World
Family
Planning
2022
Meeting the changing needs for
family planning: Contraceptive
use by age and method
UN DESA/POP/2022/TR/NO. 4
Department of Economic and Social Affairs
Population Division
World Family Planning 2022
Meeting the changing needs for family planning:
Contraceptive use by age and method
United Nations
New York, 2022
United Nations Department of Economic and Social Aairs, Population Division
e Department of Economic and Social Aairs of the United Nations Secretariat is a vital interface between
global policies in the economic, social and environmental spheres and national action. e Department
works in three main interlinked areas: (i) it compiles, generates and analyses a wide range of economic,
social and environmental data and information on which States Members of the United Nations draw to
review common problems and take stock of policy options; (ii) it facilitates the negotiations of Member
States in many intergovernmental bodies on joint courses of action to address ongoing or emerging
global challenges; and (iii) it advises interested Governments on the ways and means of translating policy
frameworks developed in United Nations conferences and summits into programmes at the country level
and, through technical assistance, helps build national capacities.
e Population Division of the Department of Economic and Social Aairs provides the international
community with timely and accessible population data and analysis of population trends and development
outcomes for all countries and areas of the world. To this end, the Division undertakes regular studies of
population size and characteristics and of all three components of population change (fertility, mortality
and migration). Founded in 1946, the Population Division provides substantive support on population
and development issues to the United Nations General Assembly, the Economic and Social Council and
the Commission on Population and Development. It also leads or participates in various interagency
coordination mechanisms of the United Nations system. e work of the Division also contributes to
strengthening the capacity of Member States to monitor population trends and to address current and
emerging population issues.
Suggested citation
United Nations Department of Economic and Social Aairs, Population Division (2022). World Family
Planning 2022: Meeting the changing needs for family planning: Contraceptive use by age and method.
UN DESA/POP/2022/TR/NO. 4.
is report is available in electronic format on the Division’s website at www.unpopulation.org. For further
information about this report, please contact the Oce of the Director, Population Division, Department of
Economic and Social Aairs, United Nations, New York, 10017, USA, by Fax: 1 212 963 2147 or by email at
popula[email protected]g.
Copyright information
Front cover: “Couple in traditional garb holds hands at wedding in Shimla, India” Pablo Heimplatz.
Back cover: “AMISOM Medical Clinic in Mogadishu, Somalia” UN Photo/Stuart Price.
United Nations Publication
Sales No.: E.22.XIII.4
ISBN: 9789211483765
eISBN: 9789210024532
Copyright © United Nations, 2022.
Figures and tables in this publication can be reproduced without prior permission under a Creative
Commons license (CC BY 3.0 IGO), http://creativecommons.org/licenses/by/3.0/igo/.
Acknowledgements
is work was supported, in part, by a grant from the Bill & Melinda Gates Foundation, Making Family
Planning Count 3.0 (Grant No. INV-033016).
is report was prepared by Sehar Ezdi, Vladimíra Kantorová and Joseph Molitoris with inputs from Philipp
Ueng and Mark Wheldon. e authors wish to thank Bela Hovy, Karoline Schmid, John Wilmoth and
Lubov Zeifman for reviewing the dra, and Bintou Papoute Ouedraogo for her assistance in editing and
desktop publishing.
Contents
Key messages ................................................................................................................ i
Introduction .................................................................................................................. 1
Trends in contraceptive use ....................................................................................3
Contraceptive use by women’s age ..................................................................... 13
Contraceptive use by method ................................................................................ 17
References ......................................................................................................................25
Notes on regions, development groups, countries or areas
e designations employed in this publication and the material presented in it do not imply the expression
of any opinions whatsoever on the part of the Secretariat of the United Nations concerning the legal status
of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or
boundaries. e term “country” as used in this report also refers, as appropriate, to territories or areas.
In this publication, data for countries and areas have been aggregated in six continental regions: Africa,
Asia, Europe, Latin America and the Caribbean, Northern America, and Oceania. Further information on
continental regions is available from https://unstats.un.org/unsd/methodology/m49/. Countries and areas
have also been grouped into geographic regions based on the classication being used to track progress
in achieving the Sustainable Development Goals of the United Nations (see: https://unstats.un.org/sdgs/
indicators/regional-groups).
e designation of “more developed” and “less developed”, or “developed” and “developing”, is intended for
statistical purposes and does not express a judgment about the stage in the development process reached
by a particular country or area. More developed regions comprise all countries and areas of Europe and
Northern America, plus Australia, New Zealand and Japan. Less developed regions comprise all countries
and areas of Africa, Asia (excluding Japan), Latin America and the Caribbean, and Oceania (excluding
Australia and New Zealand).
e group of least developed countries (LDCs) includes 47 countries, located in sub-Saharan Africa (32),
Northern Africa and Western Asia (2), Central and Southern Asia (4), Eastern and South-Eastern Asia (4),
Latin America and the Caribbean (1), and Oceania (4). Further information is available at http://unohrlls.
org/about-ldcs/.
e group of landlocked developing countries (LLDCs) includes 32 countries or territories, located in
sub-Saharan Africa (16), Northern Africa and Western Asia (2), Central and Southern Asia (8), Eastern
and South-Eastern Asia (2), Latin America and the Caribbean (2), and Europe and Northern America (2).
