Disaggregated analysis of birth averted due to family planning use in India: An evidence from NFHS-4 (2015–16)

BACKGROUND AND OBJECTIVE: India contributes a major share of global unintended births. It is established that contraception plays a significant role in preventing unintended pregnancies, maternal mortality and induced abortion. In this study, to analyze the effectiveness of our family welfare program, we tried to give district-level estimates of number of births averted due to contraception. DATA AND METHODS: Data for this study came from the cross-sectional, population-based data from the fourth round of National Family Health Survey (NFHS-4) conducted in 2015–16. Here, we discussed two methods based on robust regression for computing number of births averted at district level. Further, we analyzed the percentage increase in births (PIB) that would be experienced by each district in the absence of contraception. RESULTS: Findings of this study clearly showed that there was a huge variation in the estimates of number of births averted among different districts as well as states of India. Out of 640 districts, 315 districts achieved below-replacement fertility and 365 districts have contraceptive prevalence rate (CPR) more than 50 percent. Method 1 found around 22 percent districts showed less than 15 percent reduction in births while Method 2 suggested nearly 14 percent districts predominantly located in Uttar Pradesh, Bihar, Jharkhand, Arunachal Pradesh, Meghalaya and Manipur exhibited less than 30 percent reduction of births due to use of all forms of contraception. At all India level, an average estimate obtained by two methods, nearly 63 million births would have been averted by the use of contraception or 40 percent more than the number of births occurred during that period. CONCLUSION: The study successfully identified the districts that were not performing well at the front of utilization of various family planning methods for birth control. To achieve objectives of National Population Policy (2000), poor-performing districts must be monitored like the government keeps monitoring of Aspirational districts.