High non-use of contraception among tribal and non-tribal women in North-Eastern India: alarming but neglected

Limited evidence exists about the contraception uptake in indigenous tribal groups of the north-eastern region of India. This study based on the National Family Health Survey (NFHS) IV (2015-2016) reports aimed to describe the pattern and factors associated with contraceptive non-use in the tribal women of the north-eastern part of India. The study was a cross-sectional analytical study based on secondary analysis of NFHS-IV data. All women in the age group of 15-49 years from the north-eastern part of India were included. Data were extracted and analysed using modified STATA-14 software. The association of socio-demographic and economic characteristics with contraceptive non-use was assessed using logistic regression. The inter-group differences of population characteristics for non-use contraceptives were assessed by modified Blinder-Oaxaca decomposition technique using 'Fairlie decomposition'. A total of 65,941 women were included, of whom 34,936 (52.9%) were tribal women. The proportion of contraceptive non-use was higher in tribal women. Tribal women with age at marriage above 30 years, Christian community, and women from Assam and Manipur state had higher odds of contraceptive non-use. The decomposition analysis showed that geographical variations, parity, and Christian religion contributed the most to contraceptive use disparity in the population. A huge gap was observed in contraceptive non-use among tribal and non-tribal women in the north-eastern part of India. The healthcare system must involve community representatives in designing context-specific community-based initiatives to increase the uptake of contraceptive use in these remote vulnerable communities.