Contraceptive Use in India and its Effect on Fertility Levels – A Trend Analysis

Vaidehi Yelamanchili, International Institute for Population Sciences (IIPS)

The National Famiy Welfare Programme in India traditionally sought ‘to promote responsible and planned motherhood through voluntary and free choice of family planning methods best suited to individual acceptors’. In April, 1996 the programme was renamed the Reproductive and Child Health Programme and given a new orientation to meet the health needs of women and children completely. With regard to family planning, the new approach emphasizes the target-free promotion of contraceptive use among eligible couples, the provision to couples of a choice of contraceptive methods (including condoms, oral pills, IUD, and male and female sterilization), and the assurance of high quality care. An important component of the programme is the encouragement of adequate spacing of births, with at least three years between births. In context to the government’s new approach towards family planning, this paper attempts to understand the differentials in the contraceptive method mix in different states of India and how the usage of different contraceptive methods (modern versus traditional, spacing versus permanent) has changed over time (1992-93 to 1998-99) and how the fertility levels have been effected. This study is based on NFHS-1 and NFHS-2 data. According to some studies, India is unique in the extent to which sterilization dominates contraceptive use. The NFHS-1 data showed that 3 out of 4 users of contraception in India are sterilized. Also, the NFHS-1 results indicate substantial demand for temporary methods in India. Through this analysis we aim to study if there is any shift from excessive usage of permanent methods to spacing methods in the period between the two surveys and also to study the shift in fertility levels. Considerable variation in the usage among states exists as health and family welfare programmes in India are implemented mainly at the state level, and so analysis will be done at the state level. From this study it is observed that inspite of government’s efforts the shift from permanent to spacing methods is only marginal. Almost in all states the use of permanent methods of contraception is widespread. This could mean that people hardly practice family planning for spacing and use permanent methods directly after achieving the desired family size. Very few women use modern spacing methods that could help them delay their first births and increase intervals between pregnancies. From this analysis it is evident that irrespective of the level of contraceptive prevalence in a state female methods (permanent and spacing) are most used. Also, there are large interstate variations in contraceptive use.