BACKGROUND Uttar Pradesh (UP) is the most populous state in India with historically high levels of fertility rates than the national average. Though fertility levels in UP declined considerably in recent decades, the current level is well above the government's target of 2.1. DATA AND METHODS Fertility and family planning data obtained from the different rounds of Sample Registration System (SRS) and the National Family Health Survey (NFHS). We analyzed fertility and family planning trends in India and UP, including differences in methods mix, using SRS (1971-2016) and NFHS (1992-2016). Bivariate and multivariate regression analyses were used. RESULTS From 2000, while the total fertility rate (TFR) declined in UP, it is still well above the national level in 2015-16 (2.7 vs 2.18, respectively). The demand for family planning satisfied increased from 52 to 72% during 1998-99 to 2015-16 in UP, compared to an increase from 75 to 81% in India. Traditional methods play a much greater role in UP than in India (22 and 9% of the demand satisfied respectively), while use of sterilization was relatively low in UP when compared to the national averages (18.0 and 36.3% of current married women 15-49 years in UP and India, respectively in 2015-16). Within UP, district fertility ranged from 1.6 to 4.4, with higher fertility concentrated in districts with low female schooling, predominantly located in north-central UP. Fertility declines were largest in districts with high fertility in the late nineties (B = 7.33, p < .001). Among currently married women, use of traditional methods increased and accounted for almost one-third of users in 2015-16. Use of sterilization declined but remained the primary method (ranging from 33 to 41% of users in high and low fertility districts respectively) while condom use increased from 17 and 16% in 1998-99 to 23 and 25% in 2015-16 in low and high fertility districts respectively. CONCLUSIONS AND IMPLICATIONS Greater reliance on traditional methods and condoms coupled with relatively low demand for modern contraception suggest inadequate access to modern contraceptives, especially in district with high fertility rates. Family planning activities need to be appropriately scaled according to need and geography to ensure the achievement of state-level improvements in family planning programs and fertility outcomes.

中文翻译：

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印度北方邦的生育和计划生育：重大进展和持续存在的差距。

背景技术北方邦（UP）是印度人口最多的州，其生育率历史上高于全国平均水平。尽管近几十年来UP的生育率大大下降，但目前的水平仍大大高于政府设定的目标2.1。数据和方法从不同轮次的样本注册系统（SRS）和国家家庭健康调查（NFHS）获得的生育力和计划生育数据。我们使用SRS（1971-2016）和NFHS（1992-2016）分析了印度和UP的生育率和计划生育趋势，包括方法混合上的差异。使用双变量和多元回归分析。结果从2000年开始，虽然总生育率（TFR）下降，但仍远高于2015-16年的全国水平（分别为2.7和2.18）。UP的计划生育需求从1998-99到2015-16期间从52％增长到72％，而印度的需求从75％增长到81％。传统方法在UP中的作用远大于印度（分别满足22％和9％的需求），而与全国平均水平相比，UP中绝育的使用率相对较低（目前已婚妇女的18.0％和36.3％15-在2015-16年分别在UP和印度工作49年）。在UP内，地区的生育率介于1.6到4.4之间，较高的生育率集中在女性教育程度较低的地区，主要位于UP的中北部。在90年代后期，高生育率地区的生育率下降幅度最大（B = 7.33，p <.001）。在目前已婚妇女中，使用传统方法的人数有所增加，在2015-16年度占近三分之一的使用者。消毒的使用有所减少，但仍然是主要方法（在​​高生育率地区和低生育率地区分别为33％至41％的使用者），而安全套使用率从1998-99年的17％和16％上升到2015-16年的23％和25％的低水平地区和高生育率地区。结论和含义大量依赖传统方法和避孕套，加上对现代避孕药具的需求相对较低，这说明现代避孕药具的获取不足，特别是在高生育率地区。计划生育活动需要根据需要和地理位置进行适当调整，以确保在计划生育计划和生育结果上达到州一级的改善。