MANY COUNTRIES' CONTRACEPTIVE USERS HAVE LIMITED CHOICE

International Family Planning Perspectives, Sep 2006 by Rosenberg, Jared

According to an analysis of 96 countries with a population of at least one million people and a Demographic and Health Survey conducted since 1980,34 have a skewed contraceptive method mix-defined as 50% or more of all contraceptive users reporting use of a single method.1 In 16 such countries, traditional methods (mainly periodic abstinence and withdrawal) prevail; most of these countries are located in Sub-Saharan Africa. In three Latin American countries and India, the contraceptive method mix is dominated by female sterilization. In the remaining 14 countries, a single reversible female method-the pill, the IUD or the injectable-accounts for at least half of all use. A complimentary review of the literature on the topic of method choice finds that many factors contribute to skewed method mix, but suggests that government policies can strongly influence method prevalence, and limited method availability may result in a "self-perpetuating cycle of acceptance of a method that has been available and widely used for a long time." The authors comment that skewed contraceptive method mix is not a problem in itself, but is "particularly problematic if driven by supply factors such as a restrictive population policy, lack of availability of a range of methods, lack of information on method choices, or provider bias toward one or two methods."

1. Sullivan TM et al., Skewed contraceptive method mix: why it happens, why it matters, Journal of Biosocial Science, 2006, 38(4):501-521.