The role of change in fertility desire on change in family planning use: A longitudinal investigation in urban Uttar Pradesh, India

Background: Reproductive choice is one of the rights of any woman, but women are often ambivalent towards fertility desires and choice of contraception. Our study explores how the change in fertility desires influence the change in use of modern contraception over time in six cities of Uttar Pradesh, India. Methods : Data for this study comes from the Measurement, Learning and Evaluation (MLE) Project for Urban Health Initiative in six cities of Uttar Pradesh. Our study sample consists of 8735 women (weighted n=8655) who were fertile, non-sterilized and non-pregnant at the time of baseline survey. Potential bias due to lost to follow up was addressed using inverse probability weighing and then generalized estimating equations were applied to get odds for change in use of modern contraceptives. Results: Contraceptive use increased by different magnitudes from baseline to endline across all six cities. At baseline and endline, women who desired no more children reported a higher use of modern contraception than those who desired more children over time. Women from all cities who desired no more children at baseline had higher odds of modern contraceptive use than that of women who desired more children. The tempo of change in use of modern contraception over time among women with different fertility desires differed across the considered cities. Conclusion : Although there were city-wise differences observed, women’s fertility intentions have an impact on their use of modern contraceptives over the time period between baseline to endline. To obtain greater insight into city-level differences, mixed method studies will be more effective.