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Estimating progress towards meeting women's contraceptive needs in 185 countries: A Bayesian hierarchical modelling
Vladimíra Kantorová1, Mark C Wheldon1, Philipp Ueffing1
1Population Division, Department of Economic and Social Affairs, United Nations, New York, New York, United States of America.
Plos Medicine
|February 19, 2020
Summary
Meeting family planning needs for all women, including unmarried women, is crucial for global reproductive healthcare. Significant unmet needs persist, particularly in Africa, highlighting the need for expanded services.
Area of Science:
- Reproductive Health
- Global Health
- Demography
Background:
- Universal access to reproductive healthcare and family planning is a key goal of the 2030 Agenda for Sustainable Development.
- Monitoring family planning needs is established for married women of reproductive age (MWRA) but challenging for unmarried women (UWRA) due to data limitations.
- This study provides the first harmonized estimates to monitor family planning needs for all women of reproductive age (WRA), including UWRA.
Purpose of the Study:
- To quantify the remaining gaps in meeting family planning needs among all women of reproductive age (WRA).
- To provide harmonized estimates for monitoring family planning indicators for both married (MWRA) and unmarried women (UWRA).
Main Methods:
- Systematic analysis of 1,247 nationally representative surveys to compile family planning indicators among WRA.
- Bayesian hierarchical modeling with country-specific time trends to estimate indicators for 185 countries (1990-2019) and project to 2030.
- Model accounted for sexual activity among UWRA and changing proportions of married women.
Main Results:
- In 2019, 1.11 billion WRA had a need for family planning; 842 million used modern contraception, and 270 million had unmet need for modern methods.
- Unmarried women (UWRA) represented 15.7% of modern contraceptive users and 16.0% of women with unmet need in 2019.
- Globally, 75.7% of the need for family planning was met by modern methods (SDG indicator 3.7.1), but less than half was met in Middle and Western Africa.
Conclusions:
- Significant gaps persist in meeting family planning needs, with projected increases posing challenges for service expansion.
- Monitoring family planning indicators for all women, not just MWRA, is essential for achieving universal access to reproductive healthcare by 2030.
- The emphasis on 'leaving no one behind' in the SDG era necessitates inclusive monitoring and service provision for all women.
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