Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Feb;4(2):e31.
doi: 10.1371/journal.pmed.0040031.

Use of modern contraception by the poor is falling behind

Emmanuela Gakidou  1 , Effy Vayena
Affiliations

Use of modern contraception by the poor is falling behind

Emmanuela Gakidou et al. PLoS Med. 2007 Feb.

Abstract

Background: The widespread increase in the use of contraception, due to multiple factors including improved access to modern contraception, is one of the most dramatic social transformations of the past fifty years. This study explores whether the global progress in the use of modern contraceptives has also benefited the poorest.

Methods and findings: Demographic and Health Surveys from 55 developing countries were analyzed using wealth indices that allow the identification of the absolute poor within each country. This article explores the macro level determinants of the differences in the use of modern contraceptives between the poor and the national averages of several countries. Despite increases in national averages, use of modern contraception by the absolute poor remains low. South and Southeast Asia have relatively high rates of modern contraception in the absolute poor, on average 17% higher than in Latin America. Over time the gaps in use persist and are increasing. Latin America exhibits significantly larger gaps in use between the poor and the averages, while gaps in sub-Saharan Africa are on average smaller by 15.8% and in Southeast Asia by 11.6%.

Conclusions: The secular trend of increasing rates of modern contraceptive use has not resulted in a decrease of the gap in use for those living in absolute poverty. Countries with large economic inequalities also exhibit large inequalities in modern contraceptive use. In addition to macro level factors that influence contraceptive use, such as economic development and provision of reproductive health services, there are strong regional variations, with sub-Saharan Africa exhibiting the lowest national rates of use, South and Southeast Asia the highest use among the poor, and Latin America the largest inequalities in use.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Modern Contraceptive-Method Use in the Poorest Global Quintile
The relationship between the percentage of ever-married women and the use of modern contraceptive methods by ever-married women in the poorest global quintile is shown.
Figure 2
Figure 2. Modern Contraceptive Use and Level of Economic Development
Gaps increase at higher incomes. The gap in modern contraceptive use rates between the national average and the poorest quintile versus GDP per capita in international dollars is shown.
Figure 3
Figure 3. Multivariate Regression Coefficients and 95% Confidence Intervals for All Income Quintiles for Skilled Birth Attendance and Year of Survey
See this image and copyright information in PMC

Comment in

References

    1. Collumbien M, Gerressu M, Cleland J. Non-use and use of effective methods of contraception. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative quantification of health risks: Global and regional burden of disease attributable to selected major risk factors. Geneva: World Health Organization; 2004. pp. 1255–1319.
    1. Marston C, Cleland J. The effects of contraception on obstetric care. Geneva: World Health Organization; 2004. Available: http://www.who.int/reproductive-health/publications/2004/effects_contrac.... Accessed 29 November 2006.
    1. Bloom D, Canning D. Population, poverty reduction, and the Cairo Agenda. Proceedings of the Seminar on the Relevance of Population Aspects on the Achievement of the Millennium Development Goals; 2004 17–19 November;; New York, United States.. New York: United Nations Population Fund (UNFPA); 2005. Available: http://www.un.org/esa/population/publications/PopAspectsMDG/PopAspects.htm. Accessed 29 November 2006.
    1. United Nations Population Fund. Reducing poverty and achieving the Millennium Development Goals: Arguments for investing in reproductive health and rights. New York: United Nations Population Fund (UNFPA); 2005. Available: http://www.unfpa.org/publications/detail.cfm?ID=243. Accessed 29 November 2006.
    1. Rosenfield A, Schwartz K. Population and development—Shifting paradigms, setting goals. N Engl J Med. 2005;352:647–649. - PubMed

Publication types