Despite concerted efforts and commitments by African governments and development partners to increase the use of family planning (FP) in sub-Saharan Africa, evidence shows that there is a general stagnation in FP use in eastern and western Africa.

Contraceptive use levels are considerably lower and stagnation is worse in western Africa compared to eastern Africa.  Contraceptive use increased from 7% in 1991 to 15% in 2004 in western Africa, while it increased from 16% to 33% in eastern Africa over the same period.

There was greater increase in contraceptive use in the 1990s than in the early years of the twenty-first century. The increase dropped from 0.68 to 0.57 percentage points per year for western Africa and from 2.7 to 1.45 percentage points in eastern Africa.

This stagnation coincides with reduced funding and program effort on population and reproductive health programs due to the disproportionate emphasis on HIV and AIDS and the effect of the Bush Global Gag Rule effected in January 2001.

Western Africa’s dismal performance reflects deep-rooted leadership and resource gaps on reproductive health and strong attitudinal and cultural barriers in the region. These results are very critical considering that FP is an important intervention for improving prevention of unwanted and mistimed births, for improving maternal and child health, empowering women, reducing poverty at household and national levels, and slowing down Africa’s rapid population growth.

This new evidence points to the need for African governments and development partners to reinvigorate their investments

and programs if the MDG goal of ensuring universal access to FP and other reproductive health services is to be a reality. A careful examination of the drivers of the relatively good progress in eastern Africa and the apparent failure in western Africa would provide key policy and program lessons for western Africa and other eastern African countries that are not making good progress towards universal access to FP.

These findings are contained in a recently published paper that reviewed progress in demand, approval, access, and use of modern contraception among married or cohabiting women between 1991 and 2004 in eastern and western Africa by examining demand, approval, access and use of modern contraception.

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