A demographic dividend of the FP2020 Initiative and the SDG reproductive health target: Case studies of India and Nigeria

Background: The demographic dividend, defined as the economic growth potential resulting from favorable shifts in population age structure following rapid fertility decline, has been widely employed to advocate improving access to family planning. The current framework focuses on the long-term potential, while the short-term benefits may also help persuade policy makers to invest in family planning. Methods: We estimate the short- and medium-term economic benefits from two major family planning goals: the Family Planning 2020 (FP2020)’s goal of adding 120 million modern contraceptive users by 2020; Sustainable Development Goals (SDG) 3.7 of ensuring universal access to family planning by 2030. We apply the cohort component method to World Population Prospects and National Transfer Accounts data. India and Nigeria, respectively the most populous Asian and African country under the FP2020 initiative, are used as case studies. Results: Meeting the FP2020 target implies that on average, the number of children that need to be supported by every 100 working-age people would decrease by 8 persons in India and 11 persons in Nigeria in 2020; the associated reduction remains at 8 persons in India, but increases to 14 persons in Nigeria by 2030 under the SDG 3.7. In India meeting the FP2020 target would yield a saving of US$18.2 billion (PPP) in consumption expenditures for children and youth in the year 2020 alone, and that increased to US$89.7 billion by 2030. In Nigeria the consumption saved would be US$2.5 billion in 2020 and $12.9 billion by 2030. Conclusions: The tremendous economic benefits from meeting the FP2020 and SDG family planning targets demonstrate the cost-effectiveness of investment in promoting access to contraceptive methods. The gap already apparent between the observed and targeted trajectories indicates tremendous missing opportunities. Accelerated progress is needed to achieve the FP2020 and SDG goals and so reap the demographic dividend.

Download Full-text

A demographic dividend of the FP2020 Initiative and the SDG reproductive health target: Case studies of India and Nigeria

Gates Open Research ◽

10.12688/gatesopenres.12803.1 ◽

2018 ◽

Vol 2 ◽

pp. 11 ◽

Cited By ~ 1

Author(s):

Qingfeng Li ◽

Jose G. Rimon

Keyword(s):

Family Planning ◽

Case Studies ◽

Universal Access ◽

Economic Benefits ◽

Growth Potential ◽

World Population ◽

Modern Contraceptive ◽

Demographic Dividend ◽

Number Of Children ◽

Health Target

Download Full-text

Determine the unmet need for family planning in a hilly area in a state of North India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20212153 ◽

2021 ◽

Vol 10 (6) ◽

pp. 2234

Author(s):

Nidhi Chauhan ◽

Saurabh Rattan

Keyword(s):

Family Planning ◽

Prevalence Rate ◽

Universal Access ◽

Unmet Need ◽

Reproductive Age ◽

North India ◽

Modern Contraceptive ◽

Cross Sectional ◽

Contraceptive Prevalence Rate ◽

Contraceptive Prevalence

Background: The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved, unmet need being one of the imperative component.Methods: A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from July 2018 to June 2019. Total sample size calculated was 316. Random sampling was used to select eligible couple to whom a predesigned, pretested, semi-structured and anonymous interview schedule was administered after taking consent.Results: The mean age of the participants was 30.2±6.1 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group (15-49 years). Male condom (36%), followed by female sterilisation (30%) were the most common methods preferred. Unmet need of family planning was found to be 10.4%.Conclusions: Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity.