Further information is available at http://unohrlls.org/about-lldcs/.
e group of small island developing States (SIDS) includes 58 countries or territories, located in the
Caribbean (29), the Pacic (20), and the Atlantic, Indian Ocean, Mediterranean and South China Sea
(AIMS) (9). Further information is available at http://unohrlls.org/about-sids/.
e classication of countries and areas by income level is based on gross national income (GNI) per capita
as reported by the World Bank (2022). ese income groups are not available for all countries and areas.
Further information is available at: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-
world-bank-country-and-lending-groups
“Family Planning in Pakistan: A class in family training given by Dr. Nishat Masaud”
UN Photo/B. Wol
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
i
Key messages
1. Sexual and reproductive health and reproductive rights are key to making reproductive choices.
Patterns of contraceptive use and needs disaggregated by marital status, age and type of method reveal
that there are sub-populations of women whose needs for family planning are not being met to the
same degree as others. e needs of these groups must be addressed to advance progress towards
ensuring universal access to sexual and reproductive health-care services, including for family planning,
information, and education (SDG target 3.7), and to ensure that no one is le behind.
2. Globally, 966 million women of reproductive age are using some method of contraception.
Among 1.9 billion women of reproductive age (15-49 years), an estimated 874 million women use a
modern contraceptive method and 92 million, a traditional contraceptive method. e number of
modern contraceptive users has nearly doubled worldwide since 1990 (from 467 million). Yet, there
are still 164 million women who want to delay or avoid pregnancy and are not using any contraceptive
method, and thus are considered to have an unmet need for family planning.
3. Progress in meeting the global need for family planning with modern methods has continued.
e proportion of women of reproductive age (aged 15-49 years) who have their need for family planning
satised with modern methods (SDG indicator 3.7.1) is 77 per cent globally, a 10-percentage point
increase since 1990 (67 per cent). is progress occurred in spite of the fact that the number of women
with a need for family planning has increased from 0.7 billion in 1990 to 1.1 billion today.
4. Use of modern contraceptive methods in sub-Saharan Africa remains lower than in other regions.
In sub-Saharan Africa, the proportion of women who have their need for family planning satised with
modern methods (SDG indicator 3.7.1) continues to be among the lowest in the world at 56 per cent.
Nevertheless, it also increased faster than in any other region of the world, having more than doubled
since 1990, when this proportion was only 24 per cent.
5. In sub-Saharan Africa, national experiences vary greatly in meeting the need for family planning.
Among 10 countries that witnessed the largest increase in the use of modern methods among women
with need for family planning (SDG indicator 3.7.1) from 1990 to 2021, 8 are in sub-Saharan Africa,
including Ethiopia, Eswatini, Guinea-Bissau, Madagascar, Malawi, Rwanda, Uganda, and Zambia. Yet,
among 41 countries where still less than half of women who want to avoid pregnancy are using modern
methods, 22 countries are in sub-Saharan Africa.
6. Generally, contraceptive use is highest among women in ages between 25 and 44 years.
At the global level as well as regionally, the proportion of women who want to avoid pregnancy and the
proportion of women using any contraceptive method are highest among women aged 25 to 44 years
and lowest among women below age 25.
7. Largest gaps in meeting the need for family planning are among young women and adolescents.
Globally, the greatest increase since 2000 in the proportion of women who have their need for family
planning satised with modern methods is amongst those aged 15 to 24 years. It increased for adolescents
(15-19 years) from 45 per cent in 2000 to 61 per cent in 2020 and for young women aged 20 to 24 from
57 per cent to 66 per cent over the same period. Despite these increases, the proportion of women who
have their need for family planning satised with modern methods remains low compared to other ages
– for women above age 30, it is more than 75 per cent.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
ii
8. Contraceptive methods used by married women dier from those used by unmarried women.
Of the 820 million users who are married or in a cohabiting union, 48 per cent use permanent or
long-acting reversible contraceptives and 41 per cent use short-acting methods. By contrast, of the
146 million users who are unmarried and not in a cohabiting union, most of whom are young, only
20 per cent use permanent or long-acting methods and 69 per cent use short-acting methods.
