Estimating Contraceptive Needs from Trends in Method Mix in Developing Countries

To enable donor agencies and family planning program managers to estimate future needs for contraceptive supplies in developing countries data drawn from 106 Demographic and Health Surveys and Contraceptive Prevalence Surveys conducted in 35 Third World countries between 1974 and 1992 were reviewed. At least 2 surveys conducted a minimum of 2 years apart were used to permit calculation of changes in total and method-specific prevalence and annual rates of change. At the time of the most recent survey 44% of respondents were using contraception and 35.5% were using a modern method; these rates were 31.6% and 24.0% respectively at the initial survey. Total contraceptive prevalence increased at an annual rate of 5% while modern method use increased by 6%. Sterilization acceptance increased by 8% each year while use of the pill IUD and condom registered annual increases under 2%. In 30 of the 33 countries for which data were available the prevalence of sterilization grew at a substantially faster rate than that of other modern methods. Overall these findings suggest a need for caution against unrealistically high forecasts of the demand for supply-based contraceptive methods. On the other hand the population group eligible for contraception is increasing by 2-3% each year. It remains uncertain whether the increased availability of injectables and implants will result in greater overall contraceptive prevalence or simply substitute for pill IUD and condom use.