Data
The study has used unit level data from the fourth round of the National Family Health Survey (NFHS 4), carried out during 2015–16. This survey adopts two-stage stratified systematic random sampling. In the first stage, the primary sample unit has been selected and the household has been selected in the second stage. This survey has collected information for the representation of the districts of India. The main objectives of the survey are to provide reliable estimates on fertility, maternal and child mortality, family planning, reproductive and child health, nutritional status of children, utilization of maternal and child health care services, and women’s autonomy. The survey adopted the multistage sampling design to collect the samples [7]. The NFHS collected data using different interview schedules–household schedule and eligible women, men and biomarker schedule. The NFHS 4 survey had interviewed total 699,686 women aged 15–49 years in India. The paper limits the sample to those who were currently married women during the survey period. After excluding unmarried, divorced, separated, and widow, the total sample used for analysis is 511,377 currently married women. Among the total currently married women, total demand for family planning includes 339,537 women and demand for limiting includes 282,795 women. The details of the using sample distribution have displayed in Fig. 1. Among the women who have demand for limiting methods, the demand satisfied for limiting includes 245,941 women (185,498 by modern permanent method, 39,021 by modern reversible method and 21,422 by traditional methods).
Outcome variables
The NFHS 4 collected information on demand and using contraception method for family planning. The outcome variables have been prepared based on the following questions. “Do you want to limit your pregnancy or childbearing for permanently?” If yes, then it is called limiting demand. If women have limiting demand, the next question for them: “Are you using any contraceptives to limit your pregnancy for permanently?” If answer is yes, then it called ‘demand satisfied for limiting’ otherwise ‘unmet need for limiting’.
The selected outcome variables are (a) demand satisfied for limiting childbearing (SLD) (b) limiting demand satisfied by modern reversible contraception methods (mrSLD) (c) limiting demand satisfied by traditional contraception methods (tSLD). Here, SLD denotes when women were using any contraception methods to satisfy their limiting demand. The mrSLD means when women were using modern reversible contraception methods (pill, IUD, injectable, male condom, female condom, standard days method (SDM), diaphragm, foam/jelly, lactational amenorrhoea method (LAM), and other modern methods) to satisfy their limiting demand. And, tSLD refers when women were using traditional contraception methods (rhythm, withdrawal, and other traditional methods) to satisfy limiting demand.
Explanatory variables
The explanatory variable used in the analyses includes a range of socioeconomic and demographic variables, which have been significantly associated with unmet and met need for family planning in India and elsewhere (8–11). These independent variables are- respondent's age (15–19, 20–24, 25–29, 30–34, 35 and above years), parity (0, 1, 2, 3, 4+), have at least one son (had at least one son [Yes], had no son [No]), women's years of schooling (No schooling, 1–5 years, 6–10 years, 11 and above years), wealth status (poorest, poorer, middle, richer and richest), religion (Hindu, Muslim, Christians and other) and social group (General, other backward class [OBC], Scheduled Caste [SC], Scheduled Tribe [ST] and Don’t know), mass media exposure (had not listening family planning programme through mass-media [No], had listening family planning programme through mass-media [Yes]), place of residence (urban, rural) and geographical region (North, Central, East, North-East, West, and South). The division of geographical regions was taken from the NFHS-4 report [9].
Statistical analysis
Bivariate and multivariate analysis which includes cross-tabulation and binary logistic regression was used to accomplish the study objectives. Bivariate analysis with Chi-square significance test was applied to examine the patterns of the limiting demand, satisfied limiting, and using contraceptive method by those who satisfied limiting demand. Three separate binary logistic regression analyses were performed to determine the socio-economic correlates of SLD, mrSLD and, tSLD. These variables are binary in nature like SLD (Unmet need ‘0’, Demand satisfied ‘1’), mrSLD (No ‘0’; Yes ‘1’), and tSLD (No ‘0’; Yes ‘1’). The study used revised definitions of unmet need for limiting [12]. The results of binary logistic regression analysis were presented in the form of adjusted odds ratios (AOR) with a 95% confidence interval (CI). All analyses were carried out using statistical STATA (version 14.1 SE).