In Northern Africa and. Western Asia, the two most common methods are the pill (10.5 per cent) and IUD (9.5 per cent). Sub-Saharan Africa is the only region in
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Contraceptive Use by Method 2019 Measuring progress in meeting the need for family planning requires not only an assessment of overall levels and trends in contraceptive prevalence and the unmet need for family planning, but also an assessment of the range and types of contraceptive methods used. This data booklet presents estimates of the prevalence of contraceptive use by method based on the World Contraceptive Use 2019 (based on data from 1,247 surveys for 195 countries or areas of the world) and additional tabulations obtained from microdata and survey reports. The estimates are presented for female and male sterilisation, intrauterine device (IUD), implant, injectable, pill, male condom, withdrawal, rhythm and other methods combined. The estimates of contraceptive prevalence (any, modern or traditional) for 1994 and 2019 are from Estimates and Projections of Family Planning Indicators 2019. This work was supported, in part, by Grants No. OPP1110679 and OPP1183453, Making Family Planning Count, from the Bill & Melinda Gates Foundation. Suggested citation: United Nations, Department of Economic and Social A˜airs, Population Division (2019). Contraceptive Use by Method 2019: Data Booklet (ST/ESA/SER.A/435).Front cover photo credit: Adobe Stock/nadiinko Sales no.: E.20.XIII.9 ISBN: 978-92-1-148329-1eISBN: 978-92-1-004652-7Copyright © 2019 by United Nations, made available under a Creative Commons license (CC BY 3.0 IGO) http://creativecommons.org/licenses/by/3.0/igo/
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Contraceptive Use by Method 2019 1Introduction The Programme of Action of the International Conference on Population and Development (ICPD) includes a clear commitment to ensure that women and men have access to the widest possible range of safe and e˜ective family planning methods in order to enable them to exercise free and informed choice, while recognizing that appropriate methods for couples and individuals vary according to their age, parity, family-size preference and other factors (United Nations, 1995, para 7.23). In the Sustainable Development Goals (SDGs), target 3.7 calls on countries fiby 2030, to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmesfl. The assessment of progress towards this target requires monitoring of key family planning indicators, including the range and types of contraceptive methods used. Some contraceptive methods such as male condom, withdrawal and rhythm methods have been used for millennia while methods such as the pill and intrauterine device (IUD) started to be used in the 1960s. Some decades later, the vaginal ring, emergency contraception, subcutaneous injections or implants became available. Di˜erent pregnancy prevention needs, for either stopping childbearing altogether or delaying pregnancy, should be met with appropriate and e˜ective methods. Family planning needs also evolve over the life-course, depending on personal circumstances and changing childbearing preferences (on the number of children and the timing and spacing of births). At the population level, contraceptive prevalence and method mix will change with changes in childbearing desires, fertility trends, marriage and union formation patterns and the age structure of women of reproductive age. All available contraceptive methods have both strengths and weaknesses. Women who are only sometimes sexually active and who want to delay pregnancy for a few months or a couple of years, may prefer a short-acting method, one that they can start and stop on their own, over an IUD or an implant, both of which usually require a visit to a service provider to obtain and remove the device, or a permanent method such as sterilisation. The experience, or awareness, of side e˜ects and inconveniences of using speci˚c contraceptive methods as well as their e˜ectiveness at preventing pregnancy play a role in the choice of the method used. However, the range of choices available to women and their partners depends on the local availability and accessibility of di˜erent methods. The prevalence of speci˚c contraceptive methods varies widely across the world. Method mix has shifted over time due to changes in related policies, changes in health-care system, development of new technologies, and changes in access to the various methods. Governments at all levels have played a strong and visible role in promoting and legitimizing the provision and use of family planning and reproductive health-care services and the use of speci˚c methods.
