233 million women projected to lack modern contraceptives by 2015

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1. Among married or cohabitating women, global contraceptive prevalence increased and unmet family planning need decreased between 1990 and 2010.

2. Statistical models estimate 233 million women, primarily in developing countries, will have unmet need for modern contraceptives by 2015.

This study found that between 1990 and 2010, global contraceptive use increased and unmet need for family planning decreased. Notwithstanding, the number of married or cohabitating women of reproductive age lacking modern contraceptives (birth control pills, condoms, etc.) is projected to rise to 233 million by 2015. Though improvements in developing countries drove the positive global changes over the 20-year period studied, these countries are expected to account for 204 million (88%) of global unmet need in 2015. These projections suggest the need for increased reproductive health services worldwide, particularly in developing countries.

Limitations include the lack of empirical data on reproductive health indicators available in developing countries, which could particularly underestimate unmet need. Strengths include the geographic and economic diversity of the 194 countries or areas studied. To provide a more complete assessment of global unmet need, researchers should include all sexually active women of reproductive age in statistical models, rather than only married and cohabitating women.

Click to read the study in The Lancet

Click to read an accompanying editorial in The Lancet

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1. Among married or cohabitating women, global contraceptive prevalence increased and unmet family planning need decreased between 1990 and 2010.

2. Statistical models estimate 233 million women, primarily in developing countries, will have unmet need for modern contraceptives by 2015.

Study author, Dr. Ann Biddlecom, PhD, talks to 2 Minute Medicine: Chief, Fertility and Planning Section of the United Nations’ Population Division
“The demand for contraceptive methods worldwide continues to grow, and this is especially the case for effective methods that clinicians are best poised to counsel on and recommend for their patients. The medical field plays an important role in providing more contraceptive options indirectly via research and medical education and directly via the health care services provided to people. The rising demand for contraceptive methods, especially effective methods, requires increased investment in voluntary family planning to move beyond ‘business as usual,’ and the medical field is critical to improving access to family planning.”

This [multi-national cross-sectional] study used statistical modeling of 1950-2011 survey data to estimate trends in contraceptive prevalence and unmet need for contraception on a global scale. Model estimates are based on data from nationally representative household surveys that included observations from married or cohabitating women of reproductive age (15-49 years) regarding contraceptive use (n=930 observations from 194 countries) (n=930 observations) or unmet need for contraception in 111 countries (n=306 from 111 countries). Countries across Africa, Asia, Oceania, Europe, North and South America were represented in this study.

Worldwide need for contraception (combining contraceptive use and unmet need) is expected to increase from 900 million in 2010 to 962 million in 2015. Over the last two decades, global contraceptive prevalence has increased [1990: 54.8%, 2010: 63.3%] and unmet need has decreased [1990: 15.4%, 2010: 12.3%. As of 2010, unmet need for family planning was highest in Southern Asia (51 million, CI: 38-67 million), followed by eastern Africa, western Africa, southeastern Asia and eastern Asia.

In sum: This study found that between 1990 and 2010, global contraceptive use increased and unmet need for family planning decreased. Notwithstanding, the number of married or cohabitating women of reproductive age lacking modern contraceptives (birth control pills, condoms, etc.) is projected to rise to 233 million by 2015. Though improvements in developing countries drove the positive global changes over the 20-year period studied, these countries are expected to account for 204 million (88%) of global unmet need in 2015. These projections suggest the need for increased reproductive health services worldwide, particularly in developing countries.

Limitations include the lack of empirical data on reproductive health indicators available in developing countries, which could particularly underestimate unmet need. Strengths include the geographic and economic diversity of the 194 countries or areas studied. To provide a more complete assessment of global unmet need, researchers should include all sexually active women of reproductive age in statistical models, rather than only married and cohabitating women.

Click to read the study in The Lancet

Click to read an accompanying editorial in The Lancet 

By Caroline Huang and Leah Hawkins

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