Unmet need for social context in family planning

New evidence on the link between sexual health and social context finds a strong link between gender equality, education and family planning

Twenty-five years ago, two global events – the International Conference on Population and Development and the Fourth World Conference on Women in Beijing – officially recognized that women’s health and reproductive choices could not be separated from the social context of their lives.

Now researchers have created a dataset that brings together national surveys from 74 countries, representing 3 million women. For the first time, it allows them to describe trends in the demand / use of modern contraceptives along with social and economic indicators.

The information was published in Lancet Global Health and is the author of the London School of Hygiene and Tropical Medicine and the World Health Organization.

It shows that over time, women will more often meet their demand for modern contraception in countries where gender equality and their educational opportunities are improving.

Gender equality and education increase access to modern contraception

Trends in sexual activity and demand for the use and application of modern contraceptive methods in 74 countries: a retrospective analysis of nationally representative research finds that the satisfied need for modern contraception is strongly associated with positive developments in social structures.
For every 0.1 point increase in a country’s Gender Development Index, it found a 6.7% rise in women who were sexually active and did not want to conceive. Of these women, an additional 13.5% used modern methods to prevent pregnancy.

The expectations of every girl’s right to education have also changed. Each additional year of education is associated with an increase in demand of 2.3% and an increase in the use of modern methods of contraception by 4.7%.

“This study shows how each woman must negotiate her reproductive autonomy within the social context in which she lives, responding to obstacles and opportunities as they arise,” says Dr. Lale Say, one of the study’s authors and head of WHO and HRP.

“Gender equality is both a prerequisite and a driving force for ensuring reproductive health and women’s rights – as well as the sustainable development goals, which are our best chance at providing health and well-being to all.”

Global trends reveal new challenges in family planning

Overall, data reinforce global trends: more time spent sexually active and single, delaying parenting, and an almost universal desire for smaller families.

The study also highlights where it is necessary to act at the state level to avoid that family planning services are lagging behind in demand.

Of the 74 countries analyzed, 42 showed an increase in contraceptive demand. Only 37 countries show an increase in the use of the modern method of preventing pregnancy.

Although an unmet need for contraception has dropped in 34 countries, it has increased in 14 countries. Significantly more progress is needed and faster to ensure that every girl and woman can access the sexual and reproductive health services she needs.

Obstacles and solutions to reproductive health and rights

Gender equality can influence the use of contraceptives in many ways. From the personal and political degree to which women are free to choose their sexual activity. Access to family planning services can also shape any power imbalance within personal relationships. This study supports WHO’s recent efforts to adopt a a broader, integrated notion of sexual and reproductive health – and turn it into a policy and practice framework.

The authors argue that the goals of family planning in the 2030 Sustainable Development Agenda will not be achieved without a profound shift: from a focus on “access to contraception” to broader aspects of sexual health and social context.

As women’s reproductive health and empowerment intertwine, trends in contraceptive use may also indicate progress toward another global goal: progress in gender equality.