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Levels and trends of contraceptive use as assessed in 1998: Key Findings

Worldwide contraceptive prevalence (the percentage of married women currently using contraception) is estimated to be 58 per cent in 1993, with average levels of use in the more developed regions at 70 per cent and in the less developed regions at 55 per cent.

Among the less developed areas, contraceptive prevalence is lowest in Africa, where on average only one out of five married couples is currently using a contraceptive.  In Asia and Latin America and the Caribbean, average levels of contraceptive use are similar.  However, data at the regional levels reveal greater divergence than is implied by the overall averages.

Use of contraception among married women in less developed regions varies from a low of 8 per cent in Western Africa to a high of 83 per cent in Eastern Asia. In the more developed areas, regional prevalence variations fall within a relatively narrow range, from 69 per cent in Eastern and Southern Europe to 78 per cent in Northern Europe.

Modern methods account for the majority of currently global contraceptive practice; almost 9 out of every 10 contraceptive users rely on a modern method. Female sterilization, intra-uterine devices (IUD) and oral pills account for more than two-thirds of all contraceptive practice worldwide. Globally, female sterilization is the single-most used method, and alone accounts for one-third of all contraceptive use worldwide. The IUD is used by 22 per cent of all contraceptive users and the oral pill by 14 per cent.

The use of modern contraceptive methods differs significantly between the more and less developed areas. In the less developed areas, modern methods account for a much larger share of total contraceptive use (90 per cent) than in the more developed areas (70 per cent). This is largely because certain traditional methods including withdrawal and various forms of the calendar rhythm method are commonly used in the more developed regions.  Rhythm and withdrawal together account for 26 per cent of total contraceptive use in the more developed regions compared to 8 per cent in the less developed regions.

Seven out of ten contraceptive users in the more developed regions rely on short-acting and reversible methods such as the condom, oral pills, withdrawal and rhythm whereas in the less developed regions, method mix is comprised of longer-acting clinic methods. On average 7 out of 10 users in the less developed areas rely on sterilization or an IUD, compared to about 3 in 10 users in the more developed areas.

In Latin America and the Caribbean, unmarried women make up between 10 and 20 per cent of contraceptive users in about half the countries with data on contraceptive use by marital status. In sub-Saharan Africa, the proportion of unmarried users is one-quarter or more. In the more developed areas, use among unmarried women ranges from 30 to 40 per cent in some countries.

Significant growth of prevalence has occurred in almost all developing countries.  In more than two-thirds of countries with trend data, contraceptive prevalence increased by at least 1 percentage point per year or 10 points over the past decade. Rapid rates of growth are most common in countries with prevalence levels in the low to medium range (between 15 and 49 per cent). By contrast, in the developed countries, the average increment in growth of contraceptive use in the recent past is less than 0.5 per cent per year. This relatively low growth can be attributed to already high levels of contraceptive prevalence in the more developed areas. In general, once contraceptive prevalence exceeds 70 per cent, use levels tend to remain more or less constant. In both the more developed and less developed areas, modern methods account for most of the growth in contraceptive use.

Contraceptive prevalence at the global level will need to be at least 66 per cent 75 per cent in the more developed regions and 67 per cent in the less developed regions in order to attain the projected (medium variant) decline in fertility by the year 2025.

Those estimates imply a nearly 60 per cent increase in the number of contraceptive users among married women. The largest proportional increase will be in Africa where projections call for the number of users to more than double between 1993 and 2005, and to continue to increase rapidly thereafter.

The discrepancy between fertility preferences and contraceptive practice, the preference-use gap often termed "unmet need for contraception" is regarded as an indicator of unsatisfied demand for family planning. Unmet need is higher in sub-Saharan African countries (averaging 26.8 per cent of women currently in union) than in Asia (average of 17.6 per cent) or Latin America and the Caribbean (average of 20 per cent). Whereas in Asia and Latin America and the Caribbean, the unmet need for contraception is mainly for family size limitation, unmet need for contraception in countries of sub-Saharan Africa is in large part for the spacing of births.

Source: Levels and trends of contraceptive use as assessed in 1998 (United Nations publication, forthcoming).


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