The use of contraception varies widely around the world,
both in terms of overall use and the types of methods used.
Globally, an estimated 142 million women have an unmet
need for family planning, with many sub-Saharan countries
recording the highest levels of unmet need at 24%, double
the world’s average in 2015.1
Both supply-side and demandside
constraints contribute to unmet need for family planning.
On the supply side, constraints may include issues like
distance to a source for obtaining contraceptives, stock-outs
of contraceptives among providers, legal obstacles or inancial
costs associated with using family planning and provider
biases about certain methods or about meeting the needs of
particular clients, such as unmarried youth. On the demand
side, barriers to use of family planning include cultural and
religious objections to contraception, objections from a partner,
in-law or other family member, inadequate knowledge
or fear of side effects and restrictive gender norms that limit
reproductive agency.2,3,4 Effectively addressing unmet need
for family planning requires implementing interventions to
tackle constraints on both sides and recognizing the ways in
which supply and demand issues affect each other.
As part of the global FP2020 effort to reach 120 million new
women with access to family planning by 2020, the U.S.
Agency for International Development’s Bureau for Global
Health Ofice of Population and Reproductive Health (USAID
GH/PRH) has prioritized the need to expand method choice as
a key component of addressing unmet need for family planning.
This focus area requires attention to both supply-side
and demand-side issues. As stated in the USAID GH/PRH
Priorities for 2014-2020:
“Client-centered information, counseling and services
enable more women, youth, men, and couples
to decide and freely choose a contraceptive method
that best meets their reproductive desires and lifestyle,
while balancing other considerations important
to choice, correct use, or switching methods.” 5
One key requirement for expanding method choice is the
increased availability of methods, including diversifying the
method mix as well as developing new methods that meet
the dynamic and diverse needs of family planning clients.
As noted in a review of international data over the last three
decades, overall modern contraceptive use rises with each
additional contraceptive method that becomes available to
most of the population.6
Beyond method availability, expanding
method choice also demands an in-depth understanding
of how and why women and men choose among available
contraceptive methods across their life course to best it their
needs, as well as an examination of the full spectrum of challenges
that affect whether current family programs meet the
needs of women and men globally.