NGJI, An International Peer-Reviewed Journal NGSI-BHU, ISSN: 0027-9374/2019/1720 Vol. 65, No. 4, December 2019 Implications of Human Development on Contraception and Maternal Health: A Study of Regional Patterns in Uttar Pradesh Divyanshi Singh1 and Vijay Kumar Baraik2 1Ph.D. Scholar, Discipline of Geography, School of Sciences, IGNOU, New Delhi, 2Associate Professor, Discipline of Geography, School of Sciences, IGNOU, New Delhi (Corresponding Email- [email protected]) Abstract Women's right to have choices, sense of self- worth and their right to have access to opportunities have been a subject of serious concern. The level of human development in the society is reection of better status of a woman, which has a clear impact on the usage of contraceptive methods and maternal health. The study is an attempt to assess the performance of Uttar Pradesh on the parameters of levels of human development and to see how the developmental trajectory is inuencing the choice for contraception and maternal health. Multiple Regression has been done to analyse the relationship between development aspect, contraception and maternal health. Better education and health facilities along with good income show strong impact on choice of contraception which ultimately leads to better maternal health. Keywords: contraceptives, maternal health, multiple regression, human development, women's right Introduction Empowerment refers to principles, such as choices, with choices incorporating the ability of individuals and groups to act in dimensions like resources, agency and order to ensure their own well-being or their achievements (Kabeer, 1999, 2005). Women right to participate in decision making. empowerment is a process that occurs over N u m e r o u s t e r m s h a v e b e e n u s e d time and involves women as agents who have interchangeably to dene or capture the ability to formulate choices, control empowerment including autonomy, power, resources and take decisions affecting status, agency and so on (Dyson and Moore, important life outcomes (Pande, Malhotra & 1983; Jejeebhoy, 1995; Kishor, 1995; Mason, Namy, 2012). 1987; Presser and Sen, 2000). Women Women's empowerment is measured in empowerment has been dened as women's terms of resources, agency and achievements ability and freedom to make strategic life along with highlighting the interdependence of Implications of Human Development on Contraception and Maternal Health... 377 individual and structural change in the process There are serious health outcomes for a of empowerment. These structures shape women and her child when she is powerless, individual resources, agency and achievements denied to access opportunities and of low social (Kabeer, 1999). Autonomy to both sexes mean status. Women's desires and ability to control equal decision making ability in personal her fertility and her choice to use affairs. Moreover local level kinship structure contraceptives and choice of contraceptive have demographic implications and also decide methods are affected by her status in household the extent to which women can pursue their self and her own self of empowerment. But choice interest (Dyson and Moore,1983). The issue of of contraception and maternal health is also important role of women in economic reection of developmental status of a society. development addresses issues like need to Access to education, availability of free and invest and provide support to women, compulsory education, better health care constraints on realizing full potential of women facilities and per capita income play a major and future interventions needed to overcome role in uses of family planning methods and the constraints (Castellino and Diop, 2013). maternal health. The progress of a society in Women's status has been very detrimental human development leads to strengthening of in maternal health. The health of women and women's status which has clear implications on their children in Indian society is adversely choice for contraception and maternal health. affected by the women's inferior status within In the present study is an attempt to explore households. The subjugated position of women women's choice to use contraception is mainly result of socio-culturally determined depending upon their levels of human roles for her which dominates every aspect of development and to analyse the extent to which her life (Hameed, Azmat, and Ali, 2014). Lack the development trajectory is inuencing the of knowledge of health care, lack of regular maternal health outcomes. Many of the studies medical assistance, nutritional deciency, high focus on maternal heath and contraception but fertility resulting into greater frequency of the implications of human development on birth, repeated abortions leading to maternal contraception and maternal health is serious death and high Infant Mortality Rate- all these issue which needs greater attention. The study are evidences of or result of poverty, argues that differences in levels of human powerlessness and low social status of women. development have different implications for Maternal mortality is symptomatic of gender- maternal health and contraception. based social, cultural, economic, educational inequalities and multiple deprivations that The objective of the study is to investigate undermine women's access to health services. the impact of levels of human development on Early marriage, early pregnancy, unprotected usage of contraceptives and maternal health in sex, unwanted pregnancies and abortions bring the districts of Uttar Pradesh and to examine the down her resistance to morbidity nally relationship among the three. The study will leading to high mortality. Gender biasness in provide evidence on implications of human health care seeking behavior has been a global development on contraception and maternal picture. Women's status is a powerful source of health which would help in policymaking to longevity, mental and physical health. Lesser improve in human development parameters to the empowered women is, higher the risk of better the usage of contraception and maternal reproductive health complications will be. health in the lagging behind districts. 378 Divyanshi Singh and Vijay Kumar Baraik Study Area satisfactory level. Drop-out rate at primary Uttar Pradesh (U.P.) has been taken as the level is eight percent. 32 percent of the married study area in order to see the implications of women in Uttar Pradesh are deprived of human development on contraceptive usage institutional delivery (NFHS-4th Round 2015- and maternal health. Uttar Pradesh, the most 16). On the basis of economic development, the populous state in India, has an estimated position of the state in per capita Gross population of 197 million people in 2011 Domestic Product is second last. Human (Census, 2011), approximately 17 per cent of development in the study area needs urgent India's total population. U.P. falls behind most attention. of the other Indian states with respect to health Data sources and methodology indicators like Neo-natal Mortality Rate, Data for contraceptives usage has been Maternal Mortality Rate, Total Fertility Rate, taken from National Family Health Survey proportion of Low-Birth Weight among new (NFHS) round 4 (2015-16). NFHS is a large born, Institutional Deliveries, immunization scale, multi round survey that is conducted in and utilization of Anti-Natal and Post-Natal representative sample of households in India. care. For the proposed study, data related to the The rationale behind choosing Uttar currently married women aged 15-49 has been Pradesh for the study is that the state is the poor taken who were exposed to pregnancy during performer in Contraceptive Prevalence Rate the survey. Data on indicators of maternal (CPR, 45.5%) which is below national average health (Maternal Mortality Rate, women (53.5%) as per National Family Health Survey suffered abortions and women got infection (NFHS) Report 4th round 2015-16. Moreover, during intercourse) have been taken from the state has also been one of the poor NFHS round 4 (2015-16) and Annual Health performers in maternal health care. Neonatal Survey Report of Uttar Pradesh (2013-14). mortality and under ve mortality rate is 30 and These indicators of maternal health are selected 46 per 1000 live births (Sample Registration as they better represent the choice for System report, 2014-16) respectively in Uttar contraception. Effective Literacy Rate data has Pradesh. In the year 2016, IMR for U.P. was 41 been taken from census 2011. Infant Mortality per 1000 live births whereas for India it was 33 Rate has been taken from Annual Health per 1000 live births (Sample Registration Survey Report of Uttar Pradesh (2012-13) and System Report, 2014-16). Maternal Mortality district domestic product has been taken from Rate for Uttar Pradesh is very high with 216 per data.gov.in (2012-13). 100000 live births, whereas for India it is 122 For the study, both qualitative and per 100000 live births (MMR Special Bulletin, quantitative approach has been adopted to get 2015-17). Human Development Index value the desired goals. Calculation of Contraceptive for the state is 0.59 (2017). However, the Prevalence Rate has been done using the performance of the state in education index, following formula: health index and income index is below Implications of Human Development on Contraception and Maternal Health... 379 Maternal Health Index to investigate the been obtained by using the following formula: impact of contraception