due to desire for becoming pregnant and method failure. The high discontinuation rate was observed in most of the southern (62%) and central (46%) regions of India. DMSM has significantly and spatially associated with neighbouring districts of India (Moran's I = 0.47, p-value = 0.00). The prevalence of modern spacing method is negatively associated with discontinuation in the neighbouring districts of India. The unmet need (β = 0.84, 95% CI 0.55–1.14), desire of children (β = 0.26, 95% CI − 0.05–0.57) and female sterilization (β = 0.54, 95% CI 0.14–0.95) were three main contributing factor to DMSM. Conclusion: Districts of high DMSM need programmatic intervention. More attention for counselling to client, health worker outreach to user and better quality care services will stimulate non-user of contraception. Plain language summary: Contraceptive discontinuation is major issue of family planning of India. Without getting proper knowledge of modern spacing method, women facing serious health related issues so that they tend to discontinue their family planning method. We examine the spatial heterogeneity of discontinuation of modern spacing method in 640 district of India. Using secondary data of NFHS-4 (2015–16), we calculated 12-month discontinuation rate of any method and any modern spacing method by reason of discontinuation, also we presented discontinuation pattern by regions of India. To measure the spill over effect and associated factor of discontinuation of modern spacing method, we used OLS model and estimated Impact result. The findings of our study conveys that desire to become pregnant is the leading cause of discontinuation for both any method and any modern spacing method (12.43%), followed by other fertility related reasons and methods relates reason's (4.40%). Method failure, side effect of method and method related reason together accounts 12% of contraceptive discontinuation in India. Very low use of modern spacing method of districts should be given more attention for policy maker and planner to increase the use of modern spacing method. The districts of high discontinuation of modern spacing method need programmatic intervention. More attention for counselling to client, health worker outreach to user and better quality care services will stimulate non-user of contraception. [ABSTRACT FROM AUTHOR]