Presentation on theme: "International Family Planning Conference"— Presentation transcript:
1International Family Planning Conference The What-nots, Why-nots, and So-whats of Contraceptive Use, Method Mix and Unmet NeedScott Radloff, PhDBill & Melinda Gates Institute for Population and Reproductive HealthInternational Family Planning ConferenceAbaba, Ethiopia, November 15, 2013
2International Family Planning had been recently revitalized Presentation ThemesInternational Family Planning had been recently revitalizedIn 50 years, contraceptive use has dramatically increased……but not uniformly in pace…or in method mix by subregions…unmet need varies substantially across subregions and countries…as well as across socioeconomic strata.FP2020 offers the promise of addressing disparities in access...…as it reduces unmet need…for the benefit of women’s health, child health…and for the well-being of families, communities, and nations.
3International family planning: Three Eras Dramatic growth in donor attention and fundingUNFPA established, regular international conferences heldEarly policies/commitment/resources in LAC, Asia, North AfricaBy early 1990s, country graduation beganDemographic and health rationale primaryEra One:Priority AttentionDonors attention shifts to other health prioritiesIncreased use of basket funding approachesGreater disparity between middle/low income countriesUSAID funding declines from 1995 peakRights and health rationale become primaryEra Two:Growing NeglectGrowing attention and partnershipsUSAID funding and attention increased under GHIDFID & BMGF exert leadership, sponsoring 1st ever SummitAttention focused on high need/low income countriesGrowing recognition of demographic/economic in addition to rights and health rationaleEra Three:Revitalization
4Total Fertility Rate (TFR) High fertility correlates with low modern FP use(the two maps are nearly perfect negative images of each other)Modern Contraceptive Prevalence Rate (MCPR)Total Fertility Rate (TFR)No DataNo Data1 - 19Source: Population Reference Bureau. Population Data Sheet, 2011.
5Modern contraceptive use worldwide has ↑ 6-fold over 50 years – and 20-fold in developing regions 2012DevelopedCountriesDevelopedCountries117 million women86 million in More Developed Countries (MDCs)31 million in Less Developed Countries (LDCs)797 million women152 million in MDCs645 million in LDCsDrivers of expanded contraceptive use:Demand for smaller families + healthy timing/spacing of pregnanciesImproved access to family planning servicesWider range, safer, more effective and affordable method choicePopulation growth (from 3 to 7 billion)Source: ”Adding It Up,” Guttmacher, 2012; Bongaarts, Population and Development Review, 1984; World Contraceptive Use 2011, UN Population Division, 2011.
6Worldwide, there is a wide range of method use… CPR = 63%LAPM share of all modern method use = 57%TFR = 2.4World…and there is a wide variation across and within regions.Source: World Contraceptive Use 2011, UN Population Division, 2011.
7Contraceptive method mix differs dramatically by subregion MCPR = 70%LARC/PM share = 46%TFR = 2.1MCPR = 54%LARC/PM share = 31%TFR = 1.5MCPR = 23%LARC/PM share = 13%TFR = 5.1MCPR = 52%LARC/PM share = 83%TFR = 2.7Source: World Contraceptive Use 2011, UN Population Division, 2011.
8Use + Unmet need = Total demand for FP 24%55%Modern method useModern method useNote: Unmet need is an indicator to track achievement of Millennium Development Goal 5, improving maternal health.Source: UN Population Division, 2012; World Contraceptive Use, Data for women married or in union.
9Unmet need for FP in Developing Countries: Key facts 867 million women want to avoid pregnancy645 million using a modern method99 million using traditional methods123 million using no methodMany reasons for unmet need –Complex (e.g., access barriers; fear of side effects; partner opposition)More than just a “supply” issueRises with growing demand, i.e., in part is a marker of “success”Source: “Adding It Up”, Guttmacher, 2012.
10Modern method use, unmet need for modern FP & proportion of demand being met, by region – Part 1 Modern Method Use (MCPR)Women Using Modern FP (millions)Unmet Need Modern FP (%)Women with Unmet Need for Modern FP (millions)Proportion of Total Demand Being Met (%)Developing Countries55%645 M19%222 M74%Asia62%515 M17%141 M79%Eastern Asia88%267 M3%16 M94%Central Asia52%6 M2 M75%South Asia46%163 M24%83 M66%Southeast Asia56%64 M20%25 M72%Western Asia34%14 M35%50%Source: UN Department of Economic and Social Affairs, Population Division. World Contraceptive Use, Data for women married or in a union.
11Modern method use, unmet need for modern FP & proportion of demand being met, by region – Part 2 Modern Method Use (MCPR)Women Using Modern FP (millions)Unmet Need Modern FP (%)Women with Unmet Need for Modern FP (millions)Proportion of Total Demand Being Met (%)Africa25%51 M28%59 M46%Northern Africa45%16 M21%8 M67%Southern Africa58%9 M16%2 M82%Eastern Africa27%17 M32%20 MWestern Africa9%7 M30%19 MMiddle Africa7%37%10 M17%Latin America & Carib66%80 M19%23 M78%South America70%58 MCentral & Caribbean61%22 M20%76%Source: UN Department of Economic and Social Affairs, Population Division. World Contraceptive Use, Data for women married or in a union.
12At the country-level, variations are more wide-ranging 80%70%60%50%40%30%20%10%0%Unmet NeedTrad MethodModern MethodModern contraceptive use ranges widely, from 5-57 percent.In most countries, less than half the demand for modern FP is being met.For every woman using modern FP, one to five women have unmet need.Source: DHSSource: DHS
13Contraceptive use in Africa much lower among poorest quintile Wealthiest quintileSource: Demographic and Health Surveys.Adapted and updated from L. Dougherty, “Healthy Timing and Spacing of Pregnancy,” Knowledge Management Services Project
14London Summit commitments can reduce disparities FP2020 goal of extending family planning to 120 million new usersTranslates to:14 million fewer abortions43,000 fewer maternal deaths600,000 fewer infant deathsAs well as many other family, community, and national benefitsKey to meeting 8 MDGsSource: Global Population Assistance Report , 1994 (for period), UNFPA; Financial Resource Flows for Population Activities in 2009 ( data adjusted to align with GPAR categorization), UNFPA; data for estimated drawing upon London FP Summit, 2012 commitments. “Adding It Up,” Guttmacher, 2012
15Thank you“Family Planning 2020 (FP2020) is a global partnership that supports the rights of women and girls to decide, freely and for themselves, whether, when, and how many children they want to have. FP2020 works with governments, civil society, multi-lateral organizations, donors, the private sector, and the research and development community to enable 120 million more women and girls to use contraceptives by 2020.” -- FP2020 website