Republic of India - adolescent contraceptive use

Publication date: 2016

Adolescent contraceptive use DATA FROM THE NATIONAL FAMILY HEALTH SURVEY-3 (NFHS-3), 2005-06 R E P U B L I C O F I N D I A What can be done to support Indian adolescents to prevent unintended pregnancy? Plan for how, when and where different groups of sexually active adolescents (married and unmarried, boys and girls, rural and urban) use and do not use contraception. Learn the reasons why adolescents are not using contraception, and develop policies and programmes to better address their needs. Understand that adolescents may get contraception from a variety of sources and ensure that each of these sources can provide high quality services for adolescents. COMPILED IN 2016 | UPDATED NOVEMBER 2016 Adolescent population: who are they? In the Republic of India, there are 240.7 million adolescents aged 10–19 years – 18.8% of the country’s total population.i More than two thirds of adolescents live in rural areas, 67.3% of adolescent girls and 67.5% of adolescent boys.i By age 19, the mean number of years of schooling attended by adolescent girls is 6.9, while for adolescent boys it is 8.5.ii Among adolescents who become parents before age 20, the average age at which Indian adolescent girls have their first baby is 17.1 years, while the average age at which adolescent boys first become fathers is 18.2.ii Sexual activity and marital status Analysis of data from the NFHS-3ii show that over 19.7 million Indians aged 15–19 are currently sexually active – they are either unmarried and have had sex in the last three months or they are in a union (i.e. married or living together). On average, among adolescents who had sex before age 20, adolescent girls first have sexual intercourse at age 16.2 years and adolescent boys at 17.2 years. Among unmarried adolescents, 1.1% of adolescent girls report ever having sex and 0.3% are currently sexually active; among adolescent boys, 8.6% report ever having sex, while 4.0% are currently sexually active. Among all Indian adolescents, 27.1% of adolescent girls and 2.8% of adolescent boys are in a union. Among these adolescents, the mean age of the first union is 16.2 years for adolescent girls and 17.4 for adolescent boys. Contraceptive use and non-use among adolescent girls FIGURE 1. Use and non-use of contraception: unmarried sexually active adolescent girls, aged 15–19 years (%) Not using Withdrawal Periodic abstinence Male condom Injectable contraceptives FIGURE 2. Use and non-use of contraception: adolescent girls in union, aged 15–19 years (%) LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE LISTED FROM LEAST EFFECTIVE TO MOST EFFECTIVE Unmarried, sexually active According to NFHS-3ii analyses, of the less than 1% of adolescent girls that are unmarried and sexually active, 32.4% report not wanting a child in the next two years, yet none of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • not married (44.1%) • infrequent sex (29.7%) • not having sex (24.7%) Among all unmarried, sexually active adolescent girls aged 15–19, 74.5% are not using a method of contraception. Male condoms are the most common modern method used (13.3% of these adolescent girls). Traditional methods, withdrawal or periodic abstinence, are used by 9.8% (see Figure 1). In union According to NFHS-3ii analyses, 29.8% of adolescent girls in a union report not wanting a child in the next two years, yet only 15.7% of them are currently using any method to prevent pregnancy. The main reasons these adolescents report for not using a contraceptive method include: • breastfeeding (27.5%) • menses has not returned after giving birth (15.8%) • husband or partner is opposed (13.9%) Among all adolescent girls in a union aged 15–19, 87.0% are not using a method of contraception. Male condoms and pills are the most common modern methods used (3.3% and 2.2% of these adolescent girls, respectively). Female sterilization, which is a permanent method, is used by 1.1%. Withdrawal or periodic abstinence, traditional methods, are used by 6.1% (see Figure 2). i Urban and rural population by age and sex, 1980–2015 [online database]. New York (USA): United Nations Department of Economic and Social Affairs, Population Division; 2014 (https://esa. un.org/unpd/popdev/urpas/urpas2014.aspx, accessed 4 November 2016). ii International Institute for Population Sciences (IIPS) [India], Macro ICF International. India National Family Health Survey (NFHS-3; DHS) 2005-06 [Datasets]. IAIR52.DTA and IAMR52.DTA. Mumbai (India): IIPS and Macro ICF International; 2007 (http://dhsprogram.com/data/dataset/India_Standard-DHS_2006.cfm?flag=0, accessed 4 November 2016) . Not using Withdrawal Periodic abstinence Male condom Pill IUD Female sterilization 3.8 2.3 3.3 0.3 1.12.2 87.0 74.5 13.3 7.0 2.8 1.0 LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Source: analysis of NFHS-3, 2005-06ii Source: analysis of NFHS-3, 2005-06ii Unmarried, sexually active adolescents who are using a modern method most often get it from a private facility (46.0%) or a pharmacy (44.3%). Adolescents in a union who are using a modern method most often get it from a pharmacy (32.3%) or a shop (27.5%). Adolescent contraceptive use R E P U B L I C O F I N D I A Use and non-use of contraception adolescent girls, aged 15-19 million adolescents ages 10-19 240.7 16.2 years for adolescent girls 17.2 years for adolescent boys Among adolescents who had sex before age 20, the average age at first sex is Among adolescents who become parents before age 20, the average age at first birth is What can be done to support Indian adolescents to prevent unintended pregnancy? Main reasons for not using contraception Report not wanting a child in the next two years Sexually active, unmarried In union 32.4% sexually active, unmarried adolescent girls 29.8% adolescent girls in union 27.5% from a shop Understand that adolescents may get modern contraception from a variety of sources. Learn the reasons why adolescents are not using contraception. Plan for how, when, and where different groups of adolescents use or don’t use contraception. ANALYSIS OF THE INDIA NATIONAL FAMILY HEALTH SURVEY-3, 2005-06 COMPILED IN 2016 | UPDATED NOVEMBER 2016 IInternational Institute for Population Sciences (IIPS) [India], Macro ICF International. India National Family Health Survey (NFHS-3; DHS) 2005-06 [Datasets]. IAIR52.DTA and IAMR52.DTA. Mumbai (India): IIPS and Macro ICF International; 2007 (http://dhsprogram.com/data/dataset/India_Standard-DHS_2006.cfm?flag=0, accessed 4 November 2016). 17.1 18.2 for adolescent girls for adolescent boys LEARN MORE AT who.int/reproductivehealth/adol-contraceptive-use Sexually active, unmarried In union 44.1% not married 27.5% breastfeeding 29.7% infrequent sex 15.8% menses has not returned after giving birth 24.7% not having sex 13.9% husband or partner is opposed Method Sexually active, unmarried In union Not using 74.5% 87.0% Withdrawal 7.0% 2.3% Periodic abstinence 2.8% 3.8% Male condom 13.3% 3.3% Pill -- 2.2% Injectable contraceptives 1.0% -- IUD -- 0.3% Female sterilization -- 1.1% 32.3% from a pharmacy 46.0% from a private facility 44.3% from a pharmacy REASONS FOR NON-USE: Not married Not having sex Infrequent sex Menses has not returned after birth Breastfeeding Fatalistic (up to god) She is opposed Husband/partner is opposed Religious prohibition Knows no method Knows no source Fear of side effects/health concerns Inconvenient to use Others opposed Lack of access/too far SOURCE OF METHOD: Government facility Private facility Pharmacy Shop Friends or parents Other Community Health Worker Icon Directory METHODS: Not using Withdrawal Periodic abstinence Rhythm/calendar Female condom Male condom Standard days/cycle beads Pill Injectable contraceptives Lactational amenorrhea (LAM) Implants IUD Male sterilization Female sterilization © WHO 2016. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence WHO/RHR/16.62

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