Download Full-text

Demand for Family Planning Satisfied With Modern Methods in Urban Malawi: CHAID Analysis to Identify Predictors and Women Underserved With Family Planning Services

10.21203/rs.3.rs-111187/v1 ◽

2020 ◽

Author(s):

Nurudeen Alhassan ◽

Nyovani Janet Madise

Keyword(s):

Family Planning ◽

Unmet Need ◽

Ethnic Origin ◽

Modern Contraceptive ◽

Family Planning Services ◽

Chi Square ◽

Number Of Children ◽

Chaid Analysis ◽

Modern Methods ◽

Underserved Groups

Abstract BackgroundFamily planning progress under the SDGs is measured with a novel indicator, demand for family planning satisfied with modern methods (mDFPS), which provides a better indication of modern contraceptive coverage than unmet need and contraceptive prevalence rate. Yet, few studies have examined the predictors of mDFPS and the sub-groups of women with unsatisfied mDFPS in urban Saharan Africa. The objective of this study was to examine the predictors of mDFPS in urban Malawi and to identify the sub-groups of urban women underserved with modern contraceptives.MethodsThe study analysed data from the 2015-16 Malawi Demographic and Health survey. The sample comprised of 2,917 women in urban Malawi who had a demand for family planning services. We used a Chi-square (χ2) Automatic Interaction Detector (CHAID) model to address the study objectives.ResultsThe results show that the number of children a woman had was the most significant predictor of mDFPS. Women with one or more children, who were of Chewa, Lomwe or Tumbuka ethnic origin, and who resided in the central region had the highest mDFPS (87%). On the other hand, women with no children, and who were not exposed to FP information on television had the lowest mDFPS (41%). Among women in union, ethnicity was the best predictor of mDFPS. Ngoni, Yao and other ethnic minority women in union who were aged 15-19 and 40 years and above, and who were Catholic, SDA/Baptist or Muslim had the lowest mDFPS (36%).ConclusionThis study demonstrates significant intra-urban disparities in demand for FP satisfied with modern contraceptives in Malawi. There is the need for policy makers and reproductive health practitioners to recognise these disparities and to prioritise the underserved groups identified in this study.

Download Full-text

Estimating the levels and trends of family planning indicators in 436 sub-national areas across 26 countries in sub-Saharan Africa

10.1101/2021.03.03.21252829 ◽

2021 ◽

Author(s):

Joshua L Proctor ◽

Laina D. Mercer

Keyword(s):

Family Planning ◽

Universal Access ◽

Unmet Need ◽

Sub Saharan Africa ◽

Modern Contraceptive ◽

Model Based ◽

Administrative Unit ◽

Sub Saharan ◽

Demographic Subgroup ◽

Demographic Subgroups

Background: Scaling up access to safe, effective, and voluntary family planning (FP) services to achieve universal access for women and families will require increased commitment by countries and international organizations. On the way toward universal access, quantitative family planning goals have also been established by the United Nations through the sustainable development goals (SDGs). Here, we present a model-based framework that can help monitor progress toward these goals at the sub-national and demographic subgroup scale. Methods: We utilize 90 demographic health surveys for 26 countries that contain associated geographic position system data. We extract survey cluster level data to fit multiple small area estimation models that estimate FP indicators by administrative unit one and two regions as well as different demographic subgroups. Findings: We find significant variation of modern contraceptive prevalence rates (mCPR), unmet need, and demand satisfied by country, sub-national region, and demographic subgroup. Our model-based estimates show that on average for 436 administrative unit one regions, mCPR has increased at a rate of 0.75% per year and unmet need has decreased by 0.26% per year. There are also striking differences of FP indicators by demographic subgroup; for example, unmet need can be up to 40% different based on age and parity. Interpretation: We have developed a framework to help monitor progress, provide insights about the inequitable progress by region and demographic groups, and account for the sparsity of available data. These results and framework can help policy-makers better allocate and target interventions to help achieve family planning goals.

