Pooled prevalence of modern contraceptive utilization and its associated factors among reproductive age women in East Africa: derived from demographic and health surveys – Journal of Health, Population and Nutrition

 

Report on Modern Contraceptive Utilization and its Impact on Sustainable Development Goals

This report synthesizes findings from extensive research on family planning, focusing on the utilization of modern contraceptives in developing regions, particularly Sub-Saharan Africa. The analysis underscores the critical role of family planning as a catalyst for achieving multiple Sustainable Development Goals (SDGs).

The Foundational Role of Family Planning in SDG 3: Good Health and Well-being

Ensuring healthy lives and promoting well-being for all at all ages is a central pillar of the 2030 Agenda. Access to modern contraception is a direct and powerful intervention for achieving this goal.

Target 3.7: Universal Access to Sexual and Reproductive Health-Care Services

The global commitment to ensure universal access to sexual and reproductive healthcare, including family planning, is paramount. Research consistently demonstrates that well-designed family planning programs are essential for public health in the 21st century. The provision of modern contraceptive methods is a core component of this target, enabling individuals and couples to make informed decisions about their reproductive health.

• Global entities like the United Nations and the World Health Organization provide critical data and projections that guide efforts to meet the worldwide demand for family planning.
• Effective programs are crucial for addressing the unmet need for contraception, a significant challenge in many low-income countries.

Target 3.1: Reducing Global Maternal Mortality

The use of modern contraceptives is one of the most effective strategies for averting maternal deaths. By enabling women to plan and space their pregnancies, contraception directly mitigates risks associated with childbirth.

1. Prevention of Unintended Pregnancies: A significant portion of maternal deaths results from complications arising from unintended pregnancies. Contraception reduces the overall number of pregnancies, thereby lowering maternal mortality rates.
2. Healthier Birth Spacing: Adequate spacing between births allows for physical and nutritional recovery, reducing the risk of complications in subsequent pregnancies and improving child survival rates.
3. Reduction of Unsafe Abortions: By preventing unwanted pregnancies, contraceptive use significantly decreases the incidence of unsafe abortions, a major cause of maternal mortality and morbidity.

Advancing SDG 5: Gender Equality through Reproductive Autonomy

Achieving gender equality and empowering all women and girls is intrinsically linked to their ability to control their own fertility. Access to contraception is a fundamental tool for female empowerment.

Target 5.6: Ensuring Universal Access to Sexual and Reproductive Health and Reproductive Rights

A woman’s ability to decide whether and when to have children is a cornerstone of her autonomy and a key indicator of gender equality. Studies highlight that women’s decision-making power is a significant predictor of modern contraceptive use.

• Empowerment, often measured by factors like education, employment, and participation in household decisions, is positively correlated with contraceptive uptake.
• Conversely, lack of autonomy and gender-based power imbalances are major barriers to accessing and using family planning services.
• Involving men and addressing their role as partners is crucial for improving contraceptive use and advancing gender-equitable relationships.

Addressing Disparities and Fostering SDG 10: Reduced Inequalities

Significant inequalities in access to and use of modern contraception persist, hindering progress towards a more equitable world. These disparities exist between and within countries, often along socioeconomic, geographic, and demographic lines.

Socioeconomic and Geographic Divides

Research consistently reveals a stark divide in contraceptive use based on wealth and location.

• Urban-Rural Disparity: Women in urban areas generally have higher rates of contraceptive use due to better access to healthcare facilities, information, and educational opportunities.
• Wealth Quintile: Women from wealthier households are significantly more likely to use modern contraceptives compared to their counterparts in the poorest quintiles.
• Regional Variations: Spatial analyses within countries like Ethiopia and Ghana show significant geographic “hotspots” and “coldspots” of contraceptive use, necessitating targeted interventions.

Barriers for Youth and Adolescents

Adolescent girls and young women face unique and substantial barriers to accessing contraception, representing a critical area of inequality.

• Factors such as social stigma, lack of youth-friendly services, and provider bias often prevent young people from obtaining the reproductive health services they need.
• Addressing the needs of this demographic is essential for preventing early and unintended pregnancies, which can curtail educational and economic opportunities, perpetuating the cycle of poverty and inequality.

Key Determinants of Modern Contraceptive Use

A multitude of interconnected factors influence a woman’s ability and willingness to use modern contraception. Understanding these determinants is vital for designing effective programs that align with the SDGs.

Individual and Demographic Factors

1. Education Level: A woman’s level of education is one of the strongest and most consistent predictors of contraceptive use.
2. Age: Contraceptive needs and choices vary significantly across a woman’s reproductive lifespan.
3. Marital Status: Married women often exhibit different patterns of use compared to unmarried, sexually active women.
4. Fertility Preferences: The desire for more children is a primary determinant of whether a woman seeks to use contraception.
5. History of Pregnancy Termination: Experience with abortion can influence subsequent contraceptive adoption.

