Contraception Clustering within households in India, NFHS-5, 2019-21

In both developed and less developed worlds, the impact of family planning programs modified
with the co-occurrence of social interaction. Individuals living in isolation may have a limited
knowledge of sexual and reproductive health or child’s development. Most women discuss their
fertility behaviour, like the use of a family plan. Women’s contraceptive behaviour heavily
depends on their willingness, which is diffused by the local environment, peer pressure, and
availability. Due to this dependence of younger women on the social network, we hypothesized
in our study that contraceptive use of younger married women in the household could be
influenced by the closest social network (her next older peer). We have used the latest National
Family Health Survey round, conducted in 2019-21. For the study, we have used the stochastic
process, where younger daughter-in-law (DIL) contraception depends on the state (using or not
using) revealed for the other older DIL within the family. For the same, we have used the
dynamic panel model; the panel consists of time-ordered DIL within households. From the
analysis, we found high contraception clustering in India, with around 121% clustering in the
contraception uses younger women, which is explained by the older’s contraception use. A
multivariable multinomial logistic regression was also used to examine the adjusted association
of contraceptive use of older DIL with younger contraception use, and we found that if the
older DIL was using a permanent contraception method, younger DIL was three times more
likely to use the permanent method of contraception (95% CI (2.91-4.03)). Similar results were
obtained for all other methods, where younger DIL was found using the same method as her
older peer within the household. From the analysis, we found that women mainly discuss their
methods before adopting them, and mostly the older peer in the family, which is in India,
primarily the next DIL influenced the contraception behaviour. So, it is essential to target these
older DILs as they might be more exposed to the outside world than the younger ones to
increase the modern contraceptive rate in the country.