Search

Context: Improving contraceptive method choice is a goal of international family planning. Method mix-the percentage distribution of total contraceptive use across various methods-reflects both supply (availability of affordable methods) and demand (client preferences). We analyze changes in method mix, regional contrasts, and the relationship of the mix to contraceptive prevalence., Methods: We use 789 national surveys from the 1960s through 2019, from 113 developing countries with at least 1 million people and with data on use of 8 contraceptive methods. Two measures assess the "evenness" of the mix: method skew (more than 50% use is by 1 method), and the average deviation (AD) of the 8 methods' shares from their mean value. Population weighted and unweighted results are compared because they can differ substantially., Results: Use of traditional methods has declined but still represents 11% of all use (population weighted) or 17% (unweighted country average). Vasectomy's share was historically low with the exception of a few countries but is now even lower. The previous trend toward greater overall evenness in the mix has slowed recently. Sub-Saharan Africa shows a hormonal method progression from oral contraceptives to injectables to implants in a substantial number of countries. In some countries with high HIV prevalence, the condom share has increased. The leading method's share differs by region: female sterilization in Asia (39%) and in Latin America (31%), the pill in the Middle East/North Africa (32%), and the injectable in sub-Saharan Africa (36%). Method skew persists in 30% of countries. "Evenness" of mix is not related to contraceptive prevalence., Conclusion: The marked diversity in predominant methods underscores the conclusion that no single method mix is ideal or appropriate everywhere. But that diversity across countries, coupled with the persisting high degree of extreme skewness in many of them, argues for continued concerted efforts for programs to increase method choice., (© Bertrand et al.)

Context: Method mix-the percentage distribution of contraceptive users in a given country, by method-is one measure that reflects the availability of a range of contraceptive methods. A skewed method mix-one in which 50% or more of contraceptive users rely on a single method-could be cause for concern as a sign of insufficiency of alternative methods or provider bias. Shifts in method mix are important to individual countries, donors and scholars studying contraceptive dynamics., Methods: To determine current patterns and recent changes in method mix, we examined 109 low- and middle-income countries. A variety of statistical methods were used to test four factors as correlates of skewed method mix: geographic region, family planning program effort index, modern contraceptive prevalence rate and human development index. An assessment of changes in reliance on female and male sterilization, the IUD, the implant and the injectable was conducted for countries with available data., Results: Of the 109 countries included in this analysis, 30% had a skewed method mix-a modest decrease from 35% in a 2006 analysis. Only geographic region showed any correlation with method skew, but it was only marginally significant. The proportion of users relying on female sterilization, male sterilization or the IUD decreased in far more countries than it increased; the pattern was reversed for the injectable., Conclusion: Method mix skew is not a definitive indicator of lack of contraceptive choice or provider bias; it may instead reflect cultural preferences. In countries with a skewed method mix, investigation is warranted to identify the cause.

Presents conversion factors to be used to translate the quality of the respective contraception methods distributed to a single measure of protection for calculating couple-years of protection in family planning studies. Discusses the implications for the evaluation of family planning programs. (SLD)

Despite a state law enacted 1972 which allowed minors to obtain contraceptive services without parental consent, births to very young women in Georgia (age 14 and less) have risen in recent years. Beginning in 1974, however, this trend has reversed. Increased access to induced abortion following the 1973 U.S. Supreme Court decision appears to have been responsible for the decline. Supporting this assertion are: 1) the temporal relationship between increased access to abortion and the decline in births, 2) the geographic evidence that the decline in births occurred first in Atlanta where abortion utilization is the highest and then followed in areas with somewhat more limited utilization , and 3) a similar observation that the decline occurred earlier and more markedly among young white teenagers whose abortion utilization is higher. Although abortion appears to have had to most visible impact on births, most people would probably agree that efforts toward providing contraception to these young women remain worth the challenge. The ratio of young teenagers accepting contraceptives to young teenagers getting pregnant is suggested as a useful intermediate indicator of the success of family planting program. [ABSTRACT FROM AUTHOR]