Wang, Wenjuan, Sarah Staveteig, Rebecca Winter, and Courtney Allen. 2017. Women’s Marital Status, Contraceptive Use, and Unmet Need in Sub-Saharan Africa, Latin America, and the Caribbean. DHS Comparative Reports No. 44. Rockville, Maryland, USA: ICF.
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.