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5.3 Contraceptive prevalence rate

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Modified on 2012/03/05 16:08 by MDG Wiki Handbook Categorized as Goal 5
Contents

GOAL AND TARGET ADDRESSED

Goal 5. Improve maternal health
Target 5.B: Achieve, by 2015, universal access to reproductive health

DEFINITION AND METHOD OF COMPUTATION

Definition
The contraceptive prevalence rate is the percentage of women of reproductive age who are currently using, or whose sexual partner is currently using, at least one contraceptive method, regardless of the method used. It is reported for women aged 15 to 49 who are married or in a union.

Concepts
Women of reproductive age include all women aged 15 to 49.

Contraceptive methods include modern and traditional methods. Modern methods of contraception include female and male sterilization, oral hormonal pills, intra-uterine devices (IUD), male and female condoms, injectables, implants (including Norplant), vaginal barrier methods and spermicides. Traditional methods of contraception include the rhythm method (periodic abstinence), withdrawal, lactational amenorrhea method (LAM) and folk methods. Note that LAM is classified in some surveys as a modern method. For MDG reporting on this indicator, LAM is classified as a traditional method.

Method of computation


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RATIONALE AND INTERPRETATION

The contraceptive prevalence rate, which serves as a proxy measure of access to reproductive health services, is useful for tracking progress towards the target of achieving universal access to reproductive health, especially when the indicator is considered in conjunction with information about women’s knowledge of family planning or accessibility, and the quality of family planning services. Information on contraceptive prevalence complements the indicator of unmet need for family planning (see Indicator 5.6). The sum of contraceptive prevalence and unmet need determines the total demand for contraception. Unlike the unmet need indicator, contraceptive prevalence does not take into account whether women or couples do or do not desire additional children. This makes the indicator more difficult to interpret than unmet need because contraceptive prevalence rates vary across societies with vastly different preferred family sizes. For the same reason, it is difficult to specify the desired target for contraceptive prevalence rates.

SOURCES AND DATA COLLECTION

Contraceptive prevalence rates are calculated from nationally representative surveys with questions on current use of contraception. Surveys that commonly include this information are: Demographic and Health Surveys (DHS), Fertility and Family Surveys (FFS), Reproductive Health Surveys (RHS) conducted with assistance from the United States Centers for Disease Control and Prevention, Multiple Indicator Cluster Surveys (MICS) and other national surveys.

Surveys gather information through direct questions to women, including the woman’s age and whether she is married or in a consensual union. The questions on contraceptive methods often include two parts: a general question asking women if they are currently using a method of contraception and a follow-up question regarding the type of contraceptive method currently used. In order to obtain an accurate measure of contraceptive prevalence, it is desirable for the survey interviewer to provide a description or a list of the specific methods of family planning. If this is not done, the level of contraceptive use may be significantly underreported, especially where the use of traditional methods such as withdrawal or calendar rhythm, or use of contraceptive sterilization, is common. In some surveys, such as the DHS, the methods are described in a series of “probe” questions about methods the respondent has heard about, before the respondent is asked about current use of contraception. In highly literate populations, the interviewer might provide the respondent with a printed list of the methods.

In recording data on the type of contraceptive method used, it is important to keep in mind that some respondents may use more than one method at a time. In such cases, a selection is either made a posteriori by the survey enumerator based on the effectiveness of the methods used or by respondents based on their own assessment of the method they used most frequently. Identifying only one method or one combination of methods per respondent allows contraceptive prevalence to be computed as the sum of levels of use of each method. If more than one method or one combination of methods is recorded per respondent and no selection criteria are employed, the sum of the various methods used may exceed the overall level of contraceptive prevalence.

It is also important to note that contraceptive prevalence is measured at the time of interview. There is, however, a lag, generally between one and two years, between the date of an interview and the diffusion of the survey report. On average, the surveys are undertaken every three to five years.

