Unmet Need for Family Planning and Associated Factors Among Rural Women in Gandaki Province, Nepal: A Cross- Sectional Study
Abstract
Introduction: The unmet need for family planning remains a hurdle to reproductive health equity despite, global efforts to improve access, including in Nepal. This study aimed to assess the prevalence of unmet needs for family planning and associated factors among rural women in Nepal.
Methods: In 2023, a cross-sectional study was conducted among married women of reproductive age in a rural municipality in Gandaki Province, Nepal. We recruited 310 participants using consecutive sampling. Data were collected through face-to- face interviews using a structured questionnaire developed from previous literature, validated by experts, and pretested.Descriptive analysis was conducted for categorical variables, and multivariate logistic regression analysis was performed to identify factors associated with unmet needs.
Results: The mean age of the respondents was 28.5 ± 5.75 years (range: 17–45 years), and the mean age at marriage was 21.07 ± 3.32 years (range: 14–34 years). More than 80% of the respondents reported having good family planning knowledge, with healthcare workers being the primary source of information (74.8%). The unmet need for family planning was 18.1% (spacing: 16.5%; limiting: 1.6%). The odds of unmet need were higher in Dalit women (AOR 6.66, 95% CI:1.98–22.40) and women without children (AOR 2.78, 95% CI 1.09–7.13). Conversely, women with a basic education orbelow (AOR 0.14, 95% CI: 0.03–0.71) and those with husbands who are engaged in business (AOR 0.32, 95% CI 0.12–0.83)had lower odds.
Conclusion: This study highlights the significant unmet need for family planning among rural women in Nepal, particularly among adolescents, Dalit women, and those without children. Therefore, targeted interventions are required to address these disparities. Continued efforts should focus on improving family planning access in the study area and similar rural settings, although the findings may not be generalizable to the entire country.
2. Getaneh T, Negesse A, Dessie G, Desta M, Moltot T. Predictors of unmet need for family planning in Ethiopia 2019: a systematic review and meta analysis. Archives of Public Health. 2020;78:1-11.
3. Tadele A, Abebaw D, Ali R. Predictors of unmet need for family planning among all women of reproductive age in Ethiopia. Contraception and Reproductive Medicine. 2019;4:1-9.
4. Gelagay AA, Negash WD, Belachew TB, Bitew DA, Fentie EA, Worku AG, et al. Magnitude of unmet need for family planning and associated factors among women in the extended postpartum period in Dabat district, Northwest Ethiopia. evidence from Dabat demographic health surveys. BMC Public Health. 2023;23(1):1123.
5. Ministry of Health and Population (Nepal), New ERA, ICF. Nepal Demographic and Health Survey 2022. 2023.
6. Ministry of Health and Population (Nepal), New ERA, ICF. Nepal Demographic Health Survey 2016. 2017.
7. Bhatt N, Bhatt B, Neupane B, Karki A, Bhatta T, Thapa J, et al. Perceptions of family planning services and its key barriers among adolescents and young people in Eastern Nepal: A qualitative study. PloS one. 2021;16(5):e0252184.
8. Asif MF, Pervaiz Z. Socio-demographic determinants of unmet need for family planning among married women in Pakistan. BMC public health. 2019;19:1-8.
9. Målqvist M, Hultstrand J, Larsson M, Ashish K. High levels of unmet need for family planning in Nepal. Sexual & Reproductive Healthcare. 2018;17:1-6.
10. Bhusal CK, Bhattarai S. Factors affecting unmet need of family planning among married Tharu women of Dang District, Nepal. International journal of reproductive medicine. 2018;2018.
11. Girma Garo M, Garoma Abe S, Dugasa Girsha W, Daka DW. Unmet need for family planning and associated factors among currently married women of reproductive age in Bishoftu town, Eastern Ethiopia. PloS one. 2021;16(12):e0260972.