Download Full-text

What increase in modern contraceptive use is needed in FP2020 countries to reach 75% demand satisfied by 2030? An assessment using the Accelerated Transition Method and Family Planning Estimation Model

Gates Open Research ◽

10.12688/gatesopenres.13125.1 ◽

2020 ◽

Vol 4 ◽

pp. 113

Author(s):

Niamh Cahill ◽

Michelle Weinberger ◽

Leontine Alkema

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Universal Access ◽

Modern Contraceptive ◽

Reproductive Health Services ◽

Estimation Model ◽

Starting Point ◽

Modern Contraceptive Use ◽

The One ◽

Business As Usual

Background: Sustainable Development Goal 3.7 aims to ensure universal access to sexual and reproductive health services. One suggested benchmark is to have at least 75% of the demand for contraception satisfied with modern methods (DS) in all countries by 2030. The translation of DS-based targets into targets for the modern contraceptive prevalence rate (mCPR) is needed to make targets actionable. Methods: We propose the Accelerated Transition (AT) method for determining the mCPR needed to reach demand-satisfied targets by 2030. The starting point for this method is the projection of DS under “business as usual” using the one-country implementation of the Family Planning Estimation Model (FPEMcountry). For countries in which the DS target is projected to be later than 2030, the AT method assumes that meeting the DS target by 2030 requires an acceleration of the contraceptive use transition such that the DS target, and its associated mCPR, will be reached in 2030 as opposed to the later year. The DS-target-associated mCPR becomes the mCPR target for the year 2030. Results: We apply the AT method to assess progress needed for attaining the 75% DS target for married or in-union women in the world’s poorest countries. For 50 out of 68 countries, we estimate that accelerations are needed, with required mCPR increases ranging from 4.3 to 50.8 percentage points. Conclusions: The AT method quantifies the acceleration needed – as compared to business as usual projections – for a country to meet a family planning target. The method can be used to determine the mCPR needed to reach demand-satisfied targets.

Download Full-text

Quality of Family Planning Care as Enabling Factor for Modern Contraceptive Use in Indonesia: Evidence from PMA2020 Survey

10.21203/rs.3.rs-516964/v1 ◽

2021 ◽

Author(s):

Nurjaeni Nurjaeni ◽

Yothin Sawangdee ◽

Umaporn Pattaravanich ◽

Charamporn Holumyong ◽

Aphichat Chamratrithirong

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Modern Method ◽

Modern Contraceptive ◽

Number Of Children ◽

Modern Family ◽

Modern Contraceptive Use ◽

Ideal Number ◽

Modern Family Planning

Abstract BackgroundThe utilization of modern family planning methods is a key pointer that mirrors universal access to reproductive health cares. Fulfilling unmet needs for modern contraceptives may decrease the level of maternal mortality by almost a third. This research employed the 2016 PMA2020 survey to assess multilevel variables related to modern family planning method use among women of reproductive age in Indonesia. MethodData from interviews of female and Service Delivery Point (SDP) of the 2016 Performance Monitoring and Accountability 2020 (PMA2020) survey were linked to generate a merged dataset comprising women’s individual, cluster and SDP factors (N=10,210). Multilevel analysis was done to assess the influence of contextual factors including a summary index of SDP quality FP care on woman’s modern family planning practice. Adjusted odds ratios and 95% CIs were analysed and interpreted.ResultsModern contraceptive prevalence among women of childbearing age was 42.3% in 2016. There was a considerable variation in the likelihood of modern method use across the 372 clusters/EAs. Age, education, marital status, parity, residency, region, woman’s FP decision autonomy, cluster’s average ideal number of children, percentage of females dissatisfied with FP, and percent of females visited by CHVs were significant factors for modern FP use after adjusting for multilevel characteristics. Quality of FP care was revealed to be a significant enabling factor for modern contraceptive use in Indonesia. ConclusionsModern contraceptive prevalence among females aged 15-49 years was relatively low in 2016. The findings indicate that an advancement in modern method use can be gained by improving quality of family planning care. Likewise, an enhancement in women’s FP decision autonomy and their level of education, decline in women’s ideal number of children and diminution of the dissatisfaction with family planning are all major concerns to be addressed. Family planning policies must tackle adverse cultural norms and inequities in quality of family planning care and women’s education that would produce welfares to women, children, and communities.