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Contraceptive Use by Method 2019 2Worldwide, 922 million women of reproductive age (or their partners) are contraceptive users Among the 1.9 billion women of reproductive age (15-49 years) living in the world in 2019, 1.1 billion have a need for family planning, that is, they are either current users of contraceptivesŠ842 million use modern methods of contraception and 80 million use traditional methodsŠor have an unmet need for family planningŠ190 million women want to avoid pregnancy and do not use any contraceptive method. 1 The proportion of women who have their need for family planning satis˚ed by modern methods (Sustainable Development Goals indicator 3.7.1) is 76 per cent in 2019. 2 1 Women who want to avoid pregnancy and do not use any contraceptive method are considered to have an unmet need for family planning, which is de˚ned as the number of women that want to stop or delay childbearing but are not using any method of contraception to prevent pregnancy, including also pregnant women whose pregnancies were unwanted or mistimed at the time of conception, and postpartum amenorrhoeic women who are not using family planning and whose last birth was unwanted or mistimed. 2 The indicator is de˚ned as the number of women who are currently using, or whose sexual partner is currently using, at least one modern contraceptive method as a proportion of the number of women of reproductive age who are either using any method of contraception or having an unmet need for family planning. Figure 1. Estimated numbers of women of reproductive age (15-49 years) using modern and traditional contraceptive methods, having an unmet need for family planning and no need for family planning, worldwide, 2019 Data source: Estimates and Projections of Family Planning Indicators 2019. No Need Unmet Need Traditional methods Modern methods 842 million44%80 million4%190 million10%790 million42%
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Contraceptive Use by Method 2019 3Female sterilisation and male condom are the two most common methods used worldwide Female sterilisation is the most common contraceptive method used worldwide. In 2019, 23.7 per cent of women who are currently using contraceptionŠthat is 219 million womenŠrely on female sterilisation. Three other methods have more than 100 million users worldwide, male condom (189 million), IUD (159 million) and the pill (151 million). Overall, 45.2 per cent of contraceptive users rely on permanent or long-acting methods (female and male sterilisation, IUD, implant), 46.1 per cent on a short-acting method (such as male condom, the pill, injectable and other modern methods) and 8.7 per cent on traditional methods (withdrawal, rhythm methods and other traditional methods). Figure 2. Estimated numbers of women of reproductive age (15-49 years) using various contraceptive methods, worldwide, 2019 Data source: Calculations are based on the data compilation World Contraceptive Use 2019, additional tabulations derived from microdata sets and survey reports and estimates of contraceptive prevalence for 2019 from Estimates and Projections of Family Planning Indicators 2019. Population-weighted aggregates. Other15 million users2%Withdrawal47 million users5%Female sterilisation219 million users24%Rhythm29 million users3%Male condom189 million users21%Pill151 million users16%Injectable74 million users8%Implant23 million users2%IUD159 million users17%Male sterilisation16 million users2%TraditionalShort-actingLong-acting
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Contraceptive Use by Method 2019 4Contraceptive methods most commonly used vary widely by region In Eastern and South-Eastern Asia, IUD is the most common contraceptive method used (18.6 per cent of women rely on this method), followed closely by male condom (17.0 per cent). In Europe and Northern America, the pill and male condom are the most commonly used methods (17.8 and 14.6 per cent of women, respectively), while in Latin America and the Caribbean it is female sterilisation and the pill (16.0 and 14.9 per cent, respectively). In Oceania, the dominant method is the pill (16.9 per cent) and in Central and Southern Asia it is female sterilisation (21.8 per cent of women rely on this method). In Northern Africa and Western Asia, the two most common methods are the pill (10.5 per cent) and IUD (9.5 per cent). Sub-Saharan Africa is the only region in which injectables are the dominant method with a prevalence of 9.6 per cent among women of reproductive age. Data source: Calculations are based on the data compilation World Contraceptive Use 2019, additional tabulations derived from microdata sets and survey reports and estimates of contraceptive prevalence for 2019 from Estimates and Projections of Family Planning Indicators 2019. Population-weighted aggregates. Figure 3. Contraceptive prevalence by method among women of reproductive age (15-49 years), by region, 2019 0102030405060 IUD
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Contraceptive Use by Method 2019 6Numbers of users of all methods (apart from male sterilisation and rhythm) have increased Even though the prevalence of some methods, such as female sterilisation and IUD, have decreased on a global level since 1994, the overall number of women using these methods has grown due to population growth. The number of women relying on female sterilisation has increased between 1994 and 2019 from 195 million to 219 million and the number of women relying on IUD has risen from 133 million to 159 million. Only two methods have seen declines in the number of users over the same periodŠmale sterilisation from 43 million to 16 million users and rhythm methods from 36 million to 29 million. The largest increases have been recorded in the numbers of women relying on male condoms (from 64 million to 189 million) or on injectables (from 17 million to 74 million). It is important that population growth amongst women of reproductive age is taken into account in order to adequately plan for the provision of family planning services, including contraceptive methods. Data source: Calculations are based on the data compilation World Contraceptive Use 2019, additional tabulations derived from microdata sets and survey reports and estimates of contraceptive prevalence for 2019 from Estimates and Projections of Family Planning Indicators 2019. Population-weighted aggregates. Figure 5. Estimated numbers of women of reproductive age (15-49 years) using various contraceptive methods, 1994 and 2019 050100150200 IUD 19942019
