Factors explaining the dominion status of female sterilization in India over the past two decades (1992-2016): A multilevel study

BACKGROUND: Female sterilization is a permanent method of contraception practiced widely in India. Though, the important evidences of behavior of contraceptives is widespread in the literature, relatively less research has been conducted that explores particularly female sterilization method and how its behavior has remained dominant over the past two decades. The present study aims to examine how the level of women’s socio-demographic and fertility related characteristics intersect to shape the behavior for the dominance of female sterilization. METHODS: This study was based on pooled data from 1992–93, 1998–99, 2005–06 and 2015–16 India’s DHS (NFHS) surveys. The outcome variable of the study was different types of contraceptive methods used. Multinomial logistic model has been applied to examine the relationship between the dependent variable and the explanatory variables. The software STATA version14 has been used for the entire analysis. RESULT: The result of this study clearly demonstrates the evidence of continuing sterilization dominance in the India’s family planning program. The choice of different types of contraceptive methods is influenced by the longstanding heterogeneity of population associated with religion and the caste system. Reliance over female sterilization was observed in almost all parts of the country with southern India being the leading zone. Women in the lowest wealth quintile, uneducated, higher parity, and less exposed to media were more likely to use sterilization as a method of birth control. CONCLUSION: The study was successful in identifying the factors behind the excessive dependency on female sterilization and also highlights the weakness of family planning program to promote other useful modern methods over the past two decades.