In Tanzania, knowledge of contraception is almost universal. The most commonly known methods among men and women are the birth control pill, injectables and male condoms. Photo: Sawiche Wamunza
The number of women with an unmet need for modern contraception increased in sub-Saharan Africa, from 31 million in 2008 to 36 million in 2012. This is according to a new study released yesterday by the Guttmacher Institute and UNFPA, the United Nations Population Fund.
An estimated 80 million unintended pregnancies will occur in 2012 in the developing world as a result of contraceptive failure and non-use among women who do not want a pregnancy soon. These unintended pregnancies will result in 30 million unplanned births, 40 million abortions and 10 million miscarriages. Providing contraceptive care will save lives and reduce health service costs.
The report, Adding It Up: Costs and Benefits of Contraceptive Services – Estimates for 2012, finds that unmet need for modern contraception in the 69 poorest countries – which account for 73 per cent of all unmet need in the developing world – also increased, from 153 to 162 million women in 2008–2012. The proportion of married women with an unmet need for modern contraception is 18 per cent in the developing world, but is much higher than average (30–37per cent) in West Africa, Middle Africa and East Africa.
In the developing world as a whole, the proportion of women with an unmet need for modern methods declined by 1.7 per cent, from 27.2 per cent to 25.5 per cent, between 2008 and 2012; the annual rate of decline was 1.5 per cent. The annual rate of decline was above average in East Africa and Southern Africa.
As women’s contraceptive needs and life circumstances vary over their reproductive lifespan, women will move between needing and not needing contraception, and many will move between using modern methods and having unmet need. The current estimates presented in the study report represent a snapshot of the status of all women in developing countries in 2012.
Meeting the current need for modern contraception would reduce pregnancy-related deaths by 79,000 in the developing world. Most of this reduction – a drop of 48,000 maternal deaths – would take place in Sub-Saharan Africa, the region with the highest levels of maternal mortality and unmet need for modern contraception.
Use of modern contraceptive methods
In 2012 in the developing world, modern methods are used by 57 per cent of married women. However, in sub-Saharan Africa the figure is a low 17 per cent, the same as that recorded for 2008. In contrast to the region, the Southern African figure is a relatively high 58 per cent, which is 1 per cent higher than the global average for the developing world.
In the 69 poorest countries in the world, 40 per cent of married women are using modern methods in 2012. Between 2008 and 2012, the number of modern method users increased by 42 million in the developing world as a whole, an average annual increase of roughly 10 million users. This represents a stabilization in the level of modern contraceptive use in recent years.
Despite overall stabilization, there have been some important changes within regions. More substantial increases in modern method prevalence rates among married women were seen in East Africa (from 20 per cent in 2008 to 27 per cent in 2012), and in Southern Africa (from 54 per cent in 2008 to 58 per cent in 2012). Notably, there was no increase in West Africa (9 per cent) and Middle Africa (7 per cent), areas where modern contraceptive use continues to be very low. In these subregions, health systems are especially weak and mortality rates very high, and the need for comprehensive care that includes contraceptive, maternal, infant and child health services – relevant for all countries – is particularly great.
These different regional trends are illustrated by some country examples. Ethiopia, Malawi and Rwanda saw substantial increases, while Nigeria and Zimbabwe witnessed less change in recent years. All countries that have experienced little recent growth in contraceptive prevalence need attention, but the situation of countries such as Nigeria, where change is slow and modern method use is very low, requires particularly careful examination to determine how to meet existing contraceptive needs.
It is estimated that 52 million never-married women in the developing world as a whole are sexually active and in need of contraceptives to prevent pregnancy in 2012. About 55 per cent of never-married women in need in sub-Saharan Africa are using modern contraceptive methods.
In sub-Saharan Africa, where the proportion of never-married women in need using modern contraceptives is 19 percentage points higher than among their married counterparts, this is an indication of the strength of motivation of unmarried women to avoid childbearing before marriage, and also to avoid HIV and STI infection, as the condom is the predominant method used by never-married women in this region.
Providing the current level of contraceptive care in the developing world costs $4 billion annually and saves $5.6 billion in maternal and newborn health service costs. The report finds that fully meeting all need for modern contraceptive methods would cost $8.1 billion per year. This additional $4.1 billion investment would save another $5.7 billion, or $1.40 for every dollar spent.
The effects of filling the current unmet need for modern contraceptive methods would be dramatic.
- Unintended pregnancies would decline by two-thirds, from 80 million to 26 million.
- There would be 26 million fewer abortions (including 16 million fewer unsafe procedures).
- There would be 21 million fewer unplanned births.
- Seven million fewer miscarriages would occur.
- Pregnancy-related deaths would drop by 79,000. Most of this reduction (48,000) would take place in Sub-Saharan Africa, the region with the highest levels of both maternal mortality and unmet need for contraception.
There would be 1.1 million fewer infant deaths.
Click here to read the two-page summary of key findings: Costs and Benefits of Investing in Contraceptive Services in the Developing World
Click here to read the full report: Adding It Up: Costs and Benefits of Contraceptive Services — Estimates for 2012
About the Guttmacher Institute
The Guttmacher Institute— www.guttmacher.org —advances sexual and reproductive health worldwide through research, policy analysis and public education.
Adebayo Fayoyin, Regional Communications Adviser, UNFPA, Sub-Regional Office Johannesburg
Tel: +27 11 603 5348; Cell: +27 79 517 0320; Fax: +27 11 603 5382
Hugues Koné, Regional Communications Adviser/Conseiller Régional en Communication, UNFPA, SRO West and Central Africa, Dakar, Sénégal
Tel: +221 33 859 8231; Cell: +221 77 569 7623; Fax: +221 33 820 1731
Lindsay Barnes, Regional Communications Analyst, UNFPA, Sub-Regional Office Johannesburg
Tel: +27 11 603 5348; Fax: +27 11 603 5329