Prevalence and factors associated with unmet need for family planning among married women of reproductive age in Devchuli municipality, Nepal
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20254052Keywords:
Family planning, Unmet need, WomenAbstract
Background: Family planning (FP) is significant in enhancing maternal health, promoting gender equality, and decreasing poverty. Globally, 164 million women still have an unmet need for FP. It was approximately 21% in 2021 in Nepal. This leads to unintended pregnancies, unsafe abortions, and increased maternal mortality. The objective of this study was to determine the prevalence and factors associated with unmet need of FP in Devchuli municipality, Nepal.
Methods: A cross-sectional study was conducted from July to September 2024. Data were collected by face-to-face interviews of the 189 married women of reproductive age using the structured questionnaire. Data was analysed by SPSS.
Results: 47.6% of the respondents did not use any FP methods during the survey. 53% wanted a permanent FP method to limit, and 47% wanted to space the child’s birth by using injectables, pills, and long-acting contraceptives. The highest unmet need was found among the women belonging to Dalit (59%), followed by Janajati (31%), Brahaman/Chhetri, and others (10%). It was highest among the illiterate (72%, p<0.05, CI: 95%). 43.25% women did not use contraceptives due to the fear of the side effects (p<0.05, CI:95%), followed by the opposition by husband (27.46%, p<0.05, CI:95%), sex composition of child (21.49%), and sex composition of the service providers (7.8%).
Conclusions: The prevalence of unmet need for FP was highest among the Dalit and illiterate women. The side effects of the contraceptives and the obstruction by their husbands were statistically significant to the unmet need for FP.
Metrics
References
USAID. Data for Impact. Unmet need for family planning. Available from: https://www.data4impactproject.org/prh/family-planning/fp/unmet-need-for-family-planning/. Accessed on 3 September 2024.
Csa I: Central statistical agency (CSA) (Ethiopia) and ICF. Ethiopia demographic and health survey, 2016. Available from: https://dhsprogram.com/pubs/ pdf/fr328/fr328.pdf. Accessed on 3 September 2024.
Ayele W, Tesfaye H, Gebreyes R, Gebreselassie T. Trends and determinants of unmet need for family planning and programme options, Ethiopia. Further analysis of the 2000. 2005;2011.
WHO. Sustainable Development Goals. http://www.un.org/sustainabledevelopment/health/. Accessed on 29 September 2021.
Sedgh G, Ashford LS, Hussain R. Unmet need for contraception in developing countries: examining women’s reasons for not using a method. Guttmacher. 2016.
Lamichhane K. Unmet need for family planning among currently married young women in Nepal. J Develop Admin Stud. 2017;25(1-2):83-94.
Bishwajit G, Tang S, Yaya S, Feng Z. Unmet need for contraception and its association with unintended pregnancy in Bangladesh. BMC Pregnancy Childbirth. 2017;17(1):1-9. DOI: https://doi.org/10.1186/s12884-017-1379-4
Ahinkorah BO, Ameyaw EK, Seidu AA. Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys. Reprod Health. 2020;17:1-11. DOI: https://doi.org/10.1186/s12978-020-01018-2
United Nations Department of Economic and Social Affairs, Population Division. World Family Planning 2022: Meeting the changing needs for family planning: contraceptive use by age and method. 2022.
United Nations Department of Economic and Social Affairs, Population Division. World Family Planning 2020 Highlights: Accelerating action to ensure universal access to family planning. 2020.
Casterline JB, Sinding SW. Unmet need for family planning in developing countries and implications for population policy. Popul Dev Rev. 2000;26:691-723. DOI: https://doi.org/10.1111/j.1728-4457.2000.00691.x
Smith M, Keckley P. Adding it up: the costs and Benefits of investing in family planning and maternal and newborn health. New York Guttmacher Inst United Nations Popul Fund. 2009;91:64-6.
Gahungu J, Vahdaninia M, Regmi PR. The unmet needs for modern family planning methods among postpartum women in Sub-Saharan Africa: a systematic review of the literature. Reprod Health. 2021;18:1-15. DOI: https://doi.org/10.1186/s12978-021-01089-9
Mehata S, Paudel YR, Mehta R, Dariang M, Poudel P, Barnett S. Unmet need for family planning in nepal during the first two years postpartum. Biomed Res Int. 2014;2014. DOI: https://doi.org/10.1155/2014/649567
Bhusal CK, Bhattarai S. Factors affecting unmet need of family planning among married Tharu Women of Dang District, Nepal. Int J Reprod Med. 2018;2018:9312687.
IPPF. Family Planning Association of Nepal. Available from: https://www.ippf.org/about-us/member-associations/nepal. Accessed on 3 September 2024.
Lal B. National Family Planning Costed Implementation Plan (2024-2030) and the country's commitments to the Family, 2024. Available at: https://www.fp2030.org/commitment-maker/nepal/. Accessed on 29 September 2025.
