Table of Contents
Chapters
- Fertility Continues to Decline
- Contraceptive Use
- Contraceptive Use Grows in Developing Countries
- Current Contraceptive Use
- Differences in Contraceptive Use Among Groups
- Intentions to Use Contraception
- Contraceptive Method Mix
- Awareness and Availability of Contraception
- Other Direct Influences on Fertility
- Fertility Preferences
- Young Women
- Child Survival and Health
- Maternal Health
Highlights
- Is fertility decline slowing?
- The impact of contraception
- Intentions to use family planning
- Injectables becoming popular
- Desired family size falling
- Premarital sex: New findings
- How AIDS affects child survival
- Maternal care falls short
Published by the INFO Project, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA
Volume XXXI, Number 2,
Spring 2003
Series M, Number 17
Special Topics
Contraceptive Use
Among developing regions, levels of contraceptive use vary widely, from an average of 15% in sub-Saharan Africa to 68% in Latin America and the Caribbean (see Table 1). Fertility levels closely correspond to levels of contraceptive use. In countries where contraceptive use is widespread, fertility is low, and where contraceptive use is uncommon, fertility is high (see Figure 1).
Contraceptive Use Grows in Developing Countries
Increases in the use of contraception have been the principal direct cause of the fertility de-clines in the developing world (31, 44, 61, 131). In developing countries around the world, a growing percentage of women—both married and unmarried—are using contraception.
Currently, an estimated 55% of married women in the developing world are using some sort of contraception, and 50% are using a modern method (see Table 1). By contrast, in 1990 an estimated 41% of married women in developing countries were using contraception, and in 1983 about 33% (111, 112). These levels of contraceptive use are weighted by population size and thus are heavily influenced by levels of use in China and India, the world’s two most populous countries. Without these two countries, the percentage of married women of reproductive age currently using any contraceptive method in the developing world would be an estimated 42% instead of 55%.
Data from the 38 developing countries with multiple DHS or RHS surveys since 1990 show that use of any family planning methods among married women rose by at least 10% in all except 7 countries—El Salvador, Ghana, Jamaica, Mali, Rwanda, Turkey, and Zimbabwe (see Table 3). Levels of contraceptive use fell only in Rwanda, and there by more than 40%, as civil war and ethnic strife in the 1990s disrupted family life.
 H. Kakande, DISH II Project. |
In Uganda as in other countries, more and more women are using contraception. Increases in contraceptive use have been the principal direct cause of declines in fertility. In developing countries about half of all married women use modern methods. |
The increases in contraceptive use in developing countries since 1990 continue a longer trend. Between 1975 and 1995 contraceptive use among married women rose in 30 of 31 developing countries with two or more surveys (62). Moreover, levels of contraceptive use among unmarried sexually active women also rose in the 1990s—by 10% or more in all but 6 of 24 developing countries with such data3 (see Table C).
While other direct factors—the proportion of women married, postpartum insusceptibility, infertility, and induced abortion—are also important influences on fertility levels (see chapter 5, Other Direct Influences on Fertility), none of these has changed as much as contraceptive use has changed in developing countries in recent years. Thus none has contributed as much to fertility decline as have rising levels of contraceptive use (23, 44, 61).
An increase in modern method use—in particular injectables, but also female sterilization, oral contraceptives (OCs), and the intrauterine device (IUD)—accounts for half or more of the increase in total contraceptive use among married women in all countries but Burkina Faso, Cameroon, and Ecuador, among the 38 developing countries with multiple surveys since 1990 (31, 131) (see Table 3).
