Key facts
- Among the 1.9 billion women of reproductive age group (15–49 years) worldwide in 2021, 1.1 billion have a need for family planning; of these, 874 million are using modern contraceptive methods, and 164 million have an unmet need for contraception (1).
- The proportion of the need for family planning satisfied by modern methods, Sustainable Development Goals (SDG) indicator 3.7.1, has stagnated globally at around 77% from 2015 to 2022 but increased from 52% to 58% in sub-Saharan Africa (2).
- Only one contraceptive method, condoms, can prevent both a pregnancy and the transmission of sexually transmitted infections, including HIV.
- Use of contraception advances the human right of people to determine the number and spacing of their children.
- In 2022, global contraceptive prevalence of any method was estimated at 65% and of modern methods at 58.7% for married or in a union women (3).
Overview
There are many different types of contraception, but not all types are appropriate for all situations. The most appropriate method of birth control depends on an individual’s overall health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases. Ensuring access for all people to their preferred contraceptive methods advances several human rights including the right to life and liberty, freedom of opinion, expression and choice and the right to work and education, as well as bringing significant health and other benefits.
Impact
Use of contraception prevents pregnancy-related health risks for women, especially for adolescent girls, and when expressed in terms of interbirth intervals, children born within 2 years of an elder sibling have a 60% increased risk of infant death, and those born within 2–3 years a 10% increased risk, compared with those born after an interval of 3 years or longer (4). It offers a range of potential non-health benefits that encompass expanded education opportunities and empowerment for women, and sustainable population growth and economic development for countries.
The number of women desiring to use family planning has increased markedly over the past two decades, from 900 million in 2000 to nearly 1.1 billion in 2021 (1).
Between 2000 and 2020, the number of women using a modern contraceptive method increased from 663 million to 851 million. An additional 70 million women are projected to be added by 2030. Between 2000 and 2020, the contraceptive prevalence rate (percentage of women aged 15–49 who use any contraceptive method) increased from 47.7 to 49.0% (5).
The proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods (SDG indicator 3.7.1) is 77.5% globally in 2022, a 10% increase since 1990 (67%) (2).
Barriers
The proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods (SDG indicator 3.7.1) is 77.5% globally in 2022, an increase of 10 percentage points since 1990 (67%) (2). Reasons for this slow increase include limited choice of methods; limited access to services, particularly among young, poorer and unmarried people; fear or experience of side-effects; cultural or religious opposition; poor quality of available services; users’ and providers’ bias against some methods; and gender-based barriers to accessing services. As these barriers are addressed in some regions there have been increases in demand satisfied with modern methods of contraception.
Contraceptive methods
Methods of contraception include oral contraceptive pills, implants, injectables, patches, vaginal rings, intra uterine devices, condoms, male and female sterilization, lactational amenorrhea methods, withdrawal and fertility awareness-based methods. These methods have different mechanisms of action and effectiveness in preventing unintended pregnancy. Effectiveness of methods is measured by the number of pregnancies per 100 women using the method per year. Methods are classified by their effectiveness as commonly used into:
- very effective (0–0.9 pregnancies per 100 women)
- effective (1–9 pregnancies per 100 women)
- moderately effective (10–19 pregnancies per 100 women)
- less effective (20 or more pregnancies per 100 women).
For details on the mechanism of action and effectiveness of different contraceptive methods, click here.
WHO response
Achieving universal access and the realization of sexual and reproductive health services will be essential to fulfil the pledge of the 2030 Agenda for Sustainable Development that “no one will be left behind”. It will require intensified support for contraceptive services, including through the implementation of effective government policies and programmes.
WHO is working to promote contraception by producing evidence-based guidelines on safety and service delivery of contraceptive methods and on ensuring human rights in contraceptive programmes. WHO assists countries to adapt and implement these tools to strengthen contraceptive policies and programmes. Additionally, WHO participates in developing new contraceptive technologies to and leads and conducts implementation research for expanding access to and strengthening delivery contraceptive information and services.
References
1. 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).
2. United Nations, Department of Economic and Social Affairs, Population Division (2022). Estimates and Projections of Family Planning Indicators 2022.
3. United Nations Population Division: www.population.un.org/dataportal/home (https://population.un.org/dataportal/home. Accessed May 17, 2023).
4. 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
5. 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).