|Trends in contraceptive need and use in developing countries in 2003, 2008, and 2012: an analysis of national surveys|
||Jacqueline E Darroch, Susheela Singh
||Lancet, 381(9879):1756-62. doi: 10.1016/S0140-6736(13)60597-8.
More than one region
||Background Data for trends in contraceptive use and need are necessary to guide programme and policy decisions
and to monitor progress towards Millennium Development Goal 5, which calls for universal access to contraceptive
services. We therefore aimed to estimate trends in contraceptive use and unmet need in developing countries in 2003,
2008, and 2012 .
Methods We obtained data from national surveys for married and unmarried women aged 15–49 years in regions and
subregions of developing countries. We estimated trends in the numbers and proportions of women wanting to avoid
pregnancy, according to whether they were using modern contraceptives, or had unmet need for modern methods (ie,
using no methods or a traditional method). We used comparable data sources and methods for three reference years
(2003, 2008, and 2012). National survey data were available for 81–98% of married women using and with unmet need
for modern methods.
Findings The number of women wanting to avoid pregnancy and therefore needing eff ective contraception increased
substantially, from 716 million (54%) of 1321 million in 2003, to 827 million (57%) of 1448 million in 2008, to 867 million
(57%) of 1520 million in 2012. Most of this increase (108 million) was attributable to population growth. Use of modern
contraceptive methods also increased, and the overall proportion of women with unmet need for modern methods
among those wanting to avoid pregnancy decreased from 29% (210 million) in 2003, to 26% (222 million) in 2012.
However, unmet need for modern contraceptives was still very high in 2012, especially in sub-Saharan Africa (53 million
[60%] of 89 million), south Asia (83 million [34%] of 246 million), and western Asia (14 million [50%] of 27 million).
Moreover, a shift in the past decade away from sterilisation, the most eff ective method, towards injectable drugs and
barrier methods, might have led to increases in unintended pregnancies in women using modern methods.
Interpretation Achievement of the desired number and healthy timing of births has important benefi ts for women,
families, and societies. To meet the unmet need for modern contraception, countries need to increase resources,
improve access to contraceptive services and supplies, and provide high-quality services and large-scale public
education interventions to reduce social barriers. Our fi ndings confi rm a substantial and unfi nished agenda towards
meeting of couples’ reproductive needs