Contraceptive use dynamics in South Asia: Has there been Enough Choice?

Paper examines the contraceptive use dynamics and investigates whether there has been enough informed choice for contraceptives in South Asia using data from 3 rounds of recent DHS in four countries-Bangladesh, India Nepal and Pakistan. DHS asked the current users whether they were informed about the possible side effects, what to do if they experienced side effects, told about other methods they could use and told that sterilization is permanent. Informed choice is analyzed by selected socio-economic characteristics of users through descriptive statistics and multivariate methods.

Nepal, Bangladesh and India have made about 10% point progress (36% in early 1990s to 44%-48% in 2005-07). There is one or another dominant method of family planning in most of the countries in the region. Only 25% users in India, 38% in Pakistan and almost half in Nepal were ever informed by a health worker about other methods they could use. Also very few were informed about the side effects. Informed choice significantly differs by socio-economic characteristics of users and was low among poor and public facilities users. Finding of study that basket of contraceptive choice is limited and informed choice is significantly low, calls urgent attention from program managers and policy makers.