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Informed choice in modern contraceptive method use: pattern and predictors among young women in India

  • Manas Ranjan Pradhan (a1), Surendra Kumar Patel (a1) and Antim Alok Saraf (a1)


Research on informed choice in modern contraceptive method acceptance by young married women is pertinent in the broader context of individual freedom and reproductive rights, especially in countries where women continue to have limited control over their reproductive and contraceptive choices. This study in India asked: (1) is young married women’s acceptance of specific modern contraceptive methods an informed choice? and (2) what are the enablers and barriers to informed choice? The study used data for currently married women aged 15–24 (N = 20,752) from the fourth round of the National Family Health Survey (NFHS-4) conducted in 2015–16. A Method Information Index (MII) was calculated as a measure of informed choice from the percentage of users who responded ‘yes’ to all three questions on: whether they were informed about methods other than the one they received, told about the method-specific side-effects, and advised what to do if they experienced side-effects. Binary logistic regression analysis was carried out to examine the adjusted effect of factors associated with the MII separately for female sterilization, the intrauterine device and the oral contraceptive pill, and a combined MII including all three methods plus injectables. One-fifth of the study women used any modern contraceptive method at the time of survey, of which only 36% had fully informed choice. The likelihood of being informed about the methods was significantly higher among those using the oral contraceptive pill (OR: 1.75, CI 1.58–1.94), IUD (OR: 2.23, CI 1.97–2.52) and injectables (OR: 1.37, CI 0.97–1.94) compared with those who were sterilized. Informed choice varied by region and the socioeconomic profile of the users. Inadequately informed choice violates the reproductive rights of young women and might result in higher post-use health problems, discontinuation of and unmet need for contraceptives, unintended pregnancies, induced abortions and regret, adversely affecting women’s health. Training of health/family planning workers in India about the importance of reproductive rights is urgently required to enhance informed contraceptive choice and improve the health of young married women.


