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

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Abstract

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

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Contraceptive Method Choice in Developing Countries

John Ross, Karen Hardee, Elizabeth Mumford … (2002)

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Fertility differences among developing countries: are they still related to family planning program efforts and social settings?

Rishi K. Jain, Kevin D. Ross (2012)

In many developing countries, fertility has declined steadily in recent decades, while the average strength of family planning programs has increased and social conditions have improved. However, it is unclear whether the synergistic effect of family planning programs and social settings on fertility, first identified in the 1970s, still holds. Data from 40 developing countries in which Demographic and Health Surveys were conducted in 2003-2010 were used to examine associations among socioeconomic conditions, family planning program effort strength and fertility. Cross-tabulations and multiple regression analyses were conducted. Variation among countries in scores on the Family Planning Program Effort Index, but not on the Human Development Index, has diminished since the 1970s. On average, fertility levels were lower among countries with better social settings or stronger family planning programs than among those with poorer settings or weaker programs; they were lowest in the presence of both good social settings and strong programs. In addition, fertility was positively associated with infant mortality and negatively associated with female education, but not associated with poverty. About half of the 2.3-birth difference in fertility between countries in Sub-Saharan Africa and those elsewhere can be attributed to differences in program efforts and social settings. Policies focused on improving levels of female education, reducing infant mortality and improving family planning services can be expected to have mutually reinforcing effects on fertility decline.

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Trends in national family planning programs, 1999, 2004 and 2009.

John Ross, Ellen Smith Moland (2011)

National family planning programs in the developing world vary greatly in strength and coverage, and in the nature of their outreach. Periodic measures of their types and levels of effort have been conducted since 1972. In 2009, expert observers in 81 developing countries completed a questionnaire that assessed 31 features of family planning program effort, as well as other program measures. Data were compared with those from similar surveys fielded in 1999 and 2004 to examine trends over the decade. On average, national family planning programs improved their effort levels slightly from 1999 to 2004, and again from 2004 to 2009. The average effort in 2009, however, was only about half of maximum; component scores for service measures and for measures of access to contraception did not reach 50% of maximum in 2009. Differences by region and by effort quartile emerged in subgroup analyses. Overall, improvement of women's health and avoidance of unwanted births were the most important program justifications, ranking higher than fertility reduction, economic development or reduction of childbearing among unmarried adolescents. The subgroups given the most emphasis were poor and rural populations, while unmarried youth and postabortion women received the least. Among external influences, changes in donor and domestic funding were seen as more unfavorable than the merging of family planning programs into broader health services. Average program effort levels have been sustained, although deficiencies remain. Countries have not yet ensured universal access to a variety of contraceptive choices, through various channels, for both short- and long-term methods.

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Journal

Journal ID (iso-abbrev): Glob Health Sci Pract

Title: Global health, science and practice

Publisher: Johns Hopkins School Bloomberg School of Public Health, Center for Communication Programs

ISSN: 2169-575X

ISSN (Print): 2169-575X

Publication date (Electronic): Aug 2013

Volume: 1

Issue: 2

Affiliations

[1 ] Futures Group International , Washington, DC , USA.

[2 ] Futures Institute , Glastonbury, CT , USA.

Article

Publisher Item ID: GHSP-D-13-00010

DOI: 10.9745/GHSP-D-13-00010

PMC ID: 4168565

PubMed ID: 25276533

SO-VID: 69dc4b5e-ab6e-40dd-8d8b-5bd0127d04bd

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

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NeuroImaging Methods

Most cited references 5

Contraceptive Method Choice in Developing Countries

Fertility differences among developing countries: are they still related to family planning program efforts and social settings?

Trends in national family planning programs, 1999, 2004 and 2009.

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Cited by 95

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