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Over the past half‐century, most countries have made progress through their demographic transitions with continuing declines in mortality and fertility. The major driver of fertility decline has been the adoption of contraception by women of reproductive age who increasingly desire smaller families. This paper documents the massive changes in contraceptive behavior that have occurred since 1970 at the global and regional levels and examines contraceptive use differentials by marital status and method. To understand the proximate causes of the rise in contraceptive use, we document the changes in the potential demand for contraception (among women who want to space or limit their childbearing) and the degree to which this potential demand is satisfied by the actual practice of contraception. The paper concludes with a confirmation of the strong inverse relationship between contraceptive use and fertility. The main sources of data for these analyses are comprehensive datasets with country, regional, and global estimates of historical trends in fertility and contraceptive behavior maintained by the Population Division of the United Nations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fertility decline in sub-Saharan Africa has been slower than in other regions, with the periods of extremely slow transitions frequently described as stalled. Lack of investment in family planning programs has been proposed as a key contributing factor. However, while there is a large literature on fertility transition stalls, similar phenomena in contraceptive prevalence trends have received less attention. OBJECTIVE: We propose a probabilistic method for detecting plateaus in modern contraceptive prevalence (MCP) and in demand for family planning satisfied by modern methods (DS). METHODS: We defined a contraceptive prevalence plateau in terms of level, rate, and probability conditions, each with associated thresholds for a plateau to be identified. We used probabilistic annual model-based estimates of family planning indicators and a simple smoothing approach to produce annual estimates of plateau probabilities under a variety of thresholds. RESULTS: We applied our method to 48 countries in sub-Saharan Africa over the period 1980-2019 and found plateaus in MCP in ten countries (half in western Africa) and plateaus in DS in two (Niger and Nigeria). We found no indication of a temporal association between MCP plateaus and fertility transition stalls, although we observed that some fertility transition stalls occurred when MCP was low. CONTRIBUTION: Our method provides an updated, robust way to identify plateaus in contraceptive prevalence. Moreover, it could feasibly be applied to probabilistic model-based estimates of other demographic indicators, such as total fertility. [ABSTRACT FROM AUTHOR]

This paper presents an analysis of trends in sexual activity by marital status and age, and their associations with contraceptive use. Understanding levels of, and trends in, sexual activity is important for assessing the needs for family planning services and for analysing commonly used family planning indicators. Data were taken from 220 Demographic and Health Surveys (DHSs) and 62 Multiple Indicator Cluster Surveys (MICSs) to provide insights into sexual activity by marital status and age in a total of 94 countries in different regions of the world. The results show the sensitivity of the indicator with respect to the definition of currently sexually active, based on the timing of last sexual intercourse (during the last 4 weeks, 3 months, or 1 year). Substantial diversity in sexual activity by marital status and age was demonstrated across countries. The proportion of married women reporting recent sexual activity (sexual intercourse during the last 4 weeks) ranged from 50% to 90%. The proportion of unmarried women reporting recent sexual activity did not exceed 50% in any of the 94 countries with available data, but showed substantial regional differences: it appeared to be rare in Asia and extremely varied within Africa, Europe and Latin America and the Caribbean. Among married women, sexual activity did not vary much by age group, while for unmarried women, there was an inverted U-pattern by age, with the youngest age group (15–19 years old) having the lowest proportion sexually active. The proportion of women who reported currently using contraception and reported not being sexually active varied by the contraceptive method used and was overall much greater among unmarried women. The evidence presented in this paper can be used to improve family planning policies and programmes to serve the diverse needs, for example regarding method choice and service provision, of unmarried women. [ABSTRACT FROM AUTHOR]