Download Full-text

A community-based study to estimate the contraceptive prevalence rate among the women of reproductive age group in rural North India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20203407 ◽

2020 ◽

Vol 7 (8) ◽

pp. 3244

Author(s):

Anita Thakur ◽

Anmol K. Gupta ◽

Tripti Chauhan ◽

Nidhi Chauhan

Keyword(s):

Family Planning ◽

Prevalence Rate ◽

Universal Access ◽

Reproductive Age ◽

Modern Contraceptive ◽

Age Group ◽

Women Of Reproductive Age ◽

Contraceptive Prevalence Rate ◽

Contraceptive Prevalence ◽

Reproductive Age Group

Background: The utilization of family planning services has improved over the decade, but still the SDG’s health target to ensure universal access to sexual and reproductive health care services is yet to be achieved.Methods: A cross-sectional study was undertaken in the rural field practice area of Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India, from September to December 2019, with sample size of 316. The eligible participants were administered a predesigned, pretested, semi-structured and anonymous interview schedule after taking consent.Results: The mean age of the participants was 30.2±6.1 years. The modern contraceptive prevalence rate (mCPR) was found to be 67.7% among women of reproductive age group 15-49 years. Male condom 36%, followed by female sterilization 30% were the most common methods preferred.Conclusions: Besides male condoms and female sterilisation, other methods of contraception were adopted by meagre number of women. Though, the unmet need for family planning was lesser in this study, still, efforts are needed to plunge it, for ameliorating the contraceptive prevalence rate. Also, the availability of basket of contraceptive choices in government sector need sheer assiduity.

Download Full-text

“As a woman who watches how my family is… I take the difficult decisions”: a qualitative study on integrated family planning and childhood immunisation services in five African countries

Reproductive Health ◽

10.1186/s12978-021-01091-1 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Jenna Hoyt ◽

Shari Krishnaratne ◽

Jessie K. Hamon ◽

Lydia Boudarene ◽

Tracey Chantler ◽

...

Keyword(s):

Decision Making ◽

Family Planning ◽

Unmet Need ◽

Economic Benefits ◽

Sub Saharan Africa ◽

Cultural Norms ◽

Modern Contraceptive ◽

Health Providers ◽

Childhood Immunisation ◽

African Countries

Abstract Background Family planning (FP) has the potential to improve maternal and child health outcomes and to reduce poverty in sub-Saharan Africa. However, substantial unmet need for modern contraceptive methods (MCMs) persists in this region. Current literature highlights multi-level barriers, including socio-cultural norms that discourage the use of MCMs. This paper explores women’s choices and decision-making around MCM use and examines whether integrating FP services with childhood immunisations influenced women’s perceptions of, and decision to use, an MCM. Methods 94 semi-structured interviews and 21 focus group discussions with women, health providers, and community members (N = 253) were conducted in health facilities and outreach clinics where an intervention was delivering integrated FP and childhood immunisation services in Benin, Ethiopia, Kenya, Malawi and Uganda. Data were coded using Nvivo software and an analytical framework was developed to support interpretative and thematic analyses on women’s decision-making about MCM use. Results Most women shared the reproductive desire to space or limit births because of the perceived benefits of improved health and welfare for themselves and for their children, including the economic advantages. For some, choices about MCM use were restricted because of wider societal influences. Women’s decision to use MCMs was driven by their reproductive desires, but for some that was stymied by fears of side effects, community stigma, and disapproving husbands, which led to clandestine MCM use. Health providers acknowledged that women understood the benefits of using MCMs, but highlighted that the wider socio-cultural norms of their community often contributed to a reluctance to use them. Integration of FP and childhood immunisation services provided repeat opportunities for health providers to counter misinformation and it improved access to MCMs, including for women who needed to use them covertly. Conclusions Some women chose to use MCMs without the approval of their husbands, and/or despite cultural norms, because of the perceived health and economic benefits for themselves and for their families, and because they lived with the consequences of short birth intervals and large families. Integrated FP and childhood immunisation services expanded women’s choices about MCM use and created opportunities for women to make decisions autonomously.

