Recent Fertility Trends in Sub-Saharan Africa Workshop Summary (2016) / Chapter Skim
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4 The Effects of Contraceptive Practice
4 The Effects of Contraceptive Practice
Pages 35-48
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From page 35... ...
Pregnancy rates among women seeking to avoid pregnancy who use various methods to do so vary: the pregnancy rate for women who use no 1 Modern contraceptives -- generally those whose use requires medical assistance -- include sterilization, the intrauterine device, birth control pills or injections, and implants. Traditional methods of birth control include periodic abstinence, withdrawal, and folk methods.
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From page 36... ...
. 2 The ana lytic approach allowed Bankole and his colleagues to examine scenarios, such as women changing from using no contraceptive to using a modern method, or changing type of method.
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From page 37... ...
ROLE OF TRADITIONAL FAMILY PLANNING METHODS Despite evidence that modern methods are more effective, Rossier noted, traditional methods are used worldwide and in African nations, as Figure 4-3 shows. She noted, however, that the terms "modern" and
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From page 38... ...
Periodic abstinence and withdrawal are the primary traditional methods used worldwide, she noted; used for the purpose of preventing pregnancy, they are interventions of the modern era. The more modern versions of periodic abstinence identify fertile periods more accurately than some older methods do.
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From page 39... ...
For example, women in Central Africa, educated women, and those who live in rural areas are particularly likely to use neo-traditional methods, while unmarried women are more likely to use modern methods than neo-traditional ones. Rossier suggested several reasons why women might favor neo- traditional methods over modern ones.
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From page 40... ...
Some evidence does suggest, however, that some women may associate mod ern or neo-traditional methods with promiscuity; and that such women, particularly those who are unmarried, may prefer traditional methods. It is also true, she added, that family planning programs and products are less readily available in rural areas, and therefore women in those areas would have less opportunity to use modern methods.
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From page 41... ...
To gain a more precise picture of contraceptive practices in the subSaharan region, Tsui and her colleagues compiled national-level data to examine rates of use of modern contraception, and particularly of three methods that are discreet (that can be used without others being aware of it) among married and unmarried women.
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From page 42... ...
The weighted average data for 20 sub-Saharan countries and for 3 countries suggest that one-half of discontinuation episodes could be prevented through an effective family planning program. For example, more than 35 percent of discontinuation episodes in Ethiopia came about because of side effects or health concerns, and the total across the 20 countries studied was 24.2 percent.
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From page 43... ...
Another concern for some is that resources devoted to family planning may take away from the support for HIV prevention and care, she noted. To test this hypothesis, she and her colleagues examined the data on HIV testing for women and men to see whether there was any relationship between having been tested and use of contraception.
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From page 44... ...
They wanted to understand whether sexual activity, use of modern contraceptives, postpartum abstinence, and use of discreet methods have varied significantly over time or from country to country. The time trend and heterogeneity by country are both very strong and significant, she reported, for each of the outcomes they examined.
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From page 45... ...
FIGURE 4-7 Contraceptive use among sexually active unmarried women in four countries. NOTES: Numbers in parentheses indicate the percentage of women in each coun 2 4 try who are sexually active and unmarried and are thus included in these survey Figure 4-7, editable of two national survey samples conducted results.
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From page 46... ...
Moreover, high fertility rates in the region are generally the result of mistimed or unwanted pregnancies, which suggests that the urban poor have high unmet need for effective family planning services. Thus, in Beguy's view, improving access to those services will be critical to reducing the pace of urban growth in the region and particularly increasing the numbers of people living in slum conditions.
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From page 47... ...
One topic that received particular attention was women's preferences and decision making. One participant noted that the recent trend 3 Beguy noted in particular a reproductive health initiative that targets women in poor urban settlements, funded by the Bill & Melinda Gates Foundation, and efforts to remove financial barriers to providing family planning services.
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From page 48... ...
Looking at practical implications, one participant wondered whether it is realistic to expect family planning programs to make every contraceptive option available everywhere, and another agreed that, given budget limitations, it would be reasonable to attempt to do more to match options to women's preferences. Another participant noted that the means by which people acquire knowledge and information are changing rapidly, which should drastically change the delivery of family planning.
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