12. Dowerah J, Murthy MN, Kulkarni P. Prevalence and pattern of contraceptive use and unmet need among women of reproductive age in urban Mysuru. Clinical Epidemiology and Global Health.2020;8(4):1221-4.
13. Karki R, Gupta M, Kaphle M. Prevalence and Risk Factors of Child Marriage Among Madhesi Women in Nepal’s Terai Region. Journal of Family & Reproductive Health. 2024;18(2):94.
14. Amaje E, Ayalew T. Unmet need for family planning and associated factors, among women of child-bearing age working in Hawassa industrial park, Southern Ethiopia 2021: An institution based cross-sectional study. Clinical Epidemiology and Global Health. 2022;17:101122.
15. World Health Organization. Unmet need for family planning [Internet]. 2024 [cited 2024 May 22]. Available from: https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3414.
16. AlMulla A, Mamtani R, Cheema S, Maisonneuve P, Daghfal J, Kouyoumjian S. The association between tobacco use and COVID-19 in Qatar. Preventive Medicine Reports. 2022;28:101832.
17. Imran M, Yasmeen R. Unmet need for family planning in Pakistan: prevalence and factors influencing unmet need among women of reproductive age. International Journal of Women Empowerment. 2021;7.
18. Yaya S, Idriss-Wheeler D, Uthman OA, Bishwajit G. Determinants of unmet need for family planning in Gambia & Mozambique: implications for women’s health. BMC women's health. 2021;21:1-8.
19. Wai MM, Bjertness E, Stigum H, Htay TT, Liabsuetrakul T, Moe Myint AN, et al. Unmet need for family planning among urban and rural married women in Yangon region, Myanmar—a cross-sectional study. International journal of environmental research and public health. 2019;16(19):3742.
20. Prakash DP, Jhabindra PP, Kristin B. Unmet Need for Family Planning and Fertility in Nepal: Levels, Trends, and Determinants [Internet]. 2019 [cited 2024 2024 May 22]. Available from: https://www.dhsprogram.com/pubs/pdf/FA119/FA119.pdf.
21. Teshale AB. Factors associated with unmet need for family planning in sub-Saharan Africa: A multilevel multinomial logistic regression analysis. Plos one. 2022;17(2):e0263885.
22. Joshi AK, Tiwari DP, Poudyal A, Shrestha N, Acharya U, Dhungana GP. Utilization of family planning methods among postpartum mothers in Kailali district, Nepal. International journal of women's health. 2020:487-94.
23. Devaraj K, Gausman J, Mishra R, Kumar A, Kim R, Subramanian S. Trends in prevalence of unmet need for family planning in India: patterns of change across 36 States and Union Territories, 1993–2021. Reproductive Health. 2024;21(1):48.
24. Singh DR, Shrestha S, Karki K, Sunuwar DR, Khadka DB, Maharjan D, et al. Parental knowledge and communication with their adolescent on sexual and reproductive health issues in Nepal. Plos one. 2023;18(7):e0289116.
25. Ministry of Health and Population [Nepal]. Annual health report 2021/2022. Kathmandu:Department of Health Services 2023.
26. Bekele D, Surur F, Nigatu B, Teklu A, Getinet T, Kassa M, et al. Knowledge and attitude towards family planning among women of reproductive age in emerging regions of Ethiopia. Journal of Multidisciplinary Healthcare. 2020:1463-74.
27. Barrow A, Jobe A, Okonofua F. Prevalence and determinants of unmet family planning needs among women of childbearing age in the Gambia: analysis of nationally representative data.Gates Open Research. 2021;4(124):124.
28. Mosuse MA, Gadeyne S. Prevalence and factors associated with unmet need for family planning among women of reproductive age (15–49) in the Democratic Republic of Congo: A multilevel mixed-effects analysis. Plos one. 2022;17(10):e0275869.
| Files | ||
| Issue | Vol 11 No 3 (2025) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/jbe.v11i3.21367 | |
| Keywords | ||
| Family Planning reproductive health unmet need Nepal | ||
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