A systematic review on barriers to the use of contraceptive services and other family planning services among married couples in South Asia.

Abstract

Introduction: There is a dearth of research in terms of systematic review to explore the barriers to contraceptives faced by married couples in South Asia. This systematic review explores the evidence on issues faced by married couples in South Asia regarding the use of contraceptives and other family planning services.

Materials and methods: A systematic literature review was conducted using PubMed, EBSCO, and Web of Science databases. Articles published in English between 2011 and 2025 were included. Inclusion criteria were: South Asian married couples, forms of contraception, barriers to using contraception and other family planning services. A directed qualitative content analysis approach was employed, using Andersen's Behavioral Model to classify findings into predisposing, enabling, and need-based factors. Risk Of Bias assessment was done using CASP tool.

Results: Out of 301 records identified, 65 studies were finally included following screening and full-text assessment. Among these, 62% identified cultural and gender-related barriers, 54% highlighted religious influences (especially in Pakistan and Afghanistan), and 48% noted misinformation and knowledge gaps. Additional themes included service inaccessibility, provider bias, and poor outreach, particularly in Nepal and rural India.

Conclusion: In South Asian countries, there are major barriers to the use of contraception and other family planning services, mostly due to the overall lack of knowledge, religious factors and allowing myths and misinformation to discourage the use of contraceptives.