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Contraceptive Use by Method 2019 7In one ˜fth of countries, one contraceptive method accounts for half or more of all contraceptive use In at least one out of every ˚ve countries or areas, a single method accounts for 50 per cent or more of all contraceptive use. In the 37 countries or areas where one method constitutes half or more of all use in 2019, the dominant methods include the pill (13 countries), IUD, injectable and male condom (6 countries each), female sterilisation (4 countries) and a traditional method (3 countries). In an additional 113 countries, the most common contraceptive method accounts for between 30 and 49 per cent of total use. Countries where contraceptive practice is heavily concentrated on one or two methods can be found in all regions and at all levels of overall contraceptive prevalence. Figure 6. Percentage share of contraceptive use for the most common method among women of reproductive age (15- 49 years), 2019 Data source: Calculations are based on the data compilation World Contraceptive Use 2019, additional tabulations derived from microdata sets and survey reports and estimates of contraceptive prevalence for 2019 from Estimates and Projections of Family Planning Indicators 2019. Population-weighted aggregates. NOTE : The designations employed and the presentation of material on this map do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The ˚nal status of Jammu and Kashmir has not yet been agreed upon by the parties. Final boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined. A dispute exists between the Governments of Argentina and the United Kingdom of Great Britain and Northern Ireland concerning sovereignty over the Falkland Islands (Malvinas). Countries or areas in grey colour have no data available.
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Contraceptive Use by Method 2019 8Female sterilisation and IUD are highly prevalent in only a handful of countries Female sterilisation and IUD, while among the most common methods of contraception globally, are used by more than one ˚fth of women of reproductive age in only eight countries each. Female sterilisation has the highest prevalence in the Dominican Republic (30.6 per cent) and India (29.0 per cent). The highest prevalence of IUD is in the Democratic People™s Republic of Korea (46.9 per cent) and Uzbekistan (36.9 per cent). Injectables are used mainly in sub-Saharan Africa and South-Eastern Asia and the prevalence is over 20 per cent in Indonesia, Madagascar, Malawi, Namibia and South Africa. Implants are commonly used in only a handful of countries in sub-Saharan Africa, with the highest prevalence in Kenya (14.9 per cent). Figure 7a. Estimated prevalence of individual contraceptive methods among women of reproductive age (15-49 years), 2019 Data source: Calculations are based on the data compilation World Contraceptive Use 2019, additional tabulations derived from microdata sets and survey reports and estimates of contraceptive prevalence for 2019 from Estimates and Projections of Family Planning Indicators 2019. Population- weighted aggregates. NOTE : The designations employed and the presentation of material on this map do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The ˚nal status of Jammu and Kashmir has not yet been agreed upon by the parties. Final boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined. A dispute exists between the Governments of Argentina and the United Kingdom of Great Britain and Northern Ireland concerning sovereignty over the Falkland Islands (Malvinas). Countries or areas in grey colour have no data available. (a) Female sterilisation (b) IUD(c) Injectable (d) Implant
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Contraceptive Use by Method 2019 9The contraceptive pill and male condom are commonly used methods in many countries The pill is used by over 20 per cent of women of reproductive age in 27 countries worldwide, with the highest prevalence in European countries. Male condom use is most prevalent in Japan (34.9 per cent) and Hong Kong, Special Administrative Region of China (32.1 per cent) and the prevalence is more than 20 per cent in 22 countries. Rhythm methods and withdrawal are the two most commonly used traditional methods of contraception. The highest prevalence of withdrawal is in Albania (24.5 per cent) and of rhythm methods in Congo and Cameroon (9.5 and 9.1 per cent, respectively). Figure 7b. Estimated prevalence of individual contraceptive methods among women of reproductive age (15-49 years), by country, 2019 Data source: Calculations are based on the data compilation World Contraceptive Use 2019, additional tabulations derived from microdata sets and survey reports and estimates of contraceptive prevalence for 2019 from Estimates and Projections of Family Planning Indicators 2019. Population- weighted aggregates. NOTE : The designations employed and the presentation of material on this map do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted line represents approximately the Line of Control in Jammu and Kashmir agreed upon by India and Pakistan. The ˚nal status of Jammu and Kashmir has not yet been agreed upon by the parties. Final boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined. A dispute exists between the Governments of Argentina and the United Kingdom of Great Britain and Northern Ireland concerning sovereignty over the Falkland Islands (Malvinas). Countries or areas in grey colour have no data available. (e) Pill (f) Rhythm (g) Male condom (h) Withdrawal
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