Family Planning Practices in Kerala: A Critical Appraisal Using National Family Health Survey Data

Background Adequate attention to family planning can not only reduce poverty and hunger in countries with high birth rates but also avert maternal and childhood deaths. Kerala, the southernmost state of India, has achieved its replacement level fertility rate far ahead of India. The study aims to analyze the contraceptive prevalence of the state over the years and also at the district level and the choices of different family planning methods in the state. Methodology This study is a secondary data analysis using the available information from the National Family Health Survey (NFHS) available from “The demographic health survey program’s data distribution system.” Results The contraceptive prevalence rate (CPR) of Kerala showed an initial increase followed by a sudden fall by more than 10% in 10 years period during the 2015 survey, thereafter stabilized in 2019. Among the modern contraceptive methods, the most commonly used method consistently over the years was female sterilization (46.6%) and the least common method was male sterilization (0.1%). The unmet needs in family planning in the state varied across the districts from as high as 19.3% to 5.6% though it was reduced by 1.2 percentage units as compared to NFHS-4 data. Conclusion The findings contradict the assumption that the use of modern spacing techniques will increase with female literacy and a higher standard of living. Female-oriented nature of family planning practices in the state should be revisited and strategies should be brought to bring equal participation of males and females. Districts with reduced CPR should be prioritized and region-specific policy recommendations are necessary to address specific needs.