Healthcare News South Africa

Modern contraceptives on the rise across sub-Saharan Africa

As the world faces a pivotal moment for family planning, new data released today shows that the use of modern contraception is soaring around the world, with an estimated 371 million women of reproductive age in low- and lower-middle-income countries now using a modern method of family planning - 87 million more than just a decade ago.
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The new data released at a press briefing this morning at the International Conference on Family Planning was accompanied by commitments from governments, including the Democratic Republic of Congo (DRC), and the announcement of a historic new five-year pledge to FP2030 of $15m from the United States Agency for International Development (USAid).

Calling USAid, “a pillar of this global family-planning partnership since FP2030 was created 10 years ago,” Samukeliso Dube, executive director of FP2030, said the new commitment, “affirms the success in our new report: that a diverse global partnership, deliberately working together, can accelerate the use of family planning everywhere.

"The findings presented here today provide us with a message for global leaders meeting at major events in parallel to ours: whether at the Cop27 in Egypt, the G20 in Indonesia, or the Asia-Pacific Economic Cooperation meeting in Thailand; whether their goal is to address climate change, inequality, or economic development, they must begin with a commitment to invest in family planning.”

According to FP2030’s 2022 Measurement Report, more women in low- and lower-middle income countries are using modern family-planning methods than ever before: today, one in three women of reproductive age in low- and lower-middle income countries are now choosing to use modern contraception.

Contraceptive prevalence has steadily increased in these countries, but in 14 countries, the number of contraceptive users has actually doubled. The sharpest growth has been in sub-Saharan Africa.

In the last year alone, women’s use of contraception in low- and lower-middle income countries has averted more than 141 million unintended pregnancies, 29 million unsafe abortions and almost 150,000 maternal deaths.

The FP2030 report also suggests that despite the unprecedented strain Covid-19 placed on national health systems and global supply chains, and throughout restrictive lockdowns, record numbers of people around the world continued to seek out and use family-planning products and services.

“The scale of the Covid-19 pandemic was unprecedented,” said Dube, “and over the past 10 years, health systems have been buffeted by a number of threats, including natural disasters, violent conflicts, epidemics of Ebola and Zika, political shifts and changing economic conditions.”

Paired with the significant commitments made by governments and philanthropies, the new FP2030 report demonstrates the strength and resilience of a movement that has withstood a host of global challenges, as more and more countries and organisations recognise that voluntary, rights-based family planning is integral to their development and a major driver of gender equality.

“The benefits of family planning are enormous, and have a multiplier effect,” added Dube. “Family planning is the key to reducing maternal deaths; it is the difference between finishing high school and entering into early marriage and parenthood; and it can unlock a woman’s economic survival and prosperity. That is why we are delighted to welcome the announcement today of the USAid’s decision to support FP2030.”

A human-rights centered approach to development

Less than two years after the FP2030 global partnership was launched, 24 governments and 78 non-governmental actors - including civil society organisations, private-sector providers and youth-led organisations - have now made a public financial, policy or programmatic pledge to advance rights-based family planning, vowing to expand access to voluntary, rights-based contraception.

Also at today’s press conference, the government of DRC announced its commitment to provide every person of reproductive age in the Congo Basin country with access to affordable, quality family-planning information and services, regardless of social class, geographical location or political or religious affiliation.

The government also pledged to increase access to family-planning information and services for all adolescents and young people, from 13.1% in 2018 to at least 18% in 2025.

19 countries in sub-Saharan Africa have also finalised their FP2030 commitments: Benin, Burkina Faso, Burundi, Democratic Republic of Congo, Ethiopia, Guinea, Ivory Coast, Kenya, Madagascar, Mali, Mauritania, Mozambique, Niger, Nigeria, Rwanda, Senegal, Tanzania, Togo, and Uganda.

These commitments share many common priorities, including improving service delivery for young people, increasing domestic financing, scaling up postpartum family planning and strengthening supply chains.

According to Jason Bremner, FP2030 senior director of data and measurement, “the number of women seeking modern methods of contraception has continued to climb. This is a testament to women’s desire to control whether and when to have children, and how many children to have.”

Speakers at the press briefing today noted that meeting the growing demand for family planning will require continued efforts to understand the changing needs and preferences of women and their partners.

Today, for example, implants are the most used method in 10 countries and the second most common method in another 14 countries. This represents a stark contrast with the method mix a decade ago, when implants were not as widely available.

Stepping up progress

While celebrating the good news today, Dube also noted that in many places, access to family-planning services is under attack. The recent United States Supreme Court ruling in Dobbs vs Jackson Women’s Health Organization imperils not only abortion access, but also the right to contraception, the right to make personal medical decisions and potentially the right of LGBTQ individuals to marry and have children.

“Repressive movements around the world are threatening to roll back women’s rights, depriving people of bodily autonomy and reproductive freedom,” said Dube. “Despite the overwhelming demand for family planning, the progress of the last few years should not be taken for granted.”

At the same time, donor government funding for family planning is not keeping up with the growing demand for modern contraception.

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Data released today shows that bilateral donor funding totaled approximately $1.4bn in 2021: essentially flat compared to 2020, but substantially lower than the peak achieved in 2019 ($1.52bn). Given current financial instability and inflationary trends around the world, there could be further funding cuts in the future.

“Failing to adequately fund family-planning efforts would be a missed opportunity for millions of women,” said Dube. “We need not only to hold the line, but also to secure new funding to accommodate the surge in demand for family planning.

"To ensure that the world stays on track to meet the Sustainable Development Goals by 2030 - including the intersecting goals of gender equality, health, and prosperity - investments in family planning must be safeguarded and strengthened.”

In 2021, FP2030 introduced a new decentralised, regional model, consisting of five regional hubs on four continents.

This new structure promises to make FP2030 more inclusive - and therefore more effective - than ever before, and places family-planning decisions where they should be; firmly in the hands of the nations and communities making these commitments and seeking their own solutions.

“As more and more young people enter their reproductive years, the demand for family-planning services will continue to grow. This rising demand must be met by adequate funding and increased supply,” said Dube. “The hard-won gains of the last 10 years could slip away if we don’t act now.”

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