Inequalities in demand satisfied with modern methods of family planning among women aged 15–49 years: a secondary data analysis of Demographic and Health Surveys of six South Asian countries
Objective To estimate educational and wealth inequalities in demand satisfied with modern methods of family planning (mDFPS).Design A secondary data analyses of Demographic and Health Surveys.Setting Six South Asian countries, Afghanistan (2015), Bangladesh (2014), India (2015–2016), Maldives (2016–...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-06-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e049630.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832583764022132736 |
|---|---|
| author | Chandrashekhar T Sreeramareddy Kiran Acharya Ishwar Tiwari |
| author_facet | Chandrashekhar T Sreeramareddy Kiran Acharya Ishwar Tiwari |
| author_sort | Chandrashekhar T Sreeramareddy |
| collection | DOAJ |
| description | Objective To estimate educational and wealth inequalities in demand satisfied with modern methods of family planning (mDFPS).Design A secondary data analyses of Demographic and Health Surveys.Setting Six South Asian countries, Afghanistan (2015), Bangladesh (2014), India (2015–2016), Maldives (2016–2017), Nepal (2016) and Pakistan (2017–2018).Participants Women aged 15–49 years. Primary and secondary outcome measures mDFPS was defined as married women aged 15–49 years or their partners, who desired no child, no additional children or to postpone the next pregnancy and who are currently using any modern contraceptive method. We estimated weighted and age-standardised estimates of mDFPS. We calculated the slope index of inequality (SII) and relative index of inequality (RII) as the measures of socioeconomic inequalities.Results A total of 782 639 women were surveyed. The response rate was 84.0% and above. The prevalence of mDFPS was below 50% in Maldives (22.8%, 95% CI 20.7 to 25.0), Pakistan (42.0%, 95% CI 39.9 to 44.0) and Afghanistan (39.1%, 95% CI 36.9 to 41.3), whereas Bangladesh had achieved 76% (75.8%, 95% CI 74.2 to 77.3). Both wealth and educational inequalities varied in magnitude and direction between the countries. Except in Nepal and Bangladesh, mDFPS wealth inequalities showed a trend of increasing mDFPS as we moved towards richer, and richest wealth quintiles that is, pro-poor (RII (0.5 to 0.9); SII (−4.9 to −23.0)). In India and Nepal, higher versus no education was in favour of no education (higher mDFPS among not educated women) (RII 1.1 and 1.4; SII 4.1 and 15.3, respectively) and reverse in other countries ((RII (0.4 to 0.8); SII (−10.5 to −30.3)). Afghanistan, Maldives and Pakistan fared badly in both educational and wealth inequalities among the countries.Conclusions South Asia region still has a long way ahead towards achieving universal access to mDFPS. Diverse patterns of socioeconomic inequalities between the countries call for national governments and international development agencies to target the population subgroups for improving the mDFPS coverage. |
| format | Article |
| id | doaj-art-142e75076fd34fe4a838fe5a7ab64518 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-142e75076fd34fe4a838fe5a7ab645182025-01-28T05:45:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-049630Inequalities in demand satisfied with modern methods of family planning among women aged 15–49 years: a secondary data analysis of Demographic and Health Surveys of six South Asian countriesChandrashekhar T Sreeramareddy0Kiran Acharya1Ishwar Tiwari21 Department of Community Medicine, International Medical University School of Medicine, Kuala Lumpur, MalaysiaNew ERA, Rudramati Marga, Kalopul, Kathmandu, NepalSchool of Public Health, University of Alberta, Alberta, Edmonton, CanadaObjective To estimate educational and wealth inequalities in demand satisfied with modern methods of family planning (mDFPS).Design A secondary data analyses of Demographic and Health Surveys.Setting Six South Asian countries, Afghanistan (2015), Bangladesh (2014), India (2015–2016), Maldives (2016–2017), Nepal (2016) and Pakistan (2017–2018).Participants Women aged 15–49 years. Primary and secondary outcome measures mDFPS was defined as married women aged 15–49 years or their partners, who desired no child, no additional children or to postpone the next pregnancy and who are currently using any modern contraceptive method. We estimated weighted and age-standardised estimates of mDFPS. We calculated the slope index of inequality (SII) and relative index of inequality (RII) as the measures of socioeconomic inequalities.Results A total of 782 639 women were surveyed. The response rate was 84.0% and above. The prevalence of mDFPS was below 50% in Maldives (22.8%, 95% CI 20.7 to 25.0), Pakistan (42.0%, 95% CI 39.9 to 44.0) and Afghanistan (39.1%, 95% CI 36.9 to 41.3), whereas Bangladesh had achieved 76% (75.8%, 95% CI 74.2 to 77.3). Both wealth and educational inequalities varied in magnitude and direction between the countries. Except in Nepal and Bangladesh, mDFPS wealth inequalities showed a trend of increasing mDFPS as we moved towards richer, and richest wealth quintiles that is, pro-poor (RII (0.5 to 0.9); SII (−4.9 to −23.0)). In India and Nepal, higher versus no education was in favour of no education (higher mDFPS among not educated women) (RII 1.1 and 1.4; SII 4.1 and 15.3, respectively) and reverse in other countries ((RII (0.4 to 0.8); SII (−10.5 to −30.3)). Afghanistan, Maldives and Pakistan fared badly in both educational and wealth inequalities among the countries.Conclusions South Asia region still has a long way ahead towards achieving universal access to mDFPS. Diverse patterns of socioeconomic inequalities between the countries call for national governments and international development agencies to target the population subgroups for improving the mDFPS coverage.https://bmjopen.bmj.com/content/12/6/e049630.full |
| spellingShingle | Chandrashekhar T Sreeramareddy Kiran Acharya Ishwar Tiwari Inequalities in demand satisfied with modern methods of family planning among women aged 15–49 years: a secondary data analysis of Demographic and Health Surveys of six South Asian countries BMJ Open |
| title | Inequalities in demand satisfied with modern methods of family planning among women aged 15–49 years: a secondary data analysis of Demographic and Health Surveys of six South Asian countries |
| title_full | Inequalities in demand satisfied with modern methods of family planning among women aged 15–49 years: a secondary data analysis of Demographic and Health Surveys of six South Asian countries |
| title_fullStr | Inequalities in demand satisfied with modern methods of family planning among women aged 15–49 years: a secondary data analysis of Demographic and Health Surveys of six South Asian countries |
| title_full_unstemmed | Inequalities in demand satisfied with modern methods of family planning among women aged 15–49 years: a secondary data analysis of Demographic and Health Surveys of six South Asian countries |
| title_short | Inequalities in demand satisfied with modern methods of family planning among women aged 15–49 years: a secondary data analysis of Demographic and Health Surveys of six South Asian countries |
| title_sort | inequalities in demand satisfied with modern methods of family planning among women aged 15 49 years a secondary data analysis of demographic and health surveys of six south asian countries |
| url | https://bmjopen.bmj.com/content/12/6/e049630.full |
| work_keys_str_mv | AT chandrashekhartsreeramareddy inequalitiesindemandsatisfiedwithmodernmethodsoffamilyplanningamongwomenaged1549yearsasecondarydataanalysisofdemographicandhealthsurveysofsixsouthasiancountries AT kiranacharya inequalitiesindemandsatisfiedwithmodernmethodsoffamilyplanningamongwomenaged1549yearsasecondarydataanalysisofdemographicandhealthsurveysofsixsouthasiancountries AT ishwartiwari inequalitiesindemandsatisfiedwithmodernmethodsoffamilyplanningamongwomenaged1549yearsasecondarydataanalysisofdemographicandhealthsurveysofsixsouthasiancountries |