Socioeconomic inequalities in contraceptive use among female adolescents in south Asian countries: a decomposition analysis

BACKGROUND: Contraceptive knowledge and use has been an emerging topic of interest in adolescents in Asia. This study quantified the contribution of the socioeconomic determinants of inequality in contraceptive use among currently married female adolescents (15–24) in four south Asian countries: India, Bangladesh, Nepal and Pakistan. DATA AND METHODS: The data of Demographic Health Survey (DHS) for four South Asian countries, i.e. India (NFHS 2015–16), Nepal (DHS 2016), Bangladesh (DHS 2014) and Pakistan (DHS 2012–2013) has been used for examining the contraceptive use and inherent socioeconomic inequality. After employing logistic regression, concentration curves based on decomposition analysis have been made to analyse the socioeconomic inequality. RESULTS: The results reveal that the use of contraception among female adolescents remains low and factors like education, employment, having one or more children, media exposure were positively associated with it. In terms of socioeconomic inequality, a significant amount of variation has been observed across the countries. In India, poor economic status (95.23%), illiteracy (51.29%) and rural residence (23.06%) contributed maximum in explaining the socioeconomic inequality in contraceptive use among female adolescents. For Bangladesh, the largest contributors to inequalities were rural residence (260%), illiteracy (146.67%) while birth order 3 + (− 173.33%) contributed negatively. Illiteracy (50%), poor economic status (47.83%) and rural residence (16.30%) contributed maximum to the inequalities in contraceptive use in Pakistan while birth order 3 + (− 9.78%) contributed negatively. In Nepal, the important operators of inequalities were unemployment (105.26%), birth order 3 + (52.63%) and poor economic status (47.37%), while rural residence contributed negatively (− 63.16%) to inequalities in contraceptive use. CONCLUSIONS: Using a cross country perspective, this study presents an socioeconomic inequality analysis in contraceptive use and the important factors involved in the same. Since the factors contributing to inequalities in contraceptive use vary across countries, there is a need to imply country-specific initiatives which will look after the special needs of this age-group.