Exploring the unmet needs of family planning: Insights from a cross-sectional study in a rural area of coastal Karnataka, India

Objectives: Despite decades of programmatic initiatives, family planning remains a public health concern in India. The present study was conducted to evaluate the prevalence and determinants of unmet needs of family planning in a rural area of Udupi district in Coastal Karnataka, South India. Methods: A cross-sectional study was conducted among 565 married women aged 18–49 years, using a semi-structured questionnaire. Information on socio-demographic factors, contraceptive awareness, and contraceptive use was collected. Data was analysed to find the prevalence of unmet need for family planning and to identify associated factors. Results: A total of 565 married women aged 18–49 years participated. The overall prevalence of unmet need for family planning was 40.3% (13.5% for spacing and 26.9% for limiting). The prevalence rate of contraception was determined to be 46%, with 260 women currently using contraceptives, 77 past users, and 228 never users. Multivariate analysis showed that age below 30 years (AOR = 0.54, 95% CI: 0.30–0.98, p = 0.043), place of last delivery at home (AOR = 2.94, 95% CI: 1.04–8.36, p = 0.042), ideal number of female children as one (AOR = 4.82, 95% CI: 1.00–18.87, p = 0.050), wanting more than two children at marriage (AOR = 2.46, 95% CI: 1.09–5.57, p = 0.030), and lack of awareness about IUCD (AOR = 0.15, 95% CI: 0.03–0.71, p = 0.017) were significant independent determinants of unmet need for family planning. Conclusion: These results demonstrate the significant discrepancy between knowledge and use of contraceptive methods in this area with otherwise positive health indicators, indicating the need for focussed interventions that address sociocultural barriers and misconceptions to increase the accessibility and acceptance of family planning services.