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Ali, MM, Cleland, JG, Shah, IH and WHO (2012) Causes and Consequences of Contraceptive Discontinuation: Evidence from 60 Demographic and Health Surveys. World Health Organization, Geneva. URL: (accessed 31st October 2018).
Andaleeb, SS (2001) Service quality perceptions and patient satisfaction: a study of hospitals in a developing country. Social Science & Medicine 52(9), 13591370.
Balaiah, D, Naik, D, Ghule, M and Tapase, P (2005) Determinants of spacing contraceptive use among couples in Mumbai: a male perspective. Journal of Biosocial Science 37(6), 689704.
Baveja, R, Buckshee, K, Das, K, Das, S, Hazra, M, Gopalan, et al. (2000) Evaluating contraceptive choice through the method-mix approach: an Indian Council of Medical Research (ICMR) Task Force study. Contraception 61(2), 113119.
Blanc, AK, Curtis, SL and Croft, T (1999) Does Contraceptive Discontinuation Matter? Quality of Care and Fertility Consequences. MEASURE Evaluation, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill. URL: (accessed 31st October 2018).
Blanc, AK, Curtis, SL and Croft, TN (2002) Monitoring contraceptive continuation: links to fertility outcomes and quality of care. Studies in Family Planning 33(2), 127140.
Casterline, JB, El-Zanaty, F and El-Zeini, LO (2003) Unmet need and unintended fertility: longitudinal evidence from Upper Egypt. International Family Planning Perspectives 29(4), 158166.
Chang, KT, Mukanu, M, Bellows, B, Hameed, W, Kalamar, AM, Grépin, KAet al. (2019) Evaluating quality of contraceptive counseling: an analysis of the Method Information Index. Studies in Family Planning 50(1), 2542.
Clark, S (2000) Son preference and sex composition of children: evidence from India. Demography 37(1), 95108.
Cleland, J and Ali, MM (2004) Reproductive consequences of contraceptive failure in 19 developing countries. Obstetrics & Gynecology 104(2), 314320.
Curtis, S, Evens, E and Sambisa, W (2011) Contraceptive discontinuation and unintended pregnancy: an imperfect relationship. International Perspectives on Sexual and Reproductive Health 37(2), 58.
Dehlendorf, C, Levy, K, Ruskin, R, and Steinauer, J (2010) Health care providers’ knowledge about contraceptive evidence: a barrier to quality family planning care? Contraception 81(4), 292298.
Government of India (2014) India’s Vision FP 2020. Ministry of Health and Family Welfare (MoHFW), New Delhi. URL: (accessed 7th July 2019).
Ghule, M, Raj, A, Palaye, P, Dasgupta, A, Nair, S, Saggurti, Net al. (2018) Barriers to use of contraceptive methods among rural young married couples in Maharasthra, India: qualitative findings. Asian Journal of Research in Social Sciences and Humanities 5(6), 1823.
Hardee, K, Kumar, J, Newman, K, Bakamjian, L, Harris, S, Rodriguez, M and Brown, W (2014) Voluntary, human rights-based family planning: a conceptual framework. Studies in Family Planning 45(1), 118.
Hogmark, S, Klingberg-Allvin, M, Gemzell-Danielsson, K, Ohlsson, H and Essén, B (2013) Medical students’ knowledge, attitudes and perceptions towards contraceptive use and counselling: a cross-sectional survey in Maharashtra, India. BMJ Open 3(12), e003739.
Hubacher, D, Chen, PL and Park, S (2009) Side effects from the copper IUD: do they decrease over time? Contraception 79(5), 356362.
Huezo, C and Diaz, S (1993) Quality of care in family planning: clients’ rights and providers’ needs. Advances in Contraception 9(2), 129139.
Jain, AK (2017) Information about methods received by contraceptive users in India. Journal of Biosocial Science 49(6), 798810.
Jejeebhoy, SJ (1995) Women’s Education, Autonomy, and Reproductive Behaviour: Experience from Developing Countries. Clarendon Press, Oxford, pp. 324.
Koenig, MA, Foo, GH and Joshi, K (2000) Quality of care within the Indian family welfare programme: a review of recent evidence. Studies in Family Planning 31(1), 118.
Mavalankar, D and Sharma, B (1999) The quality of care in sterilization camps: evidence from Gujarat. In Koenig, MA and Khan, ME (eds) Improving Quality of Care in India’s Family Welfare Programme. Population Council, New York, pp. 293313.
Modugu, HR, Panda, R, Liberhan, T and Bhanot, A (2018) Entertainment education shows for increased uptake of family planning services and improved health seeking behavior in rural India. Demography India 47(2), 8399.
Moursund, A and Kravdal, Ø (2003) Individual and community effects of women’s education and autonomy on contraceptive use in India. Population Studies 57(3), 285301.
New, JR, Cahill, N, Stover, J, Gupta, YP and Alkema, L (2017) Levels and trends in contraceptive prevalence, unmet need, and demand for family planning for 29 states and union territories in India: a modelling study using the Family Planning Estimation Tool. The Lancet Global Health 5(3), e350e358.
Pande, R and Malhotra, A (2006) Son Preference and Daughter Neglect in India. International Center for Research on Women, Washington, DC. URL: (accessed 7th July 2019).
Pandey, A, Sahu, D, Bakkali, T, Reddy, D, Venkatesh, S, Kant, Set al. (2012) Estimate of HIV prevalence and number of people living with HIV in India 2008–2009. BMJ Open 2(5), e000926.
Pandey, A and Singh, K (2015) Contraceptive use before first pregnancy by women in India (2005–2006): determinants and differentials. BMC Public Health 15(1), 1316.
Petersen, MB (1988) Measuring patient satisfaction: collecting useful data. Journal of Nursing Quality Assurance 2(3), 2535.
Pradhan, MR and Ram, U (2009) Female sterilization and ethical issues: the Indian experience. Social Change 39(3), 365387.
Ram, F, Shekhar, C and Chowdhury, B (2014) Use of traditional contraceptive methods in India and its socio-demographic determinants. Indian Journal of Medical Research 140 (Supplement 1), S17.
Ravindran, TKS and Balasubramanian, P (2004) “Yes” to abortion but “No” to sexual rights: the paradoxical reality of married women in rural Tamil Nadu, India. Reproductive Health Matters 12(23), 8899.
Santhya, K (2003) Changing family planning scenario in India: an overview of recent evidence. South & East Asia Regional Working Paper No. 17. Population Council, New Delhi. URL: (accessed 31st October 2018).
Sharma, M, Joshi, S, Nagar, O and Sharma, A (2014) Determinants of intrauterine contraceptive device discontinuation among Indian women. Journal of Obstetrics & Gynaecology India 64(3), 208211.
Sharma, V, Mohan, U, Das, V and Awasthi, S (2012) Socio-demographic determinants and knowledge, attitude, practice: survey of family planning. Journal of Family Medicine and Primary Care 1(1), 4347.
Singh, A, Ogollah, R, Ram, F and Pallikadavath, S (2012) Sterilization regret among married women in India: implications for the Indian national family planning program. International Perspectives on Sexual and Reproductive Health 38(4), 187195.
Singh, SK, Sharma, B, Vishwakarma, D, Yadav, G, Srivastava, S and Maharana, B (2019) Women’s empowerment and use of contraception in India: macro and micro perpectives emerging from NFHS-4 (2015–16). Sexual and Reproductive Healthcare 19, 1523.
Srikantan, KS and Balasubramanian, K (1983) Demographic evolution of India’s family planning programme. Artha vijnana 25(3), 205230.
Srinivasan, K (2006) Population policies and family planning programmes in India: a review and recommendations. IIPS Newsletter 47(1–2), 644.
Stephenson, R (2006) District-level religious composition and adoption of sterilization in India. Journal of Health, Population and Nutrition 24(1), 100106.
Thulaseedharan, JV (2018) Contraceptive use and preferences of young married women in Kerala, India. Open Access Journal of Contraception 9, 110.
WHO (2018) Family Planning: A Global Handbook for Providers: 2018. URL: (accessed 5th July 2019).


Informed choice in modern contraceptive method use: pattern and predictors among young women in India

  • Manas Ranjan Pradhan (a1), Surendra Kumar Patel (a1) and Antim Alok Saraf (a1)


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