Understanding the healthcare provider role on post abortion contraception adoption in India using National Family Household Survey-5

Background Post abortion contraceptive use is an important area in provisioning of services associated with child birth planning. This study examines the factors related to the type and timing of initiation of contraception adoption among women who had undergone induced abortion. Study also tries to identify the role of personnel who provided the abortion service on decision of family planning adoption using complementary log-log model in India. Methodology The study uses the secondary data from the fifth round of the National Family Household Survey conducted during 2019-21. For, the analysis, we have used five-year women's reproductive calendar to extract information on contraceptive use, post last induced abortion among women. We used complementary log-log regression models, to estimate relative risk ratios and its 95% Confidence intervals (CI). Results According to NFHS-5, out of all the last pregnancies (2,55,549), about three percent resulted in abortion. Most of the abortion occurred in private facilities (55%), with the help of health professionals (71%). From the women's reproductive calendar, it was found that around 40% of the women adopted modern methods of contraception, with maximum adopting spacing method (33%), and only handful adopted permanent method (7%). It was also found that the likelihood of early adoption of permanent method increased to two times when the abortion is done by health professional compared to others [95% CI (1.25-3.30)]. Conclusion This emphasises a need for quality counselling related to timing and types of family planning as an essential part of the family planning program ensuring client centric approach suited to their needs and contexts that helps in alleviating any apprehensions associated with adverse effects of modern contraceptive methods. Keywords: Post-abortion contraception use, Health workers, Reproductive Calendar Data, National Family Household Survey, India