Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys
Summary: Background: The Family Planning 2020 (FP2020) initiative, launched at the 2012 London Summit on Family Planning, aims to enable 120 million additional women to use modern contraceptive methods by 2020 in the world's 69 poorest countries. It will require almost doubling the pre-2012 an...
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-07-01
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| Series: | The Lancet Global Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214109X19302001 |
| _version_ | 1818246269465788416 |
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| author | Saifuddin Ahmed, ProfPhD Yoonjoung Choi, DrPH Jose G Rimon, MA Souleymane Alzouma, DESS Peter Gichangi, PhD Georges Guiella, PhD Patrick Kayembe, PhD Simon P Kibira, PhD Fredrick Makumbi, PhD Funmilola OlaOlorun, PhD Elizabeth Omoluabi, PhD Easmon Otupiri, PhD Sani Oumarou, DESS Assefa Seme, MD Solomon Shiferaw, PhD Philip Anglewicz, PhD Scott Radloff, PhD Amy Tsui, PhD |
| author_facet | Saifuddin Ahmed, ProfPhD Yoonjoung Choi, DrPH Jose G Rimon, MA Souleymane Alzouma, DESS Peter Gichangi, PhD Georges Guiella, PhD Patrick Kayembe, PhD Simon P Kibira, PhD Fredrick Makumbi, PhD Funmilola OlaOlorun, PhD Elizabeth Omoluabi, PhD Easmon Otupiri, PhD Sani Oumarou, DESS Assefa Seme, MD Solomon Shiferaw, PhD Philip Anglewicz, PhD Scott Radloff, PhD Amy Tsui, PhD |
| author_sort | Saifuddin Ahmed, ProfPhD |
| collection | DOAJ |
| description | Summary: Background: The Family Planning 2020 (FP2020) initiative, launched at the 2012 London Summit on Family Planning, aims to enable 120 million additional women to use modern contraceptive methods by 2020 in the world's 69 poorest countries. It will require almost doubling the pre-2012 annual growth rate of modern contraceptive prevalence rates from an estimated 0·7 to 1·4 percentage points to achieve the goal. We examined the post-Summit trends in modern contraceptive prevalence rates in nine settings in eight sub-Saharan African countries (Burkina Faso; Kinshasa, DR Congo; Ethiopia; Ghana; Kenya; Niamey, Niger; Kaduna, Nigeria; Lagos, Nigeria; and Uganda). These settings represent almost 73% of the population of the 18 initial FP2020 commitment countries in the region. Methods: We used data from 45 rounds of the Performance Monitoring and Accountability 2020 (PMA2020) surveys, which were all undertaken after 2012, to ascertain the trends in modern contraceptive prevalence rates among all women aged 15–49 years and all similarly aged women who were married or cohabitating. The analyses were done at the national level in five countries (Burkina Faso, Ethiopia, Ghana, Kenya, and Uganda) and in selected high populous regions for three countries (DR Congo, Niger, and Nigeria). We included the following as modern contraceptive methods: oral pills, intrauterine devices, injectables, male and female sterilisations, implants, condom, lactational amenorrhea method, vaginal barrier methods, emergency contraception, and standard days method. We fitted design-based linear and quadratic logistic regression models and estimated the annual rate of changes in modern contraceptive prevalence rates for each country setting from the average marginal effects of the fitted models (expressed in absolute percentage points). Additionally, we did a random-effects meta-analysis to summarise the overall results for the PMA2020 countries. Findings: The annual rates of changes in modern contraceptive prevalence rates among all women of reproductive age (15–49 years) varied from as low as 0·77 percentage points (95% CI −0·73 to 2·28) in Lagos, Nigeria, to 3·64 percentage points (2·81 to 4·47) in Ghana, according to the quadratic model. The rate of change was also high (>1·4 percentage points) in Burkina Faso, Kinshasa (DR Congo), Kaduna (Nigeria), and Uganda. Although contraceptive use was rising rapidly in Ethiopia during the pre-Summit period, our results suggested that the yearly growth rate stalled recently (0·92 percentage points, 95% CI −0·23 to 2·07) according to the linear model. From the meta-analysis, the overall weighted average annual rate of change in modern contraceptive prevalence rates in all women across all nine settings was 1·92 percentage points (95% CI 1·14 to 2·70). Among married or cohabitating women, the annual rates of change were higher in most settings, and the overall weighted average was 2·25 percentage points (95% CI 1·37–3·13). Interpretations: Overall, the annual growth rates exceeded the 1·4 percentage points needed to achieve the FP2020 goal of 120 million additional users of modern contraceptives by 2020 in the select study settings. Local programme experiences can be studied for lessons to be shared with other countries aiming to respond to unmet demands for family planning. The findings of this study have implications for the way progress is tracked toward achieving the FP2020 goal. Funding: The Bill & Melinda Gates Foundation. |
| first_indexed | 2024-12-12T14:46:08Z |
| format | Article |
| id | doaj.art-a7a3ef269b844e8fb3396cdb8152d232 |
| institution | Directory Open Access Journal |
| issn | 2214-109X |
| language | English |
| last_indexed | 2024-12-12T14:46:08Z |
| publishDate | 2019-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Global Health |
