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. 2025 Mar 31;10(1):23.
doi: 10.1186/s40834-025-00362-7.

Voices unveiled: a mixed-methods exploration of family planning education, access, and Sociocultural determinants for enhancing contraceptive decision-making in western Gujarat, India

Vaibhav Shrivastav  1 , Yogesh M  2 , Dipesh Parmar  1 , Rohankumar Gandhi  1 , Sakshi Atulbhai Sojitra  1 , Kundal Tanmay Subhash  1 , Shah Pranjal Prasannakumar  1 , Lathiya Moxa Ashokbhai  1
Affiliations

Voices unveiled: a mixed-methods exploration of family planning education, access, and Sociocultural determinants for enhancing contraceptive decision-making in western Gujarat, India

Vaibhav Shrivastav et al. Contracept Reprod Med. .

Abstract

Background: Contraceptive use plays a crucial role in achieving desired fertility levels and improving maternal and child health outcomes. This study aimed to estimate the prevalence and determinants of contraceptive use among married women in Western Gujarat, India, using a mixed methods approach.

Methods: A community-based mixed-method study was conducted. A multistage stratified cluster sampling technique was used to recruit 840 married women aged 18-49 years for the quantitative component. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with contraceptive use. Additionally, 20 in-depth interviews and 4 focus group discussions were conducted to explore qualitative aspects of contraceptive use, using a purposive sampling technique.

Results: The contraceptive prevalence rate was 60.4%, with 46.7% using modern methods and 13.7% using traditional methods. Multivariate analysis revealed that higher education levels of women (graduation: aOR = 4.1, 95% CI: 1.4-12.0) and their husbands (graduation: aOR = 2.6, 95% CI: 1.0-6.9), women's employment status (not working: aOR = 0.6, 95% CI: 0.3-1.0), having 1-2 children (aOR = 3.6, 95% CI: 2.2-6.0), and joint decision-making was positively associated with contraceptive use. Age above 40 years (aOR = 0.2, 95% CI: 0.1-0.7) and contraceptive decisions made by other family members (aOR = 0.3, 95% CI: 0.1-0.8) were negatively associated with contraceptive use. Qualitative findings highlighted sociocultural barriers, such as community norms, religious beliefs, and gender power dynamics, as significant influences on contraceptive use.

Conclusions: This study provides a comprehensive understanding of the factors influencing contraceptive use in Western Gujarat. The findings underscore the need for multifaceted interventions that address individual, interpersonal, and sociocultural factors to improve contraceptive uptake and reproductive health outcomes. Interventions should focus on enhancing family planning education, improving access to services, promoting women's empowerment, and addressing sociocultural barriers.

Keywords: Contraceptive use; Determinants; India; Mixed methods; Prevalence; Western Gujarat.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: • Good clinical care guidelines were followed, and the guidelines were established as per the Helsinki Declaration 2008. • All the participants were given clear instructions about the study before the start of the study. • Written informed consent was obtained from the patients in the vernacular language for study participation. No identifying information or images have been included in the original article, which was submitted for publication in an online open-access publication. • The entire methodology and protocol were approved by the Institutional Ethical Committee of Shri M P Shah Government Medical College, Jamnagar, Gujarat, India. • An ethical approval was obtained from the institute (Shri M P Shah Government Medical College, Jamnagar, Gujarat, India) before the start of the study. (REF No: 285/03/23) Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
shows the mind map of the qualitative findings
See this image and copyright information in PMC

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