Changes in contraceptive method mix in developing countries.

Context: Understanding shifts in contraceptive method mix is key to helping policymakers, program managers and donor agencies meet current contraceptive demand and estimate future needs in developing countries.

Methods: Data from Demographic and Health Surveys, Reproductive Health Surveys and other nationally representative surveys were analyzed to describe trends and shifts in method mix among married women of reproductive age from 1980 to 2005. The analysis included 310 surveys from 104 developing countries.

Results: Contraceptive use among married women of reproductive age increased in all regions of the developing world, reaching 66% in Asia and 73% in Latin America and the Caribbean in 2000-2005, though only 22% in Sub- Saharan Africa. The proportion of married contraceptive users relying on the IUD declined from 24% to 20%, and the proportion using the pill fell from 16% to 12%. The share of method mix for injectables rose from 2% to 8%, and climbed from 8% to 26% in Sub-Saharan Africa, while the share for condoms was 5-7%. The overall proportion of users relying on female sterilization ranged from 29% to 39%, reaching 42-43% in Asia and in Latin America and the Caribbean in 2000-2005; on average, the share of all method use accounted for by male sterilization remained below 3% for all periods. Use of traditional methods declined in all regions; the sharpest drop-from 56% to 31% of users-occurred in Sub-Saharan Africa.

Conclusions: To meet the rising demand for modern methods, it is critical that future programmatic efforts provide methods that are both accessible and acceptable to users.