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Women in Africa least likely to use contraception

Only one out of three married women and sexually active teenage girls on the continent use contraception.

Women in Africa are less likely to make use of contraception than anywhere else because of a combination of poor health systems and social stigma, according to the United Nations’ 2015 annual Trends in Contraceptive Use report.

It states that the use of contraception is growing globally, with almost two-thirds of the world’s married women using some form of birth control, but Africa lags behind. Only a third of African women who are married or living with their partners use contraception. 

The report doesn’t comprehensively cover the “needs of sexually active women” who are not in a “marriage-like union” because research, particularly from North Africa and Asia, often fails to include unmarried women.

According to a 2014 UN Children’s Emergency Fund report, adolescent girls on the continent have even less access to contraception and family planning services, which has a “particularly negative impact” on health, education and economic progress. 

For example, Unicef says, in sub-Saharan Africa, only 36% of girls aged between 15 and 19 with multiple sexual partners in the past year used a condom during their most recent sexual encounter. 

[WATCH] Birth control: Which one’s for you?

Former Bhekisisa reporter, Amy Green, explains what the top five forms of contraception on the continent are, and why.

Highest rate of unplanned pregnancies

According to the Guttmacher Institute, a United States-based public health research organisation, in 2012, 53 out of 1 000 women globally had unplanned pregnancies, with the highest rate estimated for Africa — 80 out of 1 000 women. 

Unicef estimates that, each year, 16-million adolescent girls give birth — accounting for 11% of all births — but they disproportionately experience 23% of “the global burden of disease associated with pregnancy”. 

The situation is exacerbated in many African countries where “girls are left out of essential family planning services”, which contributes to higher levels of unplanned pregnancies, higher HIV infection rates and an “uptake of abortion services”.

2009 study, published in the journal Plos One, showed that if Uganda, where unplanned pregnancies account for 21.5% of HIV infections in infants, increased access to family planning services, fewer HIV-infected babies would be born. The study found that “HIV services to prevent mother-to-child transmission averted an estimated 8.1% of infections”, but family planning averted double that amount (19.7%). 

According to the UN’s 2015 report, globally, the “unmet need” for contraception is 12%, but for Africa the estimate is almost double that, leaving 22% of married women “without access”. This is mostly because of the stigma attached to it by their partners, society and health workers and because of the unavailability of family planning services in health centres. 

The report notes that unplanned pregnancies cost the world $5.7-billion each year but, if “all women wanting to avoid pregnancy used modern family planning methods, unintended pregnancies would decline by 71%”.

Access to contraception for adolescent girls should be “high on the African health agenda”, according to Unicef, “given the overwhelming burden” of HIV and unplanned pregnancies on this group. “Inaction is a violation of human rights that affects adolescent girls and women.”

Amy Green was a health reporter at Bhekisisa from 2013 until 2016.