Understanding drivers of family planning in rural northern India: An integrated mixed-methods approach

• DOI: 10.1371/journal.pone.0243854
• Publication Date: 2021-01-13T18:42:02Z
• Authors: Mokshada Jain; Yael Caplan; B. M. Ramesh; Shajy Isac; Preeti Anand; Elisabeth Engl; Shiva Halli; Hannah Kemp; James Blanchard; Vikas Gothalwal; Vasanthakumar Nam...; Pankaj Kumar; Sema K. Sgaier
• Keywords: Shame; Thematic Analysis; Qualitative property

Background Family planning is a key means to achieving many of the Sustainable Development Goals. Around world, governments and partners have prioritized investments increase access uptake family methods. In Uttar Pradesh, India, government its made significant efforts awareness, supply, modern contraceptives. Despite progress, remains stubbornly low. This calls for systematic research into understanding ‘why’—why people are or aren’t using methods, what drives their decisions, who influences them. Methods We use mixed-methods approach, analyzing three existing quantitative data sets identify trends geographic variation, gaps contextual factors associated with collecting new qualitative through in-depth immersion interviews, journey mapping, decision games understand systemic individual-level barriers use, household making patterns community level barriers. Results find that reasons adoption complex–while awareness critical, they not sufficient increasing Although necessary uptake, we found steep drop-off (59%) between high contraceptive methods intention an additional but smaller from actual (9%). While perceived access, age, education other demographic variables partially predict shows behavioral drivers including dynamics, shame obtain contraceptives, high-risk perception around side-effects also contribute low The reveals strong norms financial considerations by couples driving force behind when Conclusion finding stresses need shift focus towards building intention, in addition ensuring trained staff, commodities drugs equipment, capacities health care providers.