Authors: Niamh Cahill, Emily Sonneveldt, John Stover, Michelle Weinberger, Jessica Williamson, Chuchu Wei, Win Brown, Leontine Alkema
Journal: The Lancet, 391(10123). March 2018
An updated version of the Family Planning Estimation Tool (FPET) was used to construct estimates and projections of the modern contraceptive prevalence rate (mCPR), unmet need for, and demand satisfied with modern methods of contraception among women of reproductive age who are married or in a union in the focus countries of the FP2020 initiative. We assessed current levels of family planning indicators and changes between 2012 and 2017. A counterfactual analysis was used to assess if recent levels of mCPR exceeded pre-FP2020 expectations.
In 2017, the mCPR among women of reproductive age who are married or in a union in the FP2020 focus countries was 45.7%, unmet need for modern methods was 21.6%, and the demand satisfied with modern methods was 67.9%. Between 2012 and 2017 the number of women of reproductive age who are married or in a union who use modern methods increased by 28.8 million. At the regional level, Asia has seen the mCPR among women of reproductive age who are married or in a union grow from 51.0% to 51.8% between 2012 and 2017, which is slow growth, particularly when compared with a change from 23.9% to 28.5% across Africa. At the country level, based on a counterfactual analysis, we found that 61% of the countries that have made a commitment to FP2020 exceeded pre-FP2020 expectations for modern contraceptive use. Country success stories include rapid increases in Kenya, Mozambique, Malawi, Lesotho, Sierra Leone, Liberia, and Chad relative to what was expected in 2012.
Whereas the estimate of additional users up to 2017 for women of reproductive age who are married or in a union would suggest that the 120 × 20 goal for all women is overly ambitious, the aggregate outcomes mask the diversity in progress at the country level. We identified countries with accelerated progress, that provide inspiration and guidance on how to increase the use of family planning and inform future efforts, especially in countries where progress has been poor.