9. Most-used contraceptive methods dier signicantly between regions.
Short-acting methods are the most used methods in ve of the eight regions: Australia and New Zealand,
Latin America and the Caribbean, Northern Africa and Western Asia, Europe and Northern America,
and sub-Saharan Africa. Permanent or long-acting reversible methods are the most-used method in
Central and Southern Asia, Eastern and South-eastern Asia, and Oceania excluding Australia and New
Zealand. ere is no region in which traditional methods are the most commonly used.
10. Injectables play a prominent role in recent increases in the use of modern contraceptive methods.
Among 10 countries that made the greatest progress in meeting the needs for family planning with
modern methods since 1990 (SDG indicator 3.7.1.), the increase was driven by use of injectables in
5 countries, by implants and male condoms in 2 countries each, and by the pill in one country.
Introduction
e Programme of Action of the International Conference on Population and Development (ICPD),
adopted by 179 Governments in Cairo and rearmed by the 2030 Agenda for Sustainable Development,
emphasizes equality in access to “reproductive health care, including family planning and sexual health
that would allow all couples and individuals to have the basic right to decide freely and responsibly the
number and spacing of their children”. is inherently implies that it is “the right of men and women to be
informed and to have access to safe, eective, aordable and acceptable methods of family planning of their
choice” (United Nations, 1994). It was rearmed by the 2030 Agenda for Sustainable Development in target
3.7, “by 2030, ensure universal access to sexual and reproductive health-care services, including for family
planning, information and education, and the integration of reproductive health into national strategies
and programmes”. Progress towards achieving this target is monitored by indicator 3.7.1, “the proportion of
women of reproductive age (aged 15-49 years) who have their need for family planning satised with modern
methods of contraception”. e Population Division of the United Nations Department of Economic and
Social Aairs is the custodian agency for the global monitoring of this indicator.
A recent report on the topic of family planning analyzed trends in contraceptive use and their relationship
to fertility trends (United Nations, 2020a). e report showed that there is generally an inverse relationship
between fertility and contraceptive use within countries, but that the relationship between the two can vary
depending on the mix of contraceptive methods women use, the incidence of abortion, patterns of marriage
and sexual activity, as well as various economic and social inuences. Another recent report reviewed the
progress towards the achievement of target 3.7. with special attention to the increase in the numbers of
women of reproductive age in low and lower-middle-income countries that will require expansion of sexual
and reproductive health services, including family planning (United Nations, 2020b). at report showed
that nearly half of the growth in the number of modern contraceptive users worldwide between 2000 and
2020 was caused by population growth in the number of women of reproductive age, while the remainder
was due to increasing rates of contraceptive use. Furthermore, nearly two-thirds of the projected growth
in the number of users by 2030 is expected to be the result of greater uptake of modern contraceptives
and a smaller share due to population growth. is report builds on that previous work and provides
a comprehensive understanding of the patterns of contraceptive use by women’s age and by the type of
contraceptive method used.
e report is organized into three parts. Part one describes the trends in contraceptive use over the past
three decades, including trends in SDG indicator 3.7.1. Part two discusses patterns of contraceptive use by
women’s age. Part three provides trends in contraceptive use by type of method, including regional variation
in the use of specic methods.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
1
Reproductive Health in Burkina Faso; Aminata Bangaé taking a contraceptive pill
in the CSPS Health and Social Promotion Center of Moaga
Trends in contraceptive use
More women are using eective methods of contraception
Globally, the number of women of reproductive age (aged 15-49 years) rose from 1.3 billion in 1990 to
1.9 billion in 2021, an increase of 46 per cent (United Nations, 2022a). ere was an even larger increase in
the number of women of reproductive age who have a need for family planning – that is, they are married or in
a union, or are unmarried and sexually active, they are fecund and they intend to delay or avoid childbearing
(box 1). Specically, the number of women with a need for family planning rose from 0.7 billion in 1990
to 1.1 billion in 2021, an increase of 62 per cent (gure 1). is need is increasingly satised by the use of
modern contraceptive methods. At the same time, total fertility declined globally from 3.3 births per woman
in 1990 to 2.3 births per woman in 2021 (United Nations, 2022a). On average, women today live longer
periods of their reproductive lives wanting to delay or avoid childbearing.
Figure 1
Global number of women of reproductive age (15-49 years) who use modern and traditional contraceptive
methods and who have unmet need or no need for family planning, 1990 and 2021 (millions)
Source: United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and Projections of Family
Planning Indicators 2022.
