The voice of Indian women on family planning: A qualitative systematic review

Abstract Objective The systematic review explores personal experiences and perceptions of (and on) resident Indian women on family planning. Methods We included qualitative studies conducted among women, husbands and mothers-in-law. Search on five databases (published between 2000 and May 8, 2019) and forward and backward citations search of included studies were undertaken (April 2020). Three-stage screening and data extraction were done independently. Iterative process was followed to thematically analyse the data and presented it using the World Health Organization conceptual framework on social determinants of health. Result Of 857 citations, we included 48 qualitative studies. Women's intent of using family planning services/methods was influenced by multiple factors such as socio-demographic characteristics. Women's agency and social status affected their standing in family planning decision-making. Fear of side-effects of contraception methods, access to information and support, and cultural and religious beliefs hindered the use of modern methods of contraceptive. Undesirable attitudes of service providers influenced underutilisation of family planning services. Ineffective contraceptive choice counselling, particularly for poor section of the community and high-risk groups were reported. While considering inter-pregnancy interval, some of the women opted for induced abortion to terminate unplanned pregnancy however, had meagre acceptance for using modern contraceptive methods. Conclusion The findings call for reinvigorated efforts to provide effective and individually, religiously, regionally and culturally appropriate interventions to improve family planning access and ultimately support better health and rights of women in India.