Western and central Africa lag behind global improvements in family planningBMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f1790 (Published 20 March 2013) Cite this as: BMJ 2013;346:f1790
Use of contraception and family planning is improving slowly but steadily worldwide, according to the latest estimates by the United Nations. The proportion of women using any method of contraception rose from 54.8% (95% uncertainty interval 52.3% to 57.1%) in 1990 to 63.3% (60.4% to 66.0%) in 2010, whereas unmet need for family planning fell from 15.4% of women (14.1% to 16.9%) to 12.3% (10.9% to 13.9%).
Researchers modelled data from national surveys to estimate trends in 194 countries or areas and help global health agencies target their effort (and funding) where it’s needed most. Among countries at the bottom of the league table, progress has been particularly slow in western and central Africa, where unmet need has barely changed during the past two decades. In Nigeria, the region’s biggest country, only 14% of married and cohabiting women were using any form of contraception in 2010, and more than a fifth of women who wanted to were unable to control their fertility. Data from Chad, Mali, Mauritania, and Niger are equally worrying, says a linked editorial (doi:10.1016/S0140-6736(13)60588-7). Their combined population is set to almost triple by 2050, and the fragile ecosystem is unlikely to cope.
Poor access and availability, cultural ambivalence to family planning, and fear of the side effects associated with some modern methods such as pills and injections are all contributors, says the editorial.
Cite this as: BMJ 2013;346:f1790