Trends in population and contraception

Abstract

There has been an explosion in contraceptive use in the past 30 years. In 1960-65, the level of contraceptive use in the developing countries of Asia, Latin America and Africa represented about 9% of married couples of reproductive age. In the 1990s use of contraception in developing countries comprises over 50% of couples and contraceptive prevalence is increasing each year. Total fertility rates for the developing world have already fallen from over 6, where they were in 1960 to about 4, halfway toward the replacement level of 2.1. The United Nations projects that during this decade, over 90 million people will be added each year to world population. If this projection is not to be exceeded, prodigious supplies of contraceptives will have to be available at affordable cost to the people of developing countries, where 94% of this population increase will occur. New technology alone will not guarantee this success, but it would help ensure that people are able to meet their fertility objectives.

PIP: The trends are identified for population growth, the momentum of growth, contraceptive use, choice of method, and future contraceptive needs. The forecast for the 1990s, based on UN estimates, is for growth of 90 million each year. 94% of growth will occur in developing countries. Sub-Saharan Africa will experience the fastest rate of growth, but the largest numbers will be in Asia. Population is expected to increase by 112% between 190 and 2015 (550 million) in sub-Saharan Africa, by 60% (750 million) in South Asia, and by 76% in the Middle East and North Africa. Even if developing countries have replacement level fertility, the numbers of women of reproductive age are high enough in most developing countries to continue to increase population for 6 decades. Fertility rates in developing countries are halfway to replacement level with fertility rates of around 4. Worldwide there has been a ten-fold increase in contraceptive use over the past 30 years. By 1990 over 50% of married couples of reproductive age used contraception. There is evidence that family planning methods have been found to be acceptable by people of many different cultures and socioeconomic conditions. Sterilization is the most commonly used method worldwide. Most of the sterilized population lives in China (70 million) and in India (36 million), which constitutes 59% of persons of reproductive age. Populations with more than 40% of the reproductive age population sterilized include Puerto Rico, Canada, and South Korea. More than 25% of sterilized couples are found in Brazil, the Dominican Republic, El Salvador, Panama, the US, Sri Lanka, Thailand, Taiwan, and the UK. The second most popular method is the IUD. The country with the highest proportion of people using the IUD is China. 67 million in China use the IUD compared to 26 million in other developing countries and 10 million in developed countries. New methods, which lower logistical and cost factors, need to be developed; greater access to the very poor or those in remote areas is targeted. Potential users might be attracted to methods with improved safety, reduced side effects, and greater convenience. Access to a wide variety of methods is a means of reaching a larger audience of users. New contraceptive technology will be available during the 1990s, i.e., implants, a vaccine to prevent pregnancy, and a pill or injection for men.