New Delhi: The number of women of reproductive age (15-49) in India who face the need to prevent pregnancies but have no access to contraceptives reduced by over 13 percentage points between 1970 and 2019, shows a study on worldwide contraceptive use published in The Lancet journal Friday.
According to the study, over 160 million adolescents (15-19 years) and women (20-49 years) “remain with unmet need for contraception worldwide”, while the ‘demand satisfied’ category has grown to 79 per cent in 2019, from 55 per cent in 1970.
The study, conducted by researchers from the University of Washington, US, provides estimates on worldwide contraceptive use — its overall need and the types used — having tracked it continuously from 1970 to 2019, categorising the data by country, age group and marital status.
According to the data published, in 2019, about 8.5 per cent of women and adolescents in India had an unmet need of contraceptives. As many as 62.2 per cent in India used female sterilisation as contraception.
“In India, the larger proportion of women using female sterilisation is likely to be associated with incentives for sterilisation provided to some groups by the Indian government,” the authors write in the study.
Expanding access to contraceptives, the researchers note, is linked to women’s social and economic empowerment. Not only does the use of contraceptives reduce maternal and neonatal deaths by preventing unintended pregnancies, it also enables adolescents and women to remain in school, pursue further education and work, the report says.
Based on data from 1,162 self-reported representative surveys on women’s contraceptive use, the study used a modelling method to produce national estimates of various family planning indicators — the proportion of women of reproductive age using any contraceptive method, the proportion of women of reproductive age using modern contraceptive methods, the types of contraceptives in use, demand satisfied with modern methods, and unmet need for any contraceptive method.
The study shows that, worldwide, the share of women of reproductive age using modern contraceptives has increased to 48 per cent in 2019 from 28 per cent in 1970.
Despite the major increases, though, almost 163 million women in 2019 — of the total 1.2 billion women who needed contraception — had unmet need for contraception.
“Although we have observed excellent strides in contraceptive availability since the 1970s at a global level, there’s still a long way to go to ensure that every woman and adolescent girl can benefit from the economic and social empowerment that contraceptives can offer,” Annie Haakenstad, from the Institute for Health Metrics and Evaluation (IHME) at University of Washington, said in a statement.
“Our results indicate that where a woman lives in the world and their age still significantly impacts their use of contraception,” she added.
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Largest gaps observed among young, married women
Southeast Asia, east Asia and Oceania had the highest use of modern contraceptives (65 per cent) and demand satisfied (90 per cent). Meanwhile, sub-Saharan Africa had the lowest use of modern contraceptives (24 per cent) and demand satisfied (52 per cent) in 2019, the study shows.
Among countries, levels of modern contraceptive use ranged from 2 per cent in South Sudan to 88 per cent in Norway. Unmet need was highest in South Sudan (35 per cent), followed by Central African Republic (29 per cent) and Vanuatu (28 per cent) in 2019.
The study notes that, in 2019, those in the 15-19 and 20-24 age groups had the lowest rates of demand-satisfied globally — estimated at 65 per cent and 72 per cent, respectively.
Those aged 15-24 comprised 16 per cent of total need but 27 per cent of unmet need —amounting to 43 million young women and adolescents with no access to the contraceptives they need.
The researchers saw that the largest gaps globally were among young, married women.
“Importantly, our study calls attention to young women being overrepresented among those who cannot access contraception when they need it. These are the women who stand most to gain from contraceptive use, as delaying having children can help women stay in school or get other training opportunities and to enter and maintain paid employment,” Haakenstad said in the statement.
“This can lead to social and economic benefits that last throughout a woman’s lifetime and is an essential driver towards greater gender equity,” she added.
The types of contraceptive methods in use vary significantly by location. The authors suggest that the dominance of single methods could indicate a lack of suitable choices for women and adolescent girls.
In 2019, female sterilisation and oral contraceptives were dominant in Latin America and the Caribbean, the oral contraceptive pill and condoms in high-income countries, and IUDs and condoms in central and eastern Europe and central Asia.
Female sterilisation comprised over half of all contraception use in south Asia. In addition, in 28 countries, more than half the women were using the same method, indicating that there may be a limited availability of options in these areas.
“Our study highlights that not only should contraception be available to all women, but there should also be suitable choices of contraceptives. Diversifying options in areas that may be over-reliant on one method could help increase contraceptive use, particularly when the most used method is permanent,” Rafael Lozano, a professor at IHME, said in the statement.
(Edited by Zinnia Ray Chaudhuri)
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