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Aritra Das, CARE India
Shegufta Shefa Sikder, Care USA
Utpal Das, Care India Solutions for Sustainable Development
Sumit Kumar, Care India Solutions for Sustainable Development
Komal Kumari, Care India Solutions for Sustainable Development
Manoj Kumar Singh, Care India Solutions for Sustainable Development
Sweta Kumari, Care India Solutions for Sustainable Development
Rakesh Giri, CARE India
Annie Mishra, Care India Solutions for Sustainable Development
Guntur Saimala, Care India Solutions for Sustainable Development
Padma Buggineni, Care India Solutions for Sustainable Development
Tanmay Mahapatra, CARE India Solutions for Sustainable Development
As the nodal development partner in Bihar, CARE India conducted a multi-stage cluster sample survey across all 38 districts of this third largest state with highest total fertility rate, among 22,800 married women of reproductive age to understand family planning related parameters for identifying programming gaps. Results showed a median age of first marriage of 16.2 years, with an average 9-year gap before first contraceptive use. Women reported having a median of 3 children at the time of initiation of modern contraceptive use. Modern contraceptive prevalence was reported as 38.2%, with 88% of modern method mix accounted for by female sterilization. More than half of women never used any modern method, with 11% of women only used traditional methods, 31% opting for female sterilization, and only 10% ever using some modern spacing methods. Contraceptive prevalence was lowest and unmet need for spacing methods was highest among younger and low parity women. Use of modern contraception was more than ten percentage points higher among women reporting that their first child was a son rather than a daughter. Initiatives to meet modern spacing needs and their drivers among younger and lower parity couples appeared critical along with focus on underlying gender perceptions.
Keywords: Family planning and contraception, Fertility and childbirth, Gender, Sexual and Reproductive Health and Rights