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Abstract:
This comparative report analyzes
contraceptive use and unmet need for family
planning among sexually active women age 15-
49 in 21 countries of sub-Saharan Africa,
Latin America, and the Caribbean. Sexually
active unmarried women are an important and
increasing sub-population typically excluded
from large-scale studies of contraception and
unmet need. In this study we disaggregate
sexually active women into three marital
groups: currently married, never-married, and
formerly married.
Overall, countries in Latin America and the
Caribbean have the highest levels of
contraceptive use and lowest levels of unmet
need for family planning. Differentials in
contraceptive use and unmet need by women’s
marital status are negligible in this region.
Family planning practices vary substantially
within sub-Saharan Africa. Western African
and Central African countries generally have
lower contraceptive prevalence than Eastern
and Southern African countries. A
considerable proportion of women in Central
and West Africa have no need for family
planning. Sub-Saharan Africa as a whole shows
greater variation in contraceptive use by
marital status. Never-married women usually
have the highest contraceptive prevalence,
and currently married women have the lowest.
Women in sub-Saharan Africa rely on a very
limited number of modern methods, and the
predominant method differs by their marital
status. While never-married women tend to use
condoms, currently married and formerly
married women are more likely to use
injectables or pills. The differences in
contraceptive use and unmet need by
individual and household characteristics are
largely consistent across the three marriage
groups. Regression results indicate that in a
number of countries, compared with currently
married women, never-married women are
significantly more likely to have their
demand for contraceptive use satisfied, but
formerly married women are less likely. We
also found that women in polygynous marriages
are less likely to use a contraceptive method
compared with women in monogamous marriages.
Both groups share a similar method mix.
While the findings about never-married women
are somewhat encouraging, when taken as a
whole these results underscore the importance
of ensuring equitable access to family
planning among all marital groups,
particularly in countries where nonmarital
sex may be stigmatized, and of anticipating
the particular contraceptive needs of
unmarried women. The results for polygynous
versus monogamous women suggest the
importance of demand generation activities in
areas where polygyny is prevalent.
Women's Marital Status, Contraceptive Use, and Unmet Need in Sub-Saharan Africa, Latin America, and the Caribbean (PDF, 1090K)