Association of Socio-demographic and Decision Making Factors with the unmet need of family planning among Married Women in Madi Municipality, Chitwan, Nepal

Background Sustainable Development Goal of Nepal targets universal access to family planning (FP) services and increasing the contraceptive prevalence rate to 75% by 2030. Despite continuous efforts from the government of Nepal in the FP sector, the prevalence of unmet need for FP is high. This study aimed to identify sociodemographic and decision-making factors associated with the unmet need for FP among married women of reproductive age. Methods This is a community-based cross-sectional study conducted in Madi municipality, Chitwan, Nepal. Face-to-face interviews were conducted with 218 married women of reproductive age using a semi-structured questionnaire. Descriptive statistics, chi-square tests and multivariable logistic regression were used to analyse the data. Results Nearly half (47%) were age group 25–34, 58% lived in nuclear families, 76% belonged to advantaged ethnic groups, majority of respondents (67%) and their husbands (75%) had at least secondary education. Most women (59%) were involved in agriculture, while most husbands (44%) were in foreign employment. Participants (91.3%) have heard about Depo-Provera. The overall unmet need for FP was 38%. Respondents whose husbands were involved in foreign employment were more likely [aOR: 4.408; CI: 2.068–9.399] to have an unmet need for FP than those employed within the country. The likelihood of the unmet need was higher [aOR: 3.212; CI: 1.368–8.135] among couples who did not discuss using FP methods compared to those who discussed three or more times. Women with up to two children [aOR: 5.212; CI: 1.163–23.363] and three or more children [aOR: 8.758; CI: 1.691–45.355] were more likely to have a higher unmet need for FP than women without a child. Conclusion A significant proportion of women had an unmet need for FP. Intervention should focus on addressing the FP needs of migrants and their spouses, promoting spousal discussion on FP and counselling on the treatment as well as side effects of contraceptives. Furthermore, empowering women would enable them in the decision-making process and in accessing FP services.