News / Africa

Poor Countries Lack Modern Contraception

A health worker explains birth control at a clinic outside Juba, South Sudan. (H. McNeish for VOA)
A health worker explains birth control at a clinic outside Juba, South Sudan. (H. McNeish for VOA)


Joe DeCapua

A new study says little is being done to meet the growing demand for modern contraception methods in poor countries. The Guttmacher Institute says there’s an increasing desire for smaller families. 

Guttmacher says between 2003 and 2012 the number of women wanting to avoid pregnancy – and in need of modern contraception – rose from 716 million to 867 million. The sharpest increase was seen, it says, in the 69 poorest countries “where modern method use was already very low.”

Senior fellow Jacqueline Darroch co-authored the study with Susheela Singh and published their findings in a special edition of The Lancet medical journal. Darroch said that the figures are based on household surveys.

“The Guttmacher Institute for a long time has focused on issues of reproductive health and especially the high rates of unplanned child bearing and unplanned pregnancies across the world – the United States, as well as other countries. And part of the answer to both why we have such high rates of unintended pregnancy – and part of the solution – has to do with contraceptive use.”

She said between 2003 and 2012, overall modern contraceptive use in the developing world increased from 71 to 74 percent among women wanting to avoid pregnancy.

“Methods ranging from condoms to pills, implants, injections, IUD’s, sterilization,” Darroch said.

However, rates can vary across sub-regions. For example, Eastern Africa rose from 31 to 46 percent; Southern Africa from 75 to 83 percent; Southeast Asia increased from 64 to 72 percent; and South America from 73 to 79 percent.

However, there was virtually no increase reported in mid and western African countries. Darroch said that has consequences.

“Couples are having children more than they want to. They are having what we call unintended births – births, that they tells us in surveys, that they either wanted later or they didn’t want to have at all. So there’s difficulty controlling fertility.”

Some couples, she said, are turning to induced abortions in unsafe conditions that can lead to maiming or death.

“The timing and the number of children and how you control that affects women’s health by preventing pregnancies when they’re most risky – when women are very young or older – by preventing the deaths and disability from pregnancy itself, as well as for newborns. In today’s societies, smaller families tend to do better off economically in terms of the resources that families are able to use for their children.”

Darroch added that modern contraception allows women a greater opportunity to have an education.

Some of the reasons given for the lack of modern contraception in developing countries include little availability or cost, concern about possible side effects, and a spouse’s disapproval over their use.

The Guttmacher report recommends making the quality of services a priority, along with educating couples so they can make informed choices about contraception.

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