Traditional or Modern Contraception? Association between Health Worker Contact and Contraceptive Choice in India: Findings from the National Family Health Survey 2019-21

Nandita Bhan, Jindal School Of Public Health And Human Development (JSPH), O.P. Jindal Global University
Nicole Johns, Center on Gender Equity and Health, UC San Diego
Katherine Hay, Center on Gender Equity and Health, University of California San Diego
Abhishek Singh, International Institute for Population Sciences (IIPS)
Vedavati Patwardhan, Center on Gender Equity and Health, UCSD
Shruti Ambast, University of California, San Diego
Lotus McDougal, Center on Gender Equity and Health, UCSD

Despite increasing availability, lower cost, and substantial policy and programmatic efforts to increase modern contraceptive uptake, traditional contraceptive use remains common and increasing within India. We examined whether community health worker (CHW) contact was associated with contraceptive type in this context, using data from n=306,037 non-pregnant, non-sterilized participants of the 2019-21 National Family Health Survey. Multinomial regression estimated the association between recent CHW contact and contraceptive use, consistent use, and switching between traditional and modern contraceptive methods. One in five women (22.1%) reported current use of traditional contraception, and two in five (39.5%) reported CHW contact. CHW contact was associated with lower use of traditional contraception [ARRR=0.86 (95% CI: 0.82-0.89)] and higher use of reversible modern contraception [ARRR=1.18 (95% CI: 1.14-1.22)]. CHW contact was also associated with greater consistent use of modern contraception [ARRR=1.20 (95% CI: 1.16-1.24)] and greater switching from traditional to modern contraceptive methods [ARRR=1.85 (95% CI: 1.30-2.63)]. CHW engagement is associated with greater uptake and continued use of modern contraception, and may thus enable women’s agency to utilize modern contraception. However, efforts should be made to ensure these interactions do not emphasize modern methods at the expense of women’s needs or desires for traditional contraceptive use.

Keywords: Family Planning and Contraception, Sexual and Reproductive Health and Rights, Gender Dynamics

See extended abstract.