City specific interventions needed to improve contraceptive prevalence in India

Introduction: Low contraceptive prevalence combined with rapid urbanization requires new focus on meeting family planning needs of the urban poor. Survey results and intervention lessons from the Urban Health Initiative in India demonstrated the needs of context specific strategies to meet unmet need, increase contraceptive prevalence and contribute to larger family planning and health goals.

Objective: To demonstrate how to systematically design and implement specific strategies that are responsive to the needs of each population segment.

Method: A baseline survey sampled 30,929 people including 3000 married women in each of six cities of Uttar Pradesh India. Women and men questionnaires were administered. Analysis was done by age, parity and wealth quintile to best understand the need of various population segments.

Results: Contraceptive Prevalence Rate in lowest and highest wealth quintile in Aligarh is 27% and 50% and for Allahabad it is 46% and 50% respectively. Unmet need in lowest and highest wealth quintile in Aligarh is 28.6% and 8.2% and for Allahabad it is 16.4% and 6.4%. Responsive to findings, program strategies were designed to place needed emphasis in reaching the urban poor.

Conclusion: Comprehensive family planning program with specific interventions based on city's profile as well as specific interventions to reach different population groups is required to achieve city wide improvements in CPR. Successful city specific approach with a focus on urban poor helps decision makers to expedite implementation of services that increases CPR and reduces unmet need.