
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).