Rural–Urban Inequality in Modern Reversible Contraception Uptake Among Women in Spacing Need in India: A Multivariate Decomposition Analysis Using Nationally Representative Sample Survey Data
Puja Das, Tanmoy Ghosh, Margubur Rahaman, Avijit Roy, Pradip ChouhanBackground
Despite significant progress in broadening the range of contraceptive choices, the disparity between rural and urban areas in the use of contemporary reversible contraceptives remains a concern in India.
Methods
Using data from the fifth round of the National Family Health Survey (NFHS-5, 2019–2021), the study addresses the gap by examining rural–urban differences and the underlying factors influencing modern reversible contraceptive uptake. The study includes a sample of 49,046 women of reproductive age who wish to delay their next childbearing within the next 2 years, excluding all missing responses. Using descriptive statistics, bivariate chi-square significance test, and multivariate decomposition analysis, the study intends to address the objectives.
Results
More than two-thirds of women use some form of modern reversible methods, and the share was higher among urban dwellers (70.67%) than their rural counterparts (65.55%). In particular, around 75% of the rural–urban gap in the uptake was attributed to the socio-demographic characteristics of women. Of these, mass media exposure, level of education, and region of residence were the significant contributors to the gap.
Conclusions
The study findings underscore the need for interventions aiming at improving media exposure and the level of education among rural dwellers. Additionally, strategic interventions are also important for diminishing the existing rural–urban gap in the eastern and north-eastern regions.