New Study Reveals Large Differences in Types of Contraceptives Used Across Regions and Age Groups
Medical Xpress, July 22, 2022
Published today in The Lancet by the Global Burden of Disease study, the most comprehensive assessment of worldwide contraceptive need and use estimated that over 160 million women and adolescents with a need to prevent childbearing remained without contraception in 2019—despite major increases in use at a global level since 1970. This study provides estimates of worldwide contraceptive use, need and type continuously from 1970 to 2019 by country, age group, and marital status.
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Based on data from 1,162 self-reported representative surveys on women’s contraceptive use, the authors used modeling to produce national estimates of various family planning indicators, including the proportion of women of reproductive age (15-49 years) using any contraceptive method, the proportion of women of reproductive age using modern methods, the types of contraceptives in use, demand satisfied with modern methods, and unmet need for any contraceptive method. Women were defined as needing contraception when they were married or if unmarried, sexually active, able to get pregnant and not wanting a child within two years, or if they were pregnant or had just given birth but would have preferred to delay or prevent their pregnancy.
Gaps in contraceptive use remain after major global progress
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Worldwide, the share of women of reproductive age using modern contraception increased from 28% in 1970 to 48% in 2019. Demand satisfied rose from 55% in 1970 to 79% in 2019. Despite the major increases, 163 million women who were not currently using contraception were considered to have need in 2019 (out of 1.2 billion women who needed contraception in total).
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Wide disparities mean failure to reach goal in priority countries
In 2019, the availability of contraceptives still differed significantly between regions and across different countries.
Southeast Asia, East Asia and Oceania had the highest use of modern contraceptives (65%) and demand satisfied (90%); whereas sub-Saharan Africa had the lowest use of modern contraceptives (24%) and demand satisfied (52%). Between countries, levels of modern contraceptive use ranged from 2% in South Sudan to 88% in Norway. Unmet need was highest in South Sudan (35%), Central African Republic (29%) and Vanuatu (28%) in 2019.
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Lack of contraceptive variety may mean no suitable options for certain groups
The types of contraceptive methods in use vary significantly by location. The authors suggest that the dominance of single methods could indicate a lack of suitable choices for women and adolescent girls.
In 2019, female sterilization and oral contraceptives were dominant in Latin America and the Caribbean; the oral conceptive pill and condoms in high-income countries; IUDs and condoms in central Europe, eastern Europe and central Asia. Female sterilization comprised more than half of all contraceptive use in south Asia. In addition, in 28 countries, more than half of women were using the same method, indicating that there may be a limited availability of options in these areas.
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Writing in a linked Comment, Dr. Manas Ranjan Pradhan, International Institute for Population Sciences, who was not involved in the study, says that “the study estimates 1.176 billion women had need for contraception, of whom 162.9 million had unmet need; of those with an unmet need, 56.5% resided in sub-Saharan Africa and south Asia and 26.5% were aged 15–24 years in 2019. The higher unmet need among partnered adolescent women represents a risk for unintended pregnancies, affecting the subsequent socioeconomic empowerment of these groups. The sociodemographic index influences the mCPR [modern contraceptive prevalence rate] and demand satisfaction among adolescents, probably due to vast inequalities on the basis of socioeconomic status and access to health-care services. Lower mCPR and higher unmet need might delay the realization of the contraception-induced socioeconomic benefits of education and work. The study reinforces calls for implementation of strategies and programs tailored to adolescents in countries with high unmet need among younger women.”
