The worldwide use of steroidal contraception

Historically, concerns about rapidly growing populations and resources that could not support them persuaded governments of developing countries to initiate family planning programs. Between the early 1960s and the early 1980s, the number of governments supporting these programs increased from 7 to approximately 120. Today, 52 governments in developing countries provide support to family planning programs because of the demographic rationale, and 65 governments do so because of human rights and health considerations: The effective use of family planning significantly diminishes infant, child, and maternal mortality and morbidity. Forty-five percent of married women of reproductive age worldwide are practicing contraception today; however, 69% do so in East Asia and only 11% in Africa. Female sterilization and use of intrauterine devices are the most popular methods in developing countries, and oral contraceptives and condoms, in developed countries. Of the 400 million women of reproductive age, 140 million (35%) are relying on family planning methods requiring male cooperation and less than 60 million (15%) are using oral contraceptives. More than half of these oral contraceptive users live in four countries: the United States, Brazil, France, and the Federal Republic of Germany. On the other hand, the percentage of currently married women, aged 15 to 19 years, who have never used any form of contraception is as high as 85% to 90% in Bangladesh, Sudan, and Pakistan. In many developing countries, there is a statistically significant correlation between women's use of contraception and years of education. Other important factors influencing contraceptive prevalence include the established or perceived side effects of currently available methods, the status of women, the political climate, and a number of behavioral and social determinants.