Modern Contraceptive Prevalence, Unmet Need, and Met Demand for Family Planning for All 75 Districts of Uttar Pradesh State in India: A District Level Analysis with the Family Planning Estimation Tool

Background: Empowering women to choose timing and number of children is the key to improve her reproductive and overall health. This requires availability of basket of contraceptives to choose from, improving access to contraceptive methods to women for acceptance of long term and short-term family planning methods. To date, efforts to assess progress on this front have been largely limited to the estimation and projection of family planning indicators at the national and state level but they are much needed at the district level, particularly for the most populous state in India with large demographic diversity like Uttar Pradesh. Methods: We have used a statistical model that can generate estimates and projections of rates and trends in indicators related to access to reproductive health at the national and subnational levels. For this, Avenir Health has packaged this model in the form of a user-friendly web application, the Family Planning Estimation Tool (FPET), which can be operated by local stakeholders with little external support. We present annual estimates and projections of rates and trends in the modern contraceptive prevalence rate, unmet need, and met demand for modern family planning methods for Uttar Pradesh state and all its 75 districts from 1991 to 2025 produced with FPET. Findings: There is a large amount of heterogeneity between the districts; only six districts have high modern contraceptive prevalence rate (mCPR > 50%) and are likely to reach met demand with a modern contraception of more than 70 percent by 2025 whereas Uttar Pradesh will reach 57.5 percent by 2025. Two districts out of 75 districts are likely to reach met demand with a modern method greater than 74 percent by 2025. Indeed, based on the increase in the modern contraceptive rate needed to achieve 74 percent or more demand satisfied with modern methods by 2025, three districts, namely, Balrampur, Basti and Shrawasti should be prioritized as these districts are at the bottom of the table with less than 20 percent of mCPR in 2020, and need additional support to increase needed modern contraceptive users, Uttar Pradesh demands most attention with a more than 4.5 million additional users of modern contraceptives required from 2015. Interpretation: The identification of districts that are performing better or worse