Steady rise in demand for contraception among women, study shows

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Family Planning 2030's 2022 Measurement Report, which was previewed in November 2022 at the International Conference on Family Planning, shows that more women in low- and lower-middle income countries are using modern family planning methods than ever before.

Today, one in three women of reproductive age in those countries are choosing to use modern contraception. While contraceptive prevalence has increased steadily across all low- and lower-middle income countries, in 14 of them the number of contraceptive users has doubled. The sharpest growth has been in sub-Saharan Africa.

The FP2030 report also suggests that despite the unprecedented strain Covid-19 placed on national health systems and global supply chains, and throughout restrictive lockdowns, record numbers of people around the world continued to seek out and use family-planning products and services.

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“The past 10 years have been full of obstacles for country health systems – wars, political upheavals, natural disasters, deadly disease outbreaks, and lately the Covid-19 pandemic – yet through it all, women everywhere have continued to seek out and use modern contraception in ever-growing numbers,” said Samukeliso Dube, executive director of FP2030.

“What our latest report shows is just how unstoppable the demand for modern contraception is: women want to control whether and when to have children, and how many children to have.”

In the last year alone, women’s use of contraception in low- and lower-middle income countries has averted more than 141 million unintended pregnancies, 29 million unsafe abortions and almost 150,000 maternal deaths.

"The benefits of family planning are enormous, and have a multiplier effect,” added Dube. “Family planning is the key to reducing maternal deaths; it is the difference between finishing high school and entering into early marriage and parenthood; and it can unlock a woman’s economic survival and prosperity.”

Soaring demand in sub-Saharan Africa

The latest FP2030 Measurement Report took a deep dive into 15 African countries, namely Benin, Burkina Faso, Ethiopia, Guinea, Madagascar, Mali, Mauritania, Mozambique, Niger, Nigeria, Rwanda, Senegal, Tanzania, Togo, and Uganda. Among other things, it looked at contraceptive use among youth and adolescents, and examined differences in method use based on age, geography, marital status, and more.

The report found that contraceptive use among married and unmarried sexually active women aged 15 to 24 is generally higher in east and southern Africa than in West Africa. However, unmet need is still high in both regions and for both populations. In most of the 15 countries reviewed, more than one in five sexually active young women (aged 15 to 24) have an unmet need for contraception.

“This report shows us that despite progress in recent years, there is still much work to be done when it comes to meeting the needs of women of reproductive age in sub-Saharan Africa,” said Jason Bremner, FP2030 senior director of data and measurement. “If this rising demand is not met by high quality services, consistent contraceptive supplies, and supportive policies and financing, it will be a missed opportunity for millions of women - and for our collective futures.”

It’s a woman’s right to choose.
Access to sexual & #reprohealth services can be measured by the access to a desired contraception method.@UNFPA procures millions of female #condoms yearly to enable access to female-controlled methods of prevention ���� https://t.co/VjAllG4Zww pic.twitter.com/11oJdeP5Hn

— FP2030 (@FP2030Global) January 26, 2023

Women’s marital status was also found to influence method use. Young married women aged 15 to 24 were found to rely on short-acting methods such as injections and pills and obtain these from government facilities, while most unmarried sexually active women aged 15 to 24 rely on condoms and obtain these from private health sources.

Today, implants are the most used method in 10 countries and the second most common method in another 14. This represents a stark contrast with method mix a decade ago, when implants were not as widely available. There is also evidence to indicate an increase in the use of long-acting methods (such as implants) among unmarried sexually active women in West Africa. Between 2012 and 2018, the use of implants in Benin, Guinea, and Mali more than doubled among unmarried sexually active women aged 15 to 24, and today more than one in five unmarried sexually active contraceptive user in these countries is using implants.

Stepping up progress

The new FP2030 report demonstrates the strength and resilience of a movement that has withstood a host of global challenges, as more and more countries and organisations recognise that voluntary, rights-based family planning is integral to their development and a major driver of gender equality.

Less than two years after the FP2030 global partnership was launched, 24 governments and 78 non-governmental actors - including civil society organisations, private-sector providers and youth-led organisations - have now made a public financial, policy or programmatic pledge to advance rights-based family planning, vowing to expand access to voluntary, rights-based contraception.

Nineteen countries in sub-Saharan Africa have also finalised their FP2030 commitments, which share many common priorities, including improving service delivery for young people, increasing domestic financing, scaling up postpartum family planning and strengthening supply chains.

At the same time, the report shows that donor government funding for family planning is not keeping up with the growing demand for modern contraception. While bilateral donor funding totalled approximately $1.4bn in 2021, this was essentially flat compared to 2020 and substantially lower than the peak achieved in 2019 ($1.52bn). Given current financial instability and inflationary trends around the world, there could be further funding cuts in the future.

“Failing to adequately fund family-planning efforts would be a missed opportunity for millions of women,” said Dube. “We need not only to hold the line, but also to secure new funding to accommodate the surge in demand for family planning. The hard-won gains of the last 10 years could slip away if we don’t act now.”