New study shows little progress in meeting demand for contraception in poorest countries

A new study released at the third Women Deliver conference currently taking place in Kuala Lumpur, Malaysia, shows that the number of women wanting to avoid pregnancy and in need of effective contraception increased substantially as the use of contraceptive methods also increased.

The Guttmacher Institute report, Adding It Up: The Need for and Cost of Maternal and Newborn Care, Estimates for 2012 also noted that the world has made little progress towards meeting the demand for contraceptives in the world’s poorest countries.

The report’s researchers found that in the developing world between 2003 and 2012, overall modern contraceptive use increased from 71% to 74% among women wanting to avoid pregnancy, although rates varied greatly among sub regions. Notable progress was made in Eastern Africa (31-46%), Southern Africa (75-83%), Southeast Asia (64-72%), Central America (71-77%) and South America (73-79%). In contrast, virtually no progress was made in the sub regions with the lowest rates of use: in Middle Africa, contraceptive use increased from just 17 to 19% and in Western Africa from 22 to 26%. Overall, in most sub regions, modern contraceptive use grew more slowly between 2008 and 2012 than between 2003 and 2008.

One of the researchers, Jacqueline E. Darroch, noted that: “Unless the adequacy of family planning services improves more rapidly than it has in the past decade, the number of women with an unmet need for modern contraceptives will continue to rise, especially in the 69 poorest countries.”

The study also shows that among women using modern contraceptives, there has been a
shift away from sterilization towards methods with higher failure rates which could result in an overall increase in contraceptive failure and unintended pregnancies. The study calls for increasing support for users of contraception to improve the consistency and correct use of reversible methods.

According to Susheela Singh who co-authored the research: “In order to make substantial and sustainable progress, improving the quality of services must become a priority. This includes providing adequate follow-up care, facilitating informed choice among methods, increasing public education and addressing the needs of young people for quality information and services.”

Gustavo Suárez from the Guttmacher Institute clarified that the increased number of women in need of contraception between 2003 and 2012- because of a larger population and desire for smaller families - presented a serious challenge to the family planning service system - public, NGO and private. In that sense, the growth in the number of modern method users is good news because services kept up with this growth and the unmet need even decreased a little. However, it is still of concern that only very limited progress was made to meet the unmet need and that millions of women still need access to modern contraceptive information and services.

He added that some of the report’s findings have clear implications for HIV prevention, for instance the increase in use of barrier methods—primarily the male condom—which went from 15% of all modern contraceptive use in Sub-Saharan Africa in 2003 to 21% in 2012.

Also being discussed at Women Deliver 2013 this week is Link Up, a multi-country three year project with upcoming interventions geared to increase response to the contraceptive needs of young women in an integrated HIV and sexual and reproductive health and rights (SRHR) programme. According to Felicia Wong from the International HIV/AIDS Alliance which is leading the consortium of international and national organisations involved in Link Up, the project will target young people most affected by and living with HIV and it aims to reach more than one million young people with integrated SRHR/HIV services including antiretroviral drugs, contraceptives and other commodities in Uganda, Burundi, Ethiopia, Bangladesh and Myanmar.

World Health Organisation data estimates from 2010 show that the unmet need for family planning in Uganda is 33.8% while that of Ethiopia stands at 38.2%.

The Women Deliver conference has brought together voices from around the world to generate political commitment and resource investments to improve the health and wellbeing of girls and women and achieve universal access to reproductive health.