Authors: Shiva S. Halli, Damaraju Ashwini, Bidyadhar Dehury, Shajy Isac, Antony Joseph, Preeti Anand, Vikas Gothalwal, Ravi Prakash, B. M. Ramesh, James Blanchard and Ties Boerma
Uttar Pradesh (UP) is the most populous state in India with historically high levels of fertility rates than the national average. Though fertility levels in UP declined considerably in recent decades, the current level is well above the government’s target of 2.1.
Fertility and family planning data obtained from the different rounds of Sample Registration System (SRS) and the National Family Health Survey (NFHS). We analyzed fertility and family planning trends in India and UP, including differences in methods mix, using SRS (1971–2016) and NFHS (1992–2016). Bivariate and multivariate regression analyses were used.
From 2000, while the total fertility rate (TFR) declined in UP, it is still well above the national level in 2015–16 (2.7 vs 2.18, respectively). The demand for family planning satisfied increased from 52 to 72% during 1998–99 to 2015–16 in UP, compared to an increase from 75 to 81% in India. Traditional methods play a much greater role in UP than in India (22 and 9% of the demand satisfied respectively), while use of sterilization was relatively low in UP when compared to the national averages (18.0 and 36.3% of current married women 15–49 years in UP and India, respectively in 2015–16).
Within UP, district fertility ranged from 1.6 to 4.4, with higher fertility concentrated in districts with low female schooling, predominantly located in north-central UP. Fertility declines were largest in districts with high fertility in the late nineties (B = 7.33, p < .001). Among currently married women, use of traditional methods increased and accounted for almost one-third of users in 2015–16. Use of sterilization declined but remained the primary method (ranging from 33 to 41% of users in high and low fertility districts respectively) while condom use increased from 17 and 16% in 1998–99 to 23 and 25% in 2015–16 in low and high fertility districts respectively.
Greater reliance on traditional methods and condoms coupled with relatively low demand for modern contraception suggest inadequate access to modern contraceptives, especially in district with high fertility rates. Family planning activities need to be appropriately scaled according to need and geography to ensure the achievement of state-level improvements in family planning programs and fertility outcomes.
Citation: Halli, S.S., Ashwini, D., Dehury, B. et al. Fertility and family planning in Uttar Pradesh, India: major progress and persistent gaps. Reprod Health 16, 129 (2019). https://doi.org/10.1186/s12978-019-0790-x
A Monitoring and Evaluation Unit was established within UP TSU, to support the Government of Uttar Pradesh to enhance the use of data for decision-making in terms of data availability, accessibility, quality and use for improved health outcomes. This brief captures the innovative approaches and interventions adopted by UP TSU in strengthening government data eco-system in Uttar Pradesh.
This issue provides an update on UP-TSU’s efforts in integrating the Gender e-module in SBA training, a feedback workshop with Government of Uttar Pradesh health officials by medical college RRTC faculty members and support Monitoring and Evaluation division of National Health Mission on capacity building workshop for State/Division/District officials to improve data-driven decision-making.
This edition focuses on the support provided by UP TSU to the Government of Uttar Pradesh in developing guidelines to provide beneficiary centric antenatal care through the community platform and its quality certification and the systemic effort to converge the services by ASHA-AWW area alignment in each of the revenue villages. UP TSU is committed to providing state-wide roll-out support.