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. 2017 May;43(Suppl Suppl 1):166-191.
doi: 10.1111/padr.12051. Epub 2017 Mar 31.

Contraceptive Practice in Sub-Saharan Africa

Amy O Tsui  1 , Win Brown  2 , Qingfeng Li  1
Affiliations

Contraceptive Practice in Sub-Saharan Africa

Amy O Tsui et al. Popul Dev Rev. 2017 May.

Abstract

Forty eight of the African continent's 54 sovereign states are located in the Sub-Saharan Africa (SSA) region, with the government of each defining and shaping its own health services and delivery systems. This paper reviews the trends and patterns of contraceptive practice in the region. Using survey data available from the Demographic and Health Surveys and Performance Monitoring and Accountability 2020, the study finds modern contraceptive practice to be on the rise overall but with much geographic variation. The contraceptive methods most frequently used are injectables and, more recently, implants. Higher levels of use are observed among unmarried sexually active than married females. Although use is rising, contraceptive discontinuation rates are also high. Recent program initiatives discussed include expanding long-acting contraceptive options, promoting and delivering contraceptive methods in the postpartum period, and relying on community health workers for contraceptive outreach and service delivery. SSA's family planning situation remains challenged by weak health systems which must address competing priorities to manage disease prevention as well as primary health care. Increasing investments in family planning delivery in many SSA countries, however, augur for continued rapid uptake of modern contraception, possibly matching if not outpacing the record of other regions.

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Figures

Figure 1
Figure 1
Murdock Map of Ethnographic Regions of Africa Source: Murdock (1959)
Figure 1a
Figure 1a
Modern Contraceptive Prevalence (%) among Married Women 15–49 Years by World Region and Year Source: UN Model-Based Estimates 2015 for World Regions
Figure 1b
Figure 1b
Modern Contraceptive Prevalence (%) among Married Women 15–49 Years for Africa and Its Sub-Regions by Year Source: UN Model-Based Estimates 2015 for World Regions
Figure 2
Figure 2
Percent of sexually active unmarried (SAU) and currently married (CM) women age 15–49 using modern contraception: Six selected countries with DHS data from 1987–2015
Figure 3
Figure 3
Recent trends in modern contraceptive prevalence, injectable and long-acting method use for selected Sub-Saharan African countries and subnational areas: 2008–2016 PMA2020 and DHS surveys Long-acting and permanent methods (LAPM) = sterilization, IUD and implants
Figure 4
Figure 4
Postpartum modern contraceptive adoption: Cumulative proportions of mothers at 3, 6, 12 and 24 months by place of delivery for six countries Source: Calculated using DHS calendar data
Figure 5
Figure 5
Percent of non-users of contraception visited by a health worker and told about contraception, in the 12 months before the survey: 32 Sub-Saharan African countries with DHS 2006–2015
See this image and copyright information in PMC

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