Determinants of Modern Contraceptive Usage among Married Women: A Mixed-Methods Study in a Rural Community of India

Objective: A woman’s multifaceted feelings, knowledge, and perceptions of their intimate relations greatly influence their contraceptive behavior. In addition, women empowerment has been increasingly recognized as a key factor in family planning and reproductive health outcomes. This study aimed to assess modern contraceptive usage and its determinants among currently married women of reproductive-age (WRA) in rural Bengal. Materials and Methods: This mixed-method study was conducted in a rural area of Hooghly District, West Bengal from April to September 2021. The quantitative strand of the study was conducted by interviewing 210 currently married WRA. The qualitative strand was conducted via focussed group discussions among husbands/mothersin-law and in-depth interviews with healthcare workers. SPSS software was utilized for quantitative data analysis and factors associated with contraceptive usage were analyzed using logistic regression models. Qualitative data were analyzed thematically. Result: Currently 114 (54.8%) study participants were using modern contraceptive methods. Education (aOR=7.65, 95% CI=1.85-31.67), empowerment through freedom from family domination (aOR=5.56, 95% CI=1.30-23.66), attitude on contraception (aOR=4.67, 95% CI=1.26-17.19), and family planning counselling (aOR=4.41, 95% CI=1.12-17.33) were found to be significantly associated with modern contraceptive usage. Lack of couple counselling, family support, and knowledge gap was identified as the major barriers to contraceptive usage. Conclusion: Since a woman’s decision-making ability significantly affects their sexual and reproductive health outcomes, effective measures should be undertaken to empower them by creating awareness regarding their rights and freedom to make strategic life choices. Couple counselling should be prioritized to enhance male involvement and eliminate perceived barriers