Do contextual and community level determinants matter in contraceptive use: An exploratory study of rural West Bengal, India

The majority of existing studies on fertility regulation primarily seek to explain contraceptive practices and behaviour in terms of the individual’s or couple’s personal attributes, and household risk factors, neglecting the contextual, social and cultural environment in which the outcomes occur. Evidences regarding how contextual and community level factors influence contraceptive adoption are limited, especially in the developing countries. Using a multistage sampling design, data on contraceptive use and individual, household and community level information were collected from 1,348 women residing in an underdeveloped region of a rural area of West Bengal, India. Of all women in union about 88% were using one contraceptive method at the time of survey. Among them about 82% were using any modern method, while a minority (about 6%) were using any traditional method. The female sterilization was the most commonly used method (68% of women) followed by oral pill (17%). The preliminary results of multilevel binary logit analysis suggest that a significant community-level variation is present in contraceptive use. Village level developmental indicators and participation in community activities were found to be significantly associated with contraceptive use even after controlling the potential confounders.