Tarun Kumar Roy

Do current measurement approaches underestimate levels of unwanted childbearing? Evidence from rural India

The validity of estimates of unintended childbearing has often been questioned, especially given their almost exclusive reliance on responses to survey questions that ask women to recall their intentions about past pregnancies. An opportunity to compare prospective and retrospective descriptions of intendedness was provided by a follow-up survey in four Indian states in 2002–2003 of rural woman originally interviewed in the 1998–99 National Family Health Survey-2. The results demonstrate a pronounced tendency for births prospectively classified as unwanted to be retrospectively described as having been wanted or mistimed. The main reason seems to be either that mothers adapt to the reality of a new birth or are reluctant to describe an existing child as having initially been unwanted. Our findings suggest that retrospective accounts of the wantedness of a birth, such as those obtained by current Demographic and Health Surveys, may lead to significant underestimates of true levels of unwanted childbearing.

Consistency and predictive ability of fertility preference indicators: longitudinal evidence from rural India.

CONTEXT Ideal family size and desire for an additional child are the two most commonly used fertility preference indicators. However, little is known about the consistency over time of responses to each measure, the consistency between the two indicators or the predictive value of these indicators in India. METHOD Longitudinal data from the 1998-1999 National Family Health Survey and a follow-up survey conducted four years later were analyzed to determine the consistency of responses to the two fertility preference indicators (both over time and between indicators) and to determine whether baseline responses were associated with subsequent fertility, unwanted births and contraceptive use. RESULTS Responses on the measure of ideal family size were consistent at the two time points for 53% of nonsterilized women. Eighty-two percent of women who explicitly said in 1998 that they did not desire more children responded identically in 2002, although about half of these women had given birth in the intervening period. The indicators were associated with each other: Among women with at least one son, 79% of those who had attained or surpassed their ideal family size said they wanted to stop childbearing, compared with 18% of those who had not. Both indicators predicted future fertility, unwanted births and contraceptive use, particularly among women who had a son. CONCLUSION Both indicators are useful in understanding future fertility behavior. As the prevalence of son preference declines in India, the predictive ability of the indicators is likely to improve.

PROGRAMMATIC IMPLICATIONS OF MEETING THE UNMET NEED FOR CONTRACEPTION: Evidences from a longitudinal study in rural India

Based on a longitudinal study in rural India, this article examines whether (i) women in unmet need are more likely to use contraception compared to those in no need; (ii) meeting unmet need can reduce unwanted pregnancies; (iii) contraceptive intentions with fertility preferences can enhance the utility of unmet need. The study covered 6303 women interviewed in 1998 and followed-up in 2002 in the states of Bihar, Maharashtra and Tamil Nadu. During the four years, one-fifth of the women transited from unmet to met need in Bihar compared to three-fifths in Maharashtra and half in Tamil Nadu. As acceptance of contraception becomes the norm, women in unmet need tend to become a selective group with less urge to use contraception. For a population in the transitional stage of contraceptive adoption, use of unmet need is beneficial and useful in predicting unwanted pregnancies. Further, contraceptive intentions with fertility preferences enhance the scope of unmet need.