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Mali has a large youth population, making up 44% of women of reproductive age, and ambitious family planning goals. Given the potential to contribute to the country’s family planning objectives, this study examines patterns of modern contraception among youth using data from 10,519 women and 1,478 episodes of contraceptive use from the 2018 Mali Demographic and Health Survey. Across multiple outcomes, the study compares young women with their older counterparts and married women with unmarried, sexually active women who are disproportionately young.
Unmet need for modern contraception is lower among young, married women than older, married women. Unmet need is very high for unmarried women, regardless of age, and is almost double that among married women.
Women age 15-24 are less likely to use modern contraception when compared with older women, but that unmarried, sexually active women are more likely than married women to use modern contraception. Contraceptive discontinuation rates are higher for young women than for older women, and this finding holds across all modern methods of contraception. About half of all discontinuation among young women is due to reduced need, while half is discontinuation while still in need. Discontinuation because pregnancy is desired is more common among young women than older women.
The method mix varies by age and marital status. Implants and injectables contribute a larger share to the method mix among young women than older women. Implants contribute a larger share while pills a smaller share of contraceptive use among unmarried women (regardless of sexual activity) than among married women.
The source of contraception is largely determined by the method used, and not by age or marital status of the user. However, both young pill users and unmarried injectable users avoid community health centres/dispensaries, and prefer private pharmacies (pills and injectables), other private sources (pills), and government hospitals/reference health centres (injectables).
These findings suggest that investment in supply-side and demand-side interventions that promote and sustain contraceptive use among current contraceptive users and potential new users, alike, and that reduce unmet need are warranted.