Inequities in Family Planning in Low- and Middle-Income Countries

Area of Science:

• Reproductive health
• Family planning
• Health equity

Background:

• Reproductive health inequities are a significant global challenge.
• Periodic surveys are essential for monitoring trends and informing policy.
• Understanding disparities in contraceptive access is critical for public health.

Purpose of the Study:

• To assess inequities in access to 7 contraceptive methods using National Composite Index for Family Planning surveys from 2017 and 2021.
• To trace patterns of discrimination affecting 5 subgroups in low- and middle-income countries.
• To evaluate changes in contraceptive access and use equity over time.

Main Methods:

• Utilized National Composite Index for Family Planning surveys conducted in 2017 and 2021.
• Assessed access to 7 contraceptive methods and discrimination against 5 subgroups.
• Employed questionnaire ratings from national-level informants on a 1-10 scale.

Main Results:

• Average access to contraceptive methods was approximately 50%, with significant regional and country-level variations.
• Access to short-term methods (pill, injectable, condom) was better than long-term methods (sterilization, IUD, implant).
• Modest improvements in access scores were observed over time, correlating with increased contraceptive use and reduced wealth-based inequity.

Conclusions:

• Surveys from 2017 and 2021 reveal both progress and persistent deficiencies in equitable contraceptive access.
• Discriminatory practices against specific subgroups require targeted policies and provider actions.
• Continued focus on policies and national program practices can further improve contraceptive equity and use.