Paudel I, Budhathoki S. (2011). Unmet needs for family planning in Sunsari, eastern Nepal. Health Renaiss. 2011;9(3):148-51. DOI: https://doi.org/10.3126/hren.v9i3.5581
Karki R, Adhikari M, Poudel R, Kaphle M. Prevalence and determinants of unmet family planning needs among rural women in Gandaki Province, Nepal. Caspian J Reprod Med. 2024;10(2):17-23.
Poudyal JK, Pun S, Parajuli S. Prevalence and associated factors of unmet need for family planning among Magar Community women. J Health Allied Sci. 2024;13(2):40-7. DOI: https://doi.org/10.37107/jhas.511
Dowerah J, Murthy MN, Kulkarni P. Prevalence and pattern of contraceptive use and unmet need among women of reproductive age in urban Mysuru. Clin Epidemiol Glob Health. 2020;8(4):1221-4. DOI: https://doi.org/10.1016/j.cegh.2020.04.018
Imran M, Yasmeen R. Unmet need for family planning in Pakistan: prevalence and factors influencing unmet need among women of reproductive age. Int J Women Empowerment. 2021;7. DOI: https://doi.org/10.29052/2413-4252.v7.i1.2021.37-46
Yaya S, Idriss-Wheeler D, Uthman OA, Bishwajit G. Determinants of unmet need for family planning in Gambia and Mozambique: implications for women’s health. BMC Women’s Health. 2021;21:1-8.
Wai MM, Bjertness E, Stigum H, Htay TT, Liabsuetrakul T, Moe Myint AN, et al. Unmet need for family planning among urban and rural married women in Yangon region, Myanmar- a cross sectional study. Environ Int Res J Public Health. 2019;16(19):3742. DOI: https://doi.org/10.3390/ijerph16193742
Minstry of Health and Population. Nepal demographic and health survey 2022. Kathmandu, Nepal: 2023.
Prakash DP, Jhabindra PP, Kristin B. Unmet Need for Family Planning and Fertility in Nepal: Levels, Trends, and Determinants. 2019. Available from: https://www.cabidigitallibrary.org/doi/full/10.5555/20193305059. Accessed on 29 September 2021.
Asif MF, Pervaiz Z. Socio-demographic determinants of unmet need for family planning among married women in Pakistan. BMC Public Health. 2019;19(1):1-8. DOI: https://doi.org/10.1186/s12889-019-7487-5
Bhusal CK, Bhattarai S. Factors affecting unmet need of family planning among married Tharu women of Dang District, Nepal. Int J Reprod Med. 2018;2018:9312687. DOI: https://doi.org/10.1155/2018/9312687
Kandel N. Unmet need for contraception and its associated factors among married women of reproductive age in Simichaur VDC of Gulmi District. Health Prospect J Public Health. 2012;11:11-4. DOI: https://doi.org/10.3126/hprospect.v11i0.7423
Lamichhane K. Unmet need for family planning among currently married young women in Nepal. J Develop Admin Studies. 2017;25(1-2):83-94. DOI: https://doi.org/10.3126/jodas.v25i1-2.23446
Yadav K, Agarwal M, Shukla M, Singh JV, Singh VK. Unmet need for family planning services among young married women (15-24 years) living in urban slums of India. BMC Women’s Health. 2020. DOI: https://doi.org/10.1186/s12905-020-01010-9
Worku SA, Ahmed SM, Mulushewa TF. Unmet need for family planning and associated factor among women of reproductive age in Debre Berhan town, Amhara, Ethiopia. 2019. DOI: https://doi.org/10.1186/s13104-019-4180-9
Yaya S, Idriss-Wheeler D, Uthman OA, Bishwajit G. Determinants of unmet need for family planning in Gambia and Mozambique: implications for women’s health. BMC Women’s Health. 2021;21(1):123. DOI: https://doi.org/10.1186/s12905-021-01267-8
Dingeta T, Oljira L, Worku A, Berhane Y. Unmet need for contraception among young married women in eastern Ethiopia. Open Access J Contracept. 2019:89-101. DOI: https://doi.org/10.2147/OAJC.S227260
Solomon T, Nigatu M, Gebrehiwot TT, Getachew B. Unmet need for family planning and associated factors among currently married reproductive age women in Tiro Afeta District, South West Ethiopia, 2017: cross-sectional study. BMC Women’s Health. 2019;19(1):170. DOI: https://doi.org/10.1186/s12905-019-0872-5
Alem AZ, Agegnehu CD. Magnitude and associated factors of unmet need for family planning among rural women in Ethiopia: a multilevel cross-sectional analysis. BMJ Open. 2021;11:1-11. DOI: https://doi.org/10.1136/bmjopen-2020-044060