Data & Analysis > In-Depth Analysis > mCPR and Method Use
Relationship Between mCPR and Modern Method Use

The purpose of this analysis is to examine the relationship between modern contraceptive prevalence rates (mCPR) and the number of modern methods used by women of reproductive age. We used method-specific modern contraceptive prevalence data from all available DHS, MICS, PMA2020, and national reports from FP2020 countries. Globally and by region, we find a positive correlation between mCPR and the number of modern methods in the method mix.

Availability of a variety of contraceptive methods helps in meeting the individual needs of women and couples. A recent article by Ross and Stover[1] demonstrates that contraceptive use is greater when more methods are available to a large proportion of the population. The authors describe a positive association between modern contraceptive prevalence rates (mCPR; from representative national surveys) and the number of modern methods available (based on scores from the Family Planning Effort Index). Here, we examine the relationship between mCPR and the number of modern methods actually being used, based on method prevalence rates from nationally representative surveys.

The analyses on this page present the relationship between mCPR and the number of modern methods used, using data from all available DHS, MICS, PMA2020, and national reports for each country between 1986 and 2014. The method prevalence data for women currently using contraception (all and married, as available) was used to determine the number of modern methods being used in each country. A modern method was included if the method prevalence was greater than 0. Modern methods included in this analysis are: female sterilization, male sterilization, pill, IUD, implants, male condom, female condom, diaphragm/foam/jelly (combined), lactational amenorrhea method (LAM), and standard days method (SDM).

Global Picture

Figure 1 below presents data for mCPR and associated number of modern methods used from 275 surveys from 68 of the 69 FP2020 countries (there was no report data available for the Democratic People's Republic of Korea). The number of modern methods used in the FP2020 countries ranged from two to ten methods, and values for modern contraceptive prevalence (mCPR) ranged from 1% to 67%. Using a simple linear regression, this graph clearly shows a positive correlation between the mCPR and the number of modern methods in the method mix.

Figure 2 presents data for mean mCPR and associated number of modern methods used from each country. For each number of modern methods used, the unweighted mean of the mCPR values was calculated and plotted according to the corresponding number of modern methods. This plot displays that there is a positive correlation between the number of modern methods and the mCPR.

Figure 3 presents data for the mean mCPR by region. Western Africa and Central Africa had the lowest mean mCPRs (9.5% and 10.8%) while Eastern and Central Asia had the highest mCPR (43.4%). There is a 34% point difference between the mean mCPR for Western Africa and Eastern and Central Asia.

Regional Variation

How does the association between mCPR and number of modern methods vary by geographical region? The subsequent eight graphs present the data for mCPR and number of modern methods by region, allowing for examination of geographical variation in the relationship.

Latin America and Caribbean (LAC)

Figure 4A presents data from four countries in Latin America and the Caribbean and includes 18 data points. Between the first and last survey years, 1989 and 2012, women and couples used between five and eight modern methods. The mCPR was the lowest in 1989 (Bolivia, 8%, DHS) and the highest in 2006-07 (Nicaragua, 47%, RHS). A linear regression on the data points reveals a positive correlation between mCPR and the number of modern methods in the method mix.

Countries included in this region: Bolivia, Haiti, Honduras, and Nicaragua

Conclusion

This analysis demonstrates a positive correlation between mCPR and the number of methods used by women and couples. The same positive association between mCPR and modern method use is seen on a global level, as well as when data are parsed by region. Clearly, overall modern contraceptive use is greater when there are larger numbers of methods being used at a given point in time. This analysis supports the findings of Ross and Stover, suggesting that women and couples are more likely to use modern contraception to prevent pregnancy if they have access to more types of modern methods.



[1] Ross J, Stover J. Use of modern contraception increases when more methods become available: analysis of evidence from 1982–2009. Glob Health Sci Pract. 2013;1(2):203-212. http://dx.doi.org/10.9745/GHSP-D-13-00010.
Published 2015

Changes in use of traditional methods of contraception

Although the focus of FP2020 is on modern methods, it is important to remember that many women globally are attempting to prevent pregnancies through the use of traditional methods. While these methods are often not very effective and result in unintended pregnancies, it is significant that the women using them are actively trying to avoid becoming pregnant.

Traditional use varies by country and region and over time, but in many countries women still rely on traditional methods. Figure 1 below shows an analysis for FP2020 countries in which the annual rate of change in traditional method use between the last two surveys was calculated [1]. In each country where there were two survey data points available, traditional use was compared across the two surveys. A negative value for a country means that traditional use decreased between the two surveys, whereas a positive value means that traditional use increased.

The results of this analysis show that, across the 68 countries examined here, 29 countries saw a decline in the use of traditional methods, while 29 countries had an increase in the use of these methods, and ten countries (in the center of the graph below) had annual rates of change of less than 0.1 percentage point, so can be categorized as showing minimal/no change. The largest annual increase was seen in Bangladesh (3.9 percentage points per year between a 2012-13 MICS and 2014 DHS) and the largest annual decrease was seen in Afghanistan (-2.2 percentage points per year between a 2007-8 National Survey and a 2010-11 MICS).

Eight countries (Afghanistan, Burundi, CAR, Congo, Cameroon, Nepal, Rwanda, Timor-Leste) saw annual decreases of 1 percentage point or more, while eight countries (Bangladesh, Ghana, Iraq, Nigeria, Philippines, State of Palestine, Sao Tome and Principe, Uganda) saw annual increases of 1 percentage point or more. It is important to note that in some of the countries which experienced significant decreases in traditional use (such as Congo, Cameroon, Rwanda and Sri Lanka), traditional use still remains high overall.