| spelling | doaj.art-a7a3ef269b844e8fb3396cdb8152d2322022-12-22T00:21:06ZengElsevierThe Lancet Global Health2214-109X2019-07-0177e904e911Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveysSaifuddin Ahmed, ProfPhD0Yoonjoung Choi, DrPH1Jose G Rimon, MA2Souleymane Alzouma, DESS3Peter Gichangi, PhD4Georges Guiella, PhD5Patrick Kayembe, PhD6Simon P Kibira, PhD7Fredrick Makumbi, PhD8Funmilola OlaOlorun, PhD9Elizabeth Omoluabi, PhD10Easmon Otupiri, PhD11Sani Oumarou, DESS12Assefa Seme, MD13Solomon Shiferaw, PhD14Philip Anglewicz, PhD15Scott Radloff, PhD16Amy Tsui, PhD17Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Correspondence to: Prof Saifuddin Ahmed, Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USADepartment of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USADepartment of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins Universiy, Baltimore, MD, USAInstitut National de la Statistique, Niamey, NigerInternational Center for Reproductive Health-Kenya, and Technical University of Mombasa, Mombasa, KenyaInstitut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina FasoSchool of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the CongoDepartment of Community Health, Makerere University School of Public Health, Kampala, UgandaDepartment of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, UgandaDepartment of Community Medicine, University of Ibadan, Ibadan, NigeriaCenter for Research, Evaluation Resources and Development, Ile-Ife, Osun State, NigeriaDepartment of Population, Family and Reproductive Health, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaInstitut National de la Statistique, Niamey, NigerDepartment of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Reproductive Health and Health Service Management, School of Public Health, Addis Ababa University, Addis Ababa, EthiopiaDepartment of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USADepartment of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USADepartment of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USASummary: Background: The Family Planning 2020 (FP2020) initiative, launched at the 2012 London Summit on Family Planning, aims to enable 120 million additional women to use modern contraceptive methods by 2020 in the world's 69 poorest countries. It will require almost doubling the pre-2012 annual growth rate of modern contraceptive prevalence rates from an estimated 0·7 to 1·4 percentage points to achieve the goal. We examined the post-Summit trends in modern contraceptive prevalence rates in nine settings in eight sub-Saharan African countries (Burkina Faso; Kinshasa, DR Congo; Ethiopia; Ghana; Kenya; Niamey, Niger; Kaduna, Nigeria; Lagos, Nigeria; and Uganda). These settings represent almost 73% of the population of the 18 initial FP2020 commitment countries in the region. Methods: We used data from 45 rounds of the Performance Monitoring and Accountability 2020 (PMA2020) surveys, which were all undertaken after 2012, to ascertain the trends in modern contraceptive prevalence rates among all women aged 15–49 years and all similarly aged women who were married or cohabitating. The analyses were done at the national level in five countries (Burkina Faso, Ethiopia, Ghana, Kenya, and Uganda) and in selected high populous regions for three countries (DR Congo, Niger, and Nigeria). We included the following as modern contraceptive methods: oral pills, intrauterine devices, injectables, male and female sterilisations, implants, condom, lactational amenorrhea method, vaginal barrier methods, emergency contraception, and standard days method. We fitted design-based linear and quadratic logistic regression models and estimated the annual rate of changes in modern contraceptive prevalence rates for each country setting from the average marginal effects of the fitted models (expressed in absolute percentage points). Additionally, we did a random-effects meta-analysis to summarise the overall results for the PMA2020 countries. Findings: The annual rates of changes in modern contraceptive prevalence rates among all women of reproductive age (15–49 years) varied from as low as 0·77 percentage points (95% CI −0·73 to 2·28) in Lagos, Nigeria, to 3·64 percentage points (2·81 to 4·47) in Ghana, according to the quadratic model. The rate of change was also high (>1·4 percentage points) in Burkina Faso, Kinshasa (DR Congo), Kaduna (Nigeria), and Uganda. Although contraceptive use was rising rapidly in Ethiopia during the pre-Summit period, our results suggested that the yearly growth rate stalled recently (0·92 percentage points, 95% CI −0·23 to 2·07) according to the linear model. From the meta-analysis, the overall weighted average annual rate of change in modern contraceptive prevalence rates in all women across all nine settings was 1·92 percentage points (95% CI 1·14 to 2·70). Among married or cohabitating women, the annual rates of change were higher in most settings, and the overall weighted average was 2·25 percentage points (95% CI 1·37–3·13). Interpretations: Overall, the annual growth rates exceeded the 1·4 percentage points needed to achieve the FP2020 goal of 120 million additional users of modern contraceptives by 2020 in the select study settings. Local programme experiences can be studied for lessons to be shared with other countries aiming to respond to unmet demands for family planning. The findings of this study have implications for the way progress is tracked toward achieving the FP2020 goal. Funding: The Bill & Melinda Gates Foundation.http://www.sciencedirect.com/science/article/pii/S2214109X19302001 |
| spellingShingle | Saifuddin Ahmed, ProfPhD Yoonjoung Choi, DrPH Jose G Rimon, MA Souleymane Alzouma, DESS Peter Gichangi, PhD Georges Guiella, PhD Patrick Kayembe, PhD Simon P Kibira, PhD Fredrick Makumbi, PhD Funmilola OlaOlorun, PhD Elizabeth Omoluabi, PhD Easmon Otupiri, PhD Sani Oumarou, DESS Assefa Seme, MD Solomon Shiferaw, PhD Philip Anglewicz, PhD Scott Radloff, PhD Amy Tsui, PhD Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys The Lancet Global Health |
| title | Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys |
| title_full | Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys |
| title_fullStr | Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys |
| title_full_unstemmed | Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys |
| title_short | Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys |
| title_sort | trends in contraceptive prevalence rates in sub saharan africa since the 2012 london summit on family planning results from repeated cross sectional surveys |
| url | http://www.sciencedirect.com/science/article/pii/S2214109X19302001 |
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