The Trend of Intention to Not Use Contraception among Married Women in Nepal

Background: Family planning (FP) enables people to attain their desired number of children and determine the spacing of pregnancies, but many barriers prevent the use of family planning and result in unplanned pregnancies. This study investigates the trend of intention not to use contraceptives among married women in Nepal. Methods: The data for this study was obtained from three sequential Nepal Demographic and Health Surveys [NDHS] of 2006, 2011, and 2016. We used data from 4297, 4833, and 4677 women who were currently not using any FP methods on NDHS 2006, NDHS 2011, and NDHS 2016, respectively. Univariate, Bivariate and Multivariate analyses were made. Results: Minor fluctuation can be seen in the proportion of women who did not intend to use FP methods for ten years. Above a fourth (26%) women who were currently not using any FP methods had no intention to use FP in 2006, which decreased to 19% in 2011 and slightly increased to 23% in 2016. Overall, the significant socio-demographic predictors of intention to not use FP methods were the age of women, age at marriage, and education of women, religion, residence, and wealth index. Education was a significant predictor of intention not to use FP. Uneducated women and women with only primary education were 83 percent (aOR=1.84, CI=1.52-2.22) and 17 percent (aOR=1.17, CI=0.97-1.43), respectively, more likely not to intend to use FP than women with secondary or above education, and the relation was significant among uneducated women. Similarly, Muslim women were three times (aOR=3.28, CI=2.66-4.02) more likely to intend not to use contraceptives than Hindu women. Likewise, women residing in rural areas and belonging to richer wealth index were significantly more likely to intend not to use FP methods than their counterparts. Conclusion: Although expenditure for enabling environment has increased, nonuse intentions of FP have increased in 2016 than in the survey year 2011, highlighting the necessity of different program modality. This study elucidates the necessity of focusing the FP interventions among uneducated women, rural women, and those belonging to the Muslim religion to increase the intention to use FP in the future.