Download Full-text

Significant Factors in Using Contraceptives among Married Women in Cagayan de Oro City using Binary Logistic Regression

Canadian Journal of Family and Youth / Le Journal Canadien de Famille et de la Jeunesse ◽

10.29173/cjfy29498 ◽

2019 ◽

Vol 12 (1) ◽

pp. 200-224

Author(s):

Jessyl D. Orlanes ◽

Kennet G. Cuarteros

Keyword(s):

Family Planning ◽

Poverty Reduction ◽

Goodness Of Fit ◽

Contraceptive Use ◽

Binary Logistic Regression ◽

Economic Benefits ◽

Married Women ◽

P Value ◽

Number Of Children ◽

Significant Factors

Family planning is a larger concept involving preparation and knowledge around a “family future”. It allows people to attain their desired number of children and determine the spacing of pregnancies, reduces the need for abortion, especially unsafe abortion. On the other hand, contraceptives are the group of methods you use or steps you take to avoid pregnancy before you are ready. Contraceptives, one of the methods of family planning, helps prevent the transmission of other sexually transmitted infections. Moreover, it can help slow down population growth thereby contributing to economic benefits such as poverty reduction. It is also a very helpful way to improve the health of mothers and childrens through birth spacing and avoiding high risk pregnancies. In this study, significant factors in using contraceptives are determined. Based on the results from the conducted survey, three out of ten variables were considered as significant factors namely: desire of having more children, religion, and employment status (having p-values of 0.005, 0.008, and 0.000 respectively). These significant factors were used in formulating the model to predict the probability of using contraceptives among married women. Using Hosmer and Lemeshow Test of goodness-of-fit, the p-value of the model is 0.728. Thus, the model is a good fit. A re-survey was conducted to validate the model and 88% of the married women were correctly classified. Hence, the model will be very useful in predicting the probability of contraceptive use among married women.

Download Full-text

Determinants of Modern Contraceptive Methods Discontinuation among Women within Reproductive Age in Dire Dawa City, Eastern Ethiopia

International Journal of Reproductive Medicine ◽

10.1155/2020/3059435 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Gizaw T. Yifru ◽

Mesfin T. Haileyesus ◽

Belay Tafa Regassa

Keyword(s):

Family Planning ◽

Contraceptive Method ◽

Cross Sectional Study ◽

Reproductive Age ◽

Modern Contraceptive ◽

Contraceptive Methods ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Number Of Children ◽

Dire Dawa

Background. Modern family planning methods are widely believed to influence fertility reduction worldwide. Family planning had a clear effect on the health of women, children, and families worldwide especially those in developing countries. It has been shown that there are many instances in which women might discontinue contraception methods that put women’s health at risk. Objectives. To assess and identify Determinants of Modern Contraceptive Methods Discontinuation among Women in Reproductive age interval in Dire Dawa City. Method. A cross-sectional study design was employed. A total of 811 respondent women with one-year history of modern contraceptive method usage were considered in the study. A stratified random sampling method was used to select the study participants. Data was collected using a structured questionnaire and analyzed by descriptive statistics and binary logistic regression. Result. The study indicated that 634 (78.20%) of respondent mothers continued using the method that they have used before a year. Whereas 177 (21.80%) of women discontinued using the method within a year. The factors age, number of children, who made the decision on the choice of the method used, the type of contraceptive method used, and taking counseling before using the method were found significant at 5% level of significance. Conclusion. Young women, respondents who have no or a small number of children, and not the decision maker on the choice of the method were more likely to discontinue. Whereas women who did not take counseling are less likely to discontinue. When compared to women who used implant those women who used pills and injectables are more likely to discontinue. Thus, the study identified factors that contribute to the discontinuation of modern contraception methods.

Download Full-text