DISAGGREGATION

Contraceptive use may vary significantly across socioeconomic groups and regional and geographical areas. For policy purposes, information on contraceptive prevalence should be disaggregated, at a minimum, by age and current marital status. This information is important because it allows the monitoring of differences in access to contraceptive methods for more vulnerable groups such as adolescents and unmarried women.

Contraceptive use can be disaggregated by other social or economic characteristics, such as the woman’s level of educational attainment, urban or rural residence, and number of children as relevant for the policy needs of each country or area.

COMMENTS AND LIMITATIONS

Differences in survey design and implementation, as well as differences in the way survey questionnaires are formulated and administered can affect the comparability of data over time, and between countries. Some of the most common differences are the range of contraceptive methods included in the surveys, and whether or not probe questions are included in the questionnaire. The lack of probe questions can result in an underestimation of contraceptive prevalence.

The characteristics (age, sex, marital or union status) of the persons for whom contraceptive prevalence is measured (base population) also affects the comparability of data on contraceptive prevalence. Although the standard definition of the contraceptive prevalence rate refers only to women who are married or in a union, alternative base populations are sometimes presented including sexually active women (irrespective of marital status), ever-married women, or men and women who are married or in union.

The time frame used to assess contraceptive prevalence can also vary. Often it is left to the respondent to determine what is meant by “currently using” a method of contraception. Some surveys ask about use within the past month. Occasionally, when information on current use is not collected, data on use of contraceptive methods at last sexual intercourse or during the previous year has been utilized to estimate current contraceptive prevalence. Any differences between the data presented and the standard definition of contraceptive prevalence should be clearly indicated.

Sampling variability can also be an issue in data collection, especially when contraceptive prevalence is measured for a specific subgroup (according to method, age-group, level of educational attainment, place of residence, etc.) or when analyzing trends over time.

GENDER EQUALITY ISSUES

Statistics on contraception prevalence rates are based primarily on women. This is mostly for pragmatic reasons, because the majority of contraceptive methods are female-based. It can also be argued that the extent to which women control their reproduction is an indicator of how they control their own lives in general, so that the contraceptive prevalence can also be seen as an indicator of women’s empowerment. Recent surveys have also interviewed samples of men about contraceptive use.

DATA FOR GLOBAL AND REGIONAL MONITORING

Data for this indicator are reported at the global level by the United Nations Population Division. Data are obtained from national repositories or from published survey reports. In exceptional cases, data are taken from other published analytic reports. If clarification is needed, contact is made with the survey sponsors or authoring organization, which may supply corrected or adjusted estimates in response.

Regional estimates are weighted averages of the country data, using the number of married or in-union women aged 15–49 for the reference year in each country as the weight. Global estimates are weighted averages of the regional estimates, using the number of women aged 15–49 who are married or in a union in each region as the weight. No figures are reported if less than 50 per cent of the reference population in the region is covered.

SUPPLEMENTARY INFORMATION



EXAMPLES



REFERENCES



Rutstein, S. O. and G. Rojas (2006). Online Guide to DHS Statistics. Calverton, Maryland: Measure DHS. Available from http://www.measuredhs.com/help/Datasets/index.htm.

United Nations (2004). Levels and Trends of Contraceptive Use as Assessed in 2002. Sales No. E.04.XIII.9. New York. Available from http://www.un.org/esa/population/publications/wcu2002/WCU2002_Report.pdf.

United Nations (2011). World Contraceptive Use 2010. New York. Available from http://www.un.org/esa/population/publications/wcu2010/Main.html.

United Nations Population Division (2010). Multilingual Demographic Dictionary, Second Edition 1982. Available from http://en-ii.demopaedia.org/wiki/Main_Page.

World Health Organization (2006). Reproductive Health Indicators: Guidelines for their Generation, Interpretation and Analysis for Global Monitoring. Geneva. Available from http://whqlibdoc.who.int/publications/2006/924156315X_eng.pdf.

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