August 01, 2022
3 min learn
Disclosures: Haakenstad studies no related monetary disclosures. Please see the examine for all different authors’ related monetary disclosures.
An estimated 162.9 million girls globally had an unmet want for contraception in 2019, with these aged 15 to 19 years with the very best unmet demand, an evaluation printed in The Lancet confirmed.
The examine, which evaluated surveys carried out between 1970 and 2019, additionally recognized regional disparities within the quantity of unmet want and the varieties of contraceptives used.
“Though we’ve noticed glorious strides in contraceptive availability for the reason that Seventies at a worldwide stage, there’s nonetheless an extended method to go to make sure that each girl and adolescent woman can profit from the financial and social empowerment contraceptives can supply,” Annie Haakenstad, ScD, MA, an assistant professor within the College of Washington Institute for Well being Metrics and Analysis in Seattle, stated in a press launch. “Our outcomes point out that the place a lady lives on the earth and their age nonetheless considerably impacts their use of contraception.”
Defining contraceptive use, want
Utilizing 1,162 population-based surveys of ladies aged 15 to 49 years in 204 international locations and territories, Haakenstad and colleagues estimated the contraceptive prevalence fee (CPR), which included all types of contraception, equivalent to conventional strategies like withdrawal and douches. In addition they estimated the trendy CPR (mCPR), which included trendy contraceptive strategies, equivalent to male or female sterilization, male or feminine condoms and IUDs.
The researchers additionally analyzed the contraceptive strategies used, in addition to the speed of demand glad. Demand glad was outlined because the proportion of ladies utilizing trendy contraception who have been:
- fertile, sexually lively or partnered and never wanting a baby inside the subsequent 2 years;
- at present pregnant and needed to have delayed or prevented their present being pregnant; or
- postpartum amenorrheic from a start inside the previous 2 years and needed to have delayed or prevented their most up-to-date being pregnant.
World, regional traits
Total, the typical CPR in 2019 was 51.9% (95% uncertainty interval [UI], 51%-52.8%), the mCPR was 47.7% (95% UI, 46.9%-48.6%) and the demand glad was 79.1% (95% UI, 78.5%-79.8%), which have been will increase of 18.7 (95% UI, 17.1-20.3), 20.1 (95% UI, 18.7-21.6) and 24.3 (95% UI, 22.6-26.1) proportion factors, respectively, from the 1970 charges.
Between 1970 and 2019, all international locations had statistically important will increase in CPR, mCPR and demand glad, apart from Somalia, the place these charges remained largely unchanged, in response to the examine. By 2019, the proportion of conventional contraception strategies had decreased, whereas the proportion of contemporary strategies elevated.
In 2019, the mCPR was lowest in South Sudan (1.9%) and highest in Norway (87.9%); in the USA, the mCPR was 59.3%. Regionally, the typical mCPR was highest in Southeast Asia, East Asia and Oceania (64.7%; 95% UI, 63.3%-65.9%), which additionally had the very best fee of demand glad (90.4%; 95% UI, 89.5%-91.2%). Conversely, sub-Saharan Africa had the bottom common mCPR (23.6%; 95% UI, 23.1%-24.2%) and demand glad (52%; 95% UI, 51.2%-52.8%).
Charges of demand glad
Amongst 1.176 billion girls with a necessity for contraception, 162.9 million have been estimated to not have these wants met, 29.3% (95% UI, 27.9%-30.6%) of whom lived in sub-Saharan Africa and 27.2% (95% UI, 24.4%-30.3%) of whom lived in south Asia. The unmet want was largest in South Sudan (35.1%; 95% UI, 32.6%-38%), Central African Republic (29.2%; 95% UI, 27%-31.3%) and Vanuatu (28.4%; 95% UI, 25.6%-31.3%). Within the U.S., the unmet want was 2.5%.
Youthful girls had the bottom fee of demand glad globally. By age group, the speed of demand glad was lowest amongst girls aged 15 to 19 years (64.8%; 95% UI, 62.9%-66.7%) and 20 to 24 years (71.9%; 95% UI, 68.9%-74.2%), with 43.2 million girls (95% UI, 39.3-48 million) aged 15 to 24 years with unmet contraceptive wants in 2019.
“To deal with this demand, household planning applications should decide whether or not present strategies are equally most popular and accessible to youthful girls compared to older girls,” Haakenstad and colleagues wrote. “Globally, youthful girls are extra possible to make use of condoms and the oral contraceptive capsule, whereas older girls are extra possible to make use of feminine sterilization.”
Transferring ahead, the researchers steered modifying household planning applications to fulfill the wants of ladies with unhappy demand for contraception whereas sustaining applications that work for present contraceptive customers.