Annex : Sources and Annual Rate of Change in Traditional Method Use, by FP2020 Country

Country Name

Source 1

Source 2

Annual Rate of Change

Afghanistan

MICS 2010-11

National Survey 2007-08 from UN WCU 2015

-2.2

Bangladesh

pDHS 2014 (Key Indicators)

MICS 2012-13

3.9

Benin

MICS 2014

DHS 2011-12

0.1

Bhutan

MICS 2010

National Survey 2000 from UN WCU 2015

0.0

Bolivia

DHS 2008

DHS 2003

0.5

Burkina Faso

PMA2020 2014 R1

DHS 2010

-0.3

Burundi

PMS 2012

DHS 2010

-1.4

Cambodia

pDHS 2014 (Key Indicators)

DHS 2010

0.5

Cameroon

DHS 2011

MICS 2006

-1.0

CAR

MICS 2010

MICS 2006

-1.2

Chad

MICS 2010

DHS 2004

-0.2

Comoros

DHS 2012

MICS 2000

0.0

Congo

DHS 2011-12

DHS 2005

-1.1

Cote d'Ivoire

DHS 2011-12

MICS 2006

0.4

Djibouti

PAPFAM 2012 from UN WCU 2015

MICS 2006

-0.1

DPR Korea

DPRK 2010 RHS from WCU 2015

RHS DPR Korea 2002 from UN WCU 2015

-0.6

DR Congo

DHS 2013-14

MICS 2010

0.7

Egypt

DHS 2014

DHS 2008

0.0

Eritrea

DHS 2002

DHS 1995

0.0

Ethiopia

PMA2020 2015 R3

PMA2020 2014 R2

0.4

Gambia

DHS 2013

MICS 2010

-0.2

Ghana

pDHS 2014 (Key Indicators)

PMA2020 2013 R1

3.4

Guinea

DHS 2012

DHS 2005

-0.3

Guinea-Bissau

MICS 2014

MICS 2010

0.1

Haiti

DHS 2012

DHS 2005-06

-0.6

Honduras

DHS 2011-12

DHS 2005-06

0.1

India

(DLHS-3), 2007-08

DHS 2005-06

-0.6

Indonesia

Susenas 2014

Susenas 2013

0.2

Iraq

MICS 2011

MICS 2006

1.3

Kenya

pDHS 2014 (Key Indicators)

DHS 2008-09

-0.2

Kyrgyzstan

MICS 2014

DHS 2012

-0.3

Lao PDR

MICS/DHS 2011-12

National Survey 2005 from UN WCU 2015

0.6

Lesotho

pDHS 2014 (Key Indicators)

DHS 2009

-0.2

Liberia

DHS 2013

DHS 2007

0.0

Country Name

Source 1

Source 2

Annual Rate of Change

Madagascar

DHS 2008-09

DHS 2003-04

0.4

Malawi

MICS 2014

DHS 2010

-0.7

Mali

DHS 2012-13

DHS 2006

-0.1

Mauritania

MICS 2011

MICS 2007

0.0

Mongolia

MICS 2013

MICS 2010

0.6

Mozambique

DHS 2011

MICS 2008

-0.4

Myanmar

MICS 2009-10

National Survey 2007 from UN WCU 2015

-0.9

Nepal

MICS 2014

DHS 2011

-1.3

Nicaragua

DHS 2011-12 from UN WCU 2015

RHS 2006-07

0.2

Niger

DHS 2012

DHS 2006

0.0

Nigeria

DHS 2013

National Survey 2012 from UN WCU 2015

2.3

Pakistan

DHS 2012-13

LSMS 2007-08 from UN WCU 2015

0.3

Papua New Guinea

National Survey 2006

National Survey 1996-97 from UN WCU 2015

0.2

Philippines

DHS 2013

National Survey 2011 from UN WCU 2015

2.7

Rwanda

DHS 2010

DHS 2007-08

-1.0

São Tomé and Príncipe

DHS 2008-09

MICS 2006

1.0

Senegal

DHS 2014

DHS 2012-13

0.1

Sierra Leone

DHS 2013

MICS 2010

0.0

Somalia

MICS 2006

MICS 1999

0.0

South Africa

DHS 2003

DHS 1998

-0.2

South Sudan

SHHS2 2010

National Survey 2006 from UN WCU 2015

0.5

Sri Lanka

DHS 2006-07

National Survey 2000 from UN WCU 2015

-0.7

State of Palestine

MICS 2014

MICS 2010

1.2

Sudan

MICS 2006 (SHHS) from WCU 2015

National Survey 1999 from UN WCU 2015

-0.2

Tajikistan

DHS 2012

LSMS 2007 from UN WCU 2015

-0.7

Tanzania

DHS 2010

DHS 2004-05

0.1

Timor-Leste

DHS 2009-10

LSMS 2007 from UN WCU 2015

-1.1

Togo

DHS 2013-14

MICS 2010

0.3

Uganda

PMA2020 2015 R2

PMA2020 2014 R1

1.6

Uzbekistan

MICS 2006

Health Examination Survey 2002

-0.5

Vietnam

National Survey 2013 from UN WCU 2015

National Survey 2012 from WCU 2015

0.5

Yemen

pDHS 2013

MICS 2006

0.2

Zambia

DHS 2013-14

DHS 2007

-0.6

Zimbabwe

MICS 2014

DHS 2010-11

0.0



[1] Changes are calculated based on use of traditional/folk methods by women married/in union, in the two most recent comparable surveys (DHS, MICS, National, PMA2020) with data on traditional method use. Data for Solomon Islands and Western Sahara were unavailable. Values and sources are presented in the Annex below.

Published 2015

Predominance of one contraceptive method
Published 2015