Socio-Cultural and Systemic Factors

• Media Exposure: Exposure to family planning messages through mass media (radio, television) is strongly associated with higher rates of contraceptive use.
• Partner Opposition: Lack of spousal approval and communication remains a significant barrier in many cultural contexts.
• Health System Barriers: Factors such as distance to health facilities, cost of services, and limited availability of a wide range of methods impede access.
• Social Networks: The influence of peers and community members can either support or discourage the use of family planning.

Analysis of Sustainable Development Goals in the Article

SDGs Addressed in the Article

• SDG 3: Good Health and Well-being

  The article’s references extensively cover topics central to SDG 3, particularly those related to health outcomes and healthcare access. Numerous titles focus on “family planning” (Ref 1, 16, 53), “contraceptive use” (Ref 6, 7, 8), “reproductive health” (Ref 15, 33), and “maternal health” (Ref 11). The mention of “maternal mortality” (Ref 5) and “maternal deaths averted by contraceptive use” (Ref 57) directly links the content to the goal of improving health and well-being for women.

• SDG 5: Gender Equality

  The issues discussed are intrinsically linked to gender equality. The focus is predominantly on women’s health, access to services, and autonomy. References mentioning “women’s autonomy” (Ref 23), “women’s decision making power” (Ref 51, 55), and “women empowerment” (Ref 78) highlight the goal of empowering women to make their own choices about their bodies and health. The entire theme of providing access to contraception for women of reproductive age (Ref 14, 17, 22) is a cornerstone of ensuring gender equality and giving women control over their lives and futures.

Specific Targets Identified

1. Target 3.1: Reduce global maternal mortality

   This target aims to reduce the global maternal mortality ratio. The article directly addresses this through references such as “Trends in maternal mortality” (Ref 5) and “Maternal deaths averted by contraceptive use: an analysis of 172 countries” (Ref 57), which clearly connect the use of contraception to the reduction of maternal deaths.

2. Target 3.7: Ensure universal access to sexual and reproductive health-care services

   This is the most prominent target. It focuses on ensuring access to family planning, information, and education. Nearly every reference supports this target, with titles like “Family Planning Programs for the 21st Century” (Ref 1), “Factors influencing contraceptive use” (Ref 6), “Barriers to modern contraceptive utilization” (Ref 12), and “access to contraceptive services” (Ref 52). The repeated analysis of “modern contraceptive use” across various regions (sub-Saharan Africa, Ethiopia, Kenya, etc.) underscores a focus on achieving this target.

3. Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights

   This target complements Target 3.7 by emphasizing women’s rights and autonomy in reproductive health decisions. The article’s content aligns with this through studies on “women’s autonomy and modern contraception use” (Ref 23), “Married women’s decision making power on modern contraceptive use” (Ref 51), and “Gender and family planning in sub-saharan Africa” (Ref 72). These references examine the social and personal factors that enable women to exercise their reproductive rights.

Indicators for Measuring Progress

1. Indicator 3.1.1: Maternal mortality ratio

   This indicator is explicitly mentioned in the title of reference 5, “Trends in maternal mortality,” and implied in reference 57, “Maternal deaths averted by contraceptive use.” These studies provide the data needed to track progress in reducing maternal deaths.

2. Indicator 3.7.1: Proportion of women of reproductive age who have their need for family planning satisfied with modern methods

   This indicator is the central theme of the provided references. It is measured through metrics like “contraceptive prevalence rates” (Ref 8), “modern contraceptive utilization” (Ref 12, 17, 24), and analyses of “unmet need for contraception” (Ref 16, 64, 65). The numerous “Demographic and Health Surveys” (DHS) cited (Ref 14, 33, 34, 35, etc.) are primary sources for this data.

3. Indicator 3.7.2: Adolescent birth rate

   While not stated as a “rate,” this indicator is strongly implied. Many references focus on contraceptive use among “adolescent girls and young women” (Ref 14, 46, 75) and “female youth” (Ref 58). The goal of increasing contraceptive use in this demographic is to reduce unintended pregnancies and, consequently, the adolescent birth rate.

4. Indicator 5.6.1: Proportion of women who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care

   This indicator is addressed by references that analyze “women’s decision making power” (Ref 51, 55) and “women’s autonomy” (Ref 23) in the context of contraceptive use. These studies investigate the degree to which women can make independent choices about their reproductive health, which is the core of this indicator.

Summary of Findings

SDGs	Targets	Indicators
SDG 3: Good Health and Well-being	3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.	3.1.1 Maternal mortality ratio. (Implied in references on maternal mortality trends and deaths averted by contraception).
SDG 3: Good Health and Well-being	3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education.	3.7.1 Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods. (Measured by “contraceptive prevalence,” “modern contraceptive use,” and “unmet need” in numerous references). 3.7.2 Adolescent birth rate (aged 10-14 years; aged 15-19 years). (Implied by studies on contraceptive use among adolescents and youth).
SDG 5: Gender Equality	5.6 Ensure universal access to sexual and reproductive health and reproductive rights.	5.6.1 Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care. (Addressed in references on “women’s autonomy” and “decision-making power”).

Source: jhpn.biomedcentral.com