Additional Users and mCPR

Indicators 1–2

By July 2016, the end of FP2020’s fourth year, there were 30.2 million additional users of modern methods of contraception as compared to July 2012, the time of the London Summit.

Core Indicator 1 (Estimate Table 1), number of additional users of modern methods of contraception, is the most direct measure of progress toward achieving the goal of adding 120 million additional users by the year 2020. Additional users are calculated by comparing the total number of users of modern contraception in any given year with the number of users there were in 2012. The total number of users of modern contraception is calculated using Core Indicator 2 (Estimate Table 2), the prevalence of use of modern methods of contraception among all women, and the total women of reproductive age in each country.

Each year new data improve our estimates of both the total number of users of modern contraception today as well as the number of users there were in 2012, the year of the FP2020 baseline. The release of new population data in the UN Population Division’s 2015 World Population Prospects resulted in a revision of the estimated number of women of reproductive age both in 2012 and 2016. Today there are an estimated 894 million women age 15–49 in FP2020 countries, 61.5 million more than there were in 2012. Of these, more than 300 million are using a modern method of contraception, which amounts to 30.2 million additional women and girls who are using modern contraception.

Re-estimating additional users using a rolling baseline

A “rolling baseline” is used to estimate the number of additional users: each year we recalculate the baseline estimate and every subsequent year’s estimate of additional users as more survey data becomes available. This means that the number of additional users we presented in previous FP2020 Progress Reports has been re-estimated.

Our new estimates—of 21.5 million additional users in 2015 and 30.2 million in 2016—reflect data that were not available at the time of the last report, including a new round of population projections from the UN Population Division. The new estimates indicate fewer additional users in past years than previously estimated. It is important not to compare estimates in this report to those in the last report.

Closer examination of Core Indicator 1 shows that more than half of the 30.2 million additional users of contraception are in Asia (16 million), which is not surprising as the most populous FP2020 countries are in that region. India alone is home to more than 130 million of the 300 million users of contraception in the focus countries. Because India is home to 38% of all women of reproductive age in the 69 focus countries, its progress has a large influence on progress toward the FP2020 goal of 120 million additional users. India has begun to release state and territory data from its NFHS-4, but the full results for national estimates and for all states and territories are not yet available. As a result, this year’s estimate for India is based on data available from 17 states and territories combined with prior trends for the remaining areas. Based on this approach, India has added more than 7.6 million additional users since 2012, more than any other country but less than previously estimated. When available, the full set of national and state-level data will allow India to better assess progress toward its FP2020 goal and will help identify opportunities to expand access to a range of contraceptive methods and improve the quality of services.

Many of the largest FP2020 countries are seeing growth in the total number of contraceptive users as their populations grow. In Nigeria, for example, the population of women of reproductive age grows each year by more than 1 million, and family planning programs must serve a greater number of clients just to keep the proportion of users—the country’s mCPR—constant. In several other countries, particularly in Asia and Latin America, contraceptive use is already relatively high and growth in mCPR has been very slow. Thus most of the growth in additional users in these regions has been due to an increase in the population of women of reproductive age rather than an increase in the proportion of the population using a modern method.

Other regions have seen more additional users added due to growth in mCPR. Contraceptive use is generally lower in many African countries than in Asia or Latin America, so there is greater potential for reaching additional users through increasing mCPR (see S-Curve for more information). Since 2012, focus countries in Africa have added 13 million additional users, or 44% of the total additional users across all focus countries, despite these countries representing only 27% of the total number of women of reproductive age. Looking forward, Africa is likely to continue to contribute a disproportionate number of additional users as both the population of women of reproductive age and mCPR increase and as desired family size in many countries declines.

Levels of contraceptive use vary widely across FP2020 countries, and have implications for how much acceleration countries can expect as they strive toward their FP2020 goals. Across the FP2020 countries, all women mCPR averaged 33.5% in 2016, compared to 32.4% in 2012 (weighted averages). Growth has varied greatly across regions, and progress in mCPR growth since 2012 is partly related to where countries lie on the S-Curve. At the midpoint of 2016, in 14 of the focus countries, mCPR was greater than 40%. In 29 countries, mCPR ranged from 20% to 40%, and in 26 countries, mCPR was less than 20%.

Many countries in Asia, including several of the largest FP2020 countries such as India, Indonesia, and Bangladesh, already had relatively high levels of contraceptive use in 2012 and have shown little growth in the proportion of women using a modern method since 2012. In contrast, many countries in Eastern and Southern Africa are in a period of great potential for mCPR growth. The region has seen the most rapid growth in mCPR since 2012, and for the first time ever, more than 30% of women and girls are using a modern method of contraception, up from 25% in 2012. Several countries in the region are among the most rapidly growing FP2020 countries, including Ethiopia, Kenya, Lesotho, Malawi, and Mozambique, each of which has seen mCPR rise by almost 5 percentage points or more since 2012. Looking forward, some of these countries are well-positioned for continued or even faster mCPR growth if they make the right investments in program expansion and improved service quality to meet their populations’ family planning needs. Others may see their rapid progress naturally slow as mCPR reaches high levels, and these countries will need to look more carefully at their subnational data to guide further program investments.

Western and Central Africa had the lowest levels of contraceptive use in 2012, and historically the region has seen little progress in increasing mCPR. Recent estimates suggest that several Western African countries, including Senegal, Niger, and Benin, are now showing signs of increasing modern contraceptive use, and may with the right investments enter a period of rapid mCPR growth. Contraceptive use in several other countries in Western and Central Africa, however, still remains extremely low—under 10%—and shows no sign of growth. South-South exchange through the Ouagadougou Partnership and other platforms can help these lowest prevalence countries learn from the successes of their neighbors and encourage a focus on generating demand for family planning.

All women versus married or in-union women mCPR estimates

FP2020’s goal is based on the fundamental belief that all women, regardless of marital status, should have access to the high-quality family planning services of their choosing. Therefore, FP2020 monitors modern contraceptive use among all women, rather than only married or in-union women. This represents a global shift in how contraceptive prevalence is normally reported at both the international and national levels. In this report, “all women” estimates are presented whenever possible;

in some cases, however, information was only available for married or in-union women. To mark this distinction, you will see “all women” or “married or in-union women” next to the estimates to indicate which population was surveyed. When looking at mCPR data in this report, it is important to note which population is being measured because in most countries, mCPR for married or in-union women will be higher than mCPR for all women.