Cahill, Niamh and Sonneveldt, Emily and Stover, John and Weinberger, Michelle and Williamson, Jessica and Wei, Chuchu and Brown, Win and Alkema, Leontine
(2018)
Modern contraceptive use, unmet need, and demand
satisfied among women of reproductive age who are
married or in a union in the focus countries of the Family
Planning 2020 initiative: a systematic analysis using the
Family Planning Estimation Tool.
The Lancet, 391.
pp. 870-882.
ISSN 0140-6736
Abstract
Background The London Summit on Family Planning in 2012 inspired the Family Planning 2020 (FP2020) initiative
and the 120×20 goal of having an additional 120 million women and adolescent girls become users of modern
contraceptives in 69 of the world’s poorest countries by the year 2020. Working towards achieving 120×20 is crucial
for ultimately achieving the Sustainable Development Goals of universal access and satisfying demand for reproductive
health. Thus, a performance assessment is required to determine countries’ progress.
Methods An updated version of the Family Planning Estimation Tool (FPET) was used to construct estimates and
projections of the modern contraceptive prevalence rate (mCPR), unmet need for, and demand satisfied with modern
methods of contraception among women of reproductive age who are married or in a union in the focus countries of
the FP2020 initiative. We assessed current levels of family planning indicators and changes between 2012 and 2017.
A counterfactual analysis was used to assess if recent levels of mCPR exceeded pre-FP2020 expectations.
Findings In 2017, the mCPR among women of reproductive age who are married or in a union in the FP2020 focus
countries was 45·7% (95% uncertainty interval [UI] 42·4–49·1), unmet need for modern methods was 21·6%
(19·7–23·9), and the demand satisfied with modern methods was 67·9% (64·4–71·1). Between 2012 and 2017 the
number of women of reproductive age who are married or in a union who use modern methods increased by 28·8 million
(95% UI 5·8–52·5). At the regional level, Asia has seen the mCPR among women of reproductive age who are married
or in a union grow from 51·0% (95% UI 48·5–53·4) to 51·8% (47·3–56·5) between 2012 and 2017, which is slow growth,
particularly when compared with a change from 23·9% (22·9–25·0) to 28·5% (26·8–30·2) across Africa. At the country
level, based on a counterfactual analysis, we found that 61% of the countries that have made a commitment to FP2020
exceeded pre-FP2020 expectations for modern contraceptive use. Country success stories include rapid increases in
Kenya, Mozambique, Malawi, Lesotho, Sierra Leone, Liberia, and Chad relative to what was expected in 2012.
Interpretation Whereas the estimate of additional users up to 2017 for women of reproductive age who are married or
in a union would suggest that the 120×20 goal for all women is overly ambitious, the aggregate outcomes mask the
diversity in progress at the country level. We identified countries with accelerated progress, that provide inspiration
and guidance on how to increase the use of family planning and inform future efforts, especially in countries where
progress has been poor. Funding The Bill & Melinda Gates Foundation, through grant support to the University of Massachusetts Amherst
and Avenir Health.
| Item Type: |
Article
|
| Keywords: |
contraceptive use; Family
Planning 2020; systematic analysis;
Family Planning Estimation Tool; |
| Academic Unit: |
Faculty of Science and Engineering > Mathematics and Statistics |
| Item ID: |
13160 |
| Identification Number: |
https://doi.org/10.1016/S0140-6736(17)33104-5 |
| Depositing User: |
Niamh Cahill
|
| Date Deposited: |
31 Jul 2020 16:43 |
| Journal or Publication Title: |
The Lancet |
| Publisher: |
Elsevier |
| Refereed: |
Yes |
| URI: |
|
| Use Licence: |
This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available
here |
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