Use of modern contraception increases when more methods become available: analysis of evidence from 1982-2009

Abstract

Objective: To examine how much contraceptive use increases as additional methods are made available to populations.

Methods: We used data estimating contraceptive use from representative national surveys and data estimating method availability from special surveys to make comparisons for 6 modern contraceptive methods, in each of 6 years: 1982, 1989, 1994, 1999, 2004, and 2009. To estimate method availability, we used various method accessibility rules governing different proportions of the total population (ranging from 20% to 80%) that must have access to a method in order for it to qualify as "available."

Results: Contraceptive use is greater when more methods are available to a large portion of the population, both cross-sectionally and over time. The addition of 1 method available to at least half the population correlates with an increase of 4-8 percentage points in total use of the 6 modern methods, for example, from 40% to 44% or 48%. A consistent pattern emerges for the relationship of contraceptive use and choice among multiple methods.

Conclusions: Use of contraception may be increased by extending the availability of current methods, by improving features of current methods, or by introducing new methods. A wider choice of methods also improves the ability to meet the individual needs of women and couples. Although the method mix has been improving over time, current availability is far from ideal; in 2009, only about 3.5 methods, on average, were available to at least half of the population in the 113 countries included in our analysis.

Figure 1.

Impact of Adding New Contraceptive Methods on the Number of Users, 1965–1973 Reproduced with permission from Freedman R, Berelson B. The record of family planning programs. Stud Fam Plann. 1976, 7(1):1–40.

Figure 2.

MCPR and Number of Available Methods, by Various Accessibility Rules, 1982–2009 Abbreviation: MCPR, modern contraceptive prevalence rate.

Figure 3.

Relationship Between MCPR for 113 Surveyed Countries and Number of Available Methods, According to the 50% Accessibility Rule, 2009 Abbreviation: MCPR, modern contraceptive prevalence rate. Solid line represents the least squares line across all countries.

Figure 4.

Relationship Between MCPR and the Number of Available Methods, by Accessibility Rule, 1982–2009 Abbreviation: MCPR, modern contraceptive prevalence rate. The 6 points on each line represent the 6 survey years, starting with 1982 at the lower left of each line and moving up to the right for 1989, 1994, 1999, 2004, and 2009.

Figure 5.

Relationship Between MCPR and Sum of Access Scores for All Modern Methods, Ethiopia, 1982–2009 Abbreviation: MCPR, modern contraceptive prevalence rate.