Overview of Family Planning and Contraception
Family Planning is a crucial aspect of global health and individual well-being, empowering individuals and couples to decide the number and spacing of their children. In 2021, among the 1.9 billion women of reproductive age worldwide, a significant 1.1 billion had a need for family planning. Of these, 874 million women were using modern contraceptive methods, highlighting the widespread adoption of family planning globally. However, a concerning 164 million women still have an unmet need for contraception, indicating ongoing challenges in access and availability.
Contraception, often used interchangeably with family planning, encompasses various methods designed to prevent pregnancy. The selection of the most suitable birth control method is a personal decision, influenced by factors such as overall health, age, frequency of sexual activity, number of partners, future family aspirations, and family medical history. Access to preferred contraceptive methods is not only a matter of personal choice but also a fundamental human right. It underpins the rights to life, liberty, freedom of opinion and expression, and access to work and education, leading to substantial health and societal advantages.
The Significant Impact of Family Planning
The utilization of contraception offers profound health benefits, particularly for women and children. It plays a vital role in preventing pregnancy-related health risks, especially for adolescent girls who are more vulnerable to complications. Furthermore, family planning significantly impacts child health. Research indicates that children born within two years of a previous sibling face a 60% higher risk of infant mortality compared to those born after an interval of three years or more. Even births spaced two to three years apart carry a 10% increased risk. These statistics underscore the importance of adequate birth spacing for improved child survival rates.
Beyond health advantages, family planning extends to broader societal benefits. It creates opportunities for women’s empowerment through enhanced educational and professional paths. When women have control over their reproductive health, they are better positioned to pursue education and contribute to the workforce, fostering gender equality and economic growth. At a national level, family planning contributes to sustainable population growth and overall economic development by allowing resources to be managed more effectively and promoting healthier, more educated populations.
The global demand for family planning has seen a considerable surge in recent decades. The number of women wanting to use family planning has risen from 900 million in 2000 to almost 1.1 billion in 2021. This growing desire is reflected in the increasing adoption of modern contraceptive methods. Between 2000 and 2020, the number of women using modern contraception increased from 663 million to 851 million, and projections estimate an additional 70 million users by 2030. Globally, contraceptive prevalence – the percentage of women aged 15–49 using any contraceptive method – rose from 47.7% in 2000 to 49.0% in 2020. Significantly, the proportion of women’s family planning needs met by modern methods reached 77.5% globally in 2022, a notable 10% increase since 1990.
Overcoming Barriers to Family Planning Access
Despite the progress, the increase in the proportion of women’s needs met for family planning has been slow, increasing by only 10 percentage points since 1990. Several interconnected barriers contribute to this slow progress. Limited choice of contraceptive methods remains a significant issue, restricting individuals’ ability to find a method that suits their needs and preferences. Access to services is also uneven, particularly for vulnerable populations such as young people, those living in poverty, and unmarried individuals who often face social and logistical hurdles in accessing reproductive health services.
Concerns about side effects, whether based on factual information or misinformation, can deter individuals from using contraception. Cultural or religious opposition to family planning also presents a barrier in certain communities, impacting both individual acceptance and service provision. Poor quality of available services, including inadequate counseling, lack of privacy, or judgmental attitudes from healthcare providers, can discourage uptake and continued use. Furthermore, biases held by both users and providers against specific methods can limit the range of options effectively offered and considered. Gender-based barriers, such as lack of female autonomy in decision-making or societal expectations around women’s roles, also play a significant role in restricting access to and utilization of family planning services. Addressing these multifaceted barriers is crucial to accelerate progress and ensure universal access to family planning.
Understanding Different Contraceptive Methods
A wide array of contraceptive methods is available, each with unique mechanisms of action and varying levels of effectiveness in preventing unintended pregnancy. These methods include oral contraceptive pills, implants, injectables, patches, vaginal rings, intrauterine devices (IUDs), condoms, male and female sterilization, lactational amenorrhea methods (LAM), withdrawal, and fertility awareness-based methods.
Contraceptive methods are generally categorized by their effectiveness based on the number of pregnancies per 100 women using the method over a year:
- Very effective methods (0–0.9 pregnancies per 100 women): These methods, such as implants and IUDs, offer the highest level of protection against pregnancy.
- Effective methods (1–9 pregnancies per 100 women): This category includes injectables, pills, patches, and vaginal rings, providing a high degree of effectiveness when used correctly and consistently.
- Moderately effective methods (10–19 pregnancies per 100 women): Methods like condoms, diaphragms, and fertility awareness-based methods fall into this category, requiring consistent and correct use to achieve their effectiveness.
- Less effective methods (20 or more pregnancies per 100 women): Withdrawal and spermicides are examples of less effective methods, with a higher risk of unintended pregnancy.
It’s important to note that condoms are unique as the only contraceptive method that can prevent both pregnancy and the transmission of sexually transmitted infections (STIs), including HIV.
WHO’s Role in Promoting Family Planning
The World Health Organization (WHO) plays a leading role in promoting family planning globally as essential for achieving the Sustainable Development Goals (SDGs) and ensuring that “no one is left behind.” WHO’s efforts are focused on producing evidence-based guidelines regarding the safety and delivery of contraceptive methods, as well as upholding human rights within family planning programs. The organization actively assists countries in adapting and implementing these guidelines to strengthen their national contraceptive policies and programs.
Furthermore, WHO is involved in the development of new contraceptive technologies and spearheads implementation research aimed at expanding access to and improving the delivery of contraceptive information and services worldwide. Through these comprehensive efforts, WHO is dedicated to ensuring that individuals globally have access to the family planning information and services they need to make informed choices about their reproductive health and well-being.
References
- United Nations Department of Economic and Social Affairs, Population Division (2022). World Family Planning 2022: Meeting the changing needs for family planning: Contraceptive use by age and method. UN DESA/POP/2022/TR/NO. 4 (https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2023/Feb/undesa_pd_2022_world-family-planning.pdf).
- United Nations, Department of Economic and Social Affairs, Population Division (2022). Estimates and Projections of Family Planning Indicators 2022.
- United Nations Population Division: https://www.un.org/development/desa/pd/
- Cleland J, Conde-Agudelo A, Peterson H, Ross J, Tsui A. Contraception and health. Lancet. 2012;380(9837):149-156. doi:10.1016/S0140-6736(12)60609-6
- United Nations Department of Economic and Social Affairs, Population Division (2020). World Family Planning 2020 Highlights: Accelerating action to ensure universal access to family planning (ST/ESA/SER.A/450).