Use of modern contraceptive methods is one of the most eective ways to reduce the risk of unintended
pregnancies, enabling women and couples to plan how many children they have and when to have them.
e number of women using modern contraception nearly doubled from 467 million in 1990 to 874 million
in 2021. While in 1990, 35 per cent of women used a modern method of contraception, this proportion
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
3
increased to 45 per cent in 2021. e number of women of reproductive age using traditional contraceptive
methods increased from 84 million in 1990 to 92 million in 2021, even as the proportion declined from
6to 5 per cent. Similarly, the number of women of reproductive age having an unmet need for family
planning increased from 147 million in 1990 to 164 million in 2021, even though their proportion among
women of reproductive age declined from 11 to 8 per cent over the same period.
Box 1
Denition of indicators and contraceptive methods
Contraceptive prevalence: Proportion of women of reproductive age (15-49 years) who are currently
using or whose sexual partner is currently using at least one method of contraception.
1
Generally, in
surveys, if a woman reports using more than one method, only the most eective method is used to
calculate contraceptive prevalence; therefore, the overall use of methods frequently used in combination
with another method (such as the male condom, rhythm or withdrawal) might be underestimated.
For analytical purposes, contraceptive methods are oen classied as either modern or traditional.
In this report, modern methods of contraception include female and male sterilization, intra-uterine
devices (IUD), implants, injectables, oral contraceptive pills, male and female condoms, vaginal barrier
methods (including the diaphragm, cervical cap and spermicidal foam, jelly, cream and sponge),
the lactational amenorrhea method (LAM), emergency contraception and other modern methods.
Traditional methods of contraception include rhythm (e.g., fertility awareness-based methods, periodic
abstinence), withdrawal and other traditional methods.
e married category pertains to women who are married (dened in relation to the marriage laws or
customs of a country) and to women in a union (referring to women living with their partner in the
same household, i.e., cohabiting unions, consensual unions, unmarried unions, or “living together”).
e unmarried category pertains to women who are not married and not in a union.
Unmet need for family planning: e percentage of women who are fecund and sexually active, who
wish to stop or delay childbearing, but who are not using any form of contraception. A woman is also
considered to have an unmet need if she was pregnant at the time of data collection, but reported that
the pregnancy was unwanted or mistimed, or if a woman was postpartum amenorrhoeic, not using
family planning and her most recent birth was unwanted or mistimed (Bradley and others, 2012;
United Nations, 2022b). is indicator measures, at the population level, the gap between women’s
reproductive intentions and their contraceptive behaviour.
Demand for family planning satised with modern methods: e proportion of women of
reproductive age (aged 15-49 years) who have their need for family planning satised with modern
methods (SDG indicator 3.7.1) is calculated as follows: the number of women who are currently using,
or whose sexual partner is currently using, at least one modern contraceptive method, as a proportion
of the number of women of reproductive age who express a demand for family planning either by using
any method of contraception or by having an unmet need for family planning as dened above. It is
one of two indicators used for the global monitoring of progress towards ensuring, by 2030, universal
access to sexual and reproductive health-care services, including for family planning, information and
education, and the integration of reproductive health into national strategies and programmes (SDG
target 3.7).
A detailed explanation of contraceptive methods is provided in World Health Organization and Johns Hopkins Bloomberg School of Public
Health, 2022.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
4
Box continued
Figure I provides a stylised representation of the key indicators. e population of women of reproductive
age may be considered as belonging to one of four categories: users of modern contraceptive methods
(blue), users of traditional contraceptive methods (green), women with an unmet need for family
planning (orange) and women with no need for family planning (grey).
2
Each rectangle represents
1 per cent of the women of reproductive age. As indicated in the gure, contraceptive prevalence (total,
modern or traditional) and unmet need for family planning are expressed as a proportion of all women
of reproductive age. e sum of all contraceptive users and women with an unmet need for family
planning represents the total demand for family planning – the population of women of reproductive
age wanting to avoid pregnancy. e ratio of modern contraceptive users to the total demand for family
planning is the SDG indicator 3.7.1 – the proportion of the demand for family planning satised with
modern methods.
Figure I
Stylised representation of population of women of reproductive age according to contraceptive use
and needs
is color code will be used to represent these indicators throughout the text.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
5
In 41
countries, fewer than half of all women of reproductive age who want to avoid pregnancy use
modern methods of contraception
Globally, among women who want to avoid pregnancy, 77 per cent used modern contraceptive methods
in 2021 (gure 2). Regions with the highest proportions of modern contraceptive use among women who
want to avoid pregnancy are Eastern and South-Eastern Asia (87 per cent), Australia and New Zealand
(85 per cent), Latin America and the Caribbean (83 per cent), and Europe and Northern America (80 per
cent). In these regions, among women who want to avoid pregnancy, the proportion of women using no
contraceptive method ranges from 9 per cent to 12 per cent, and the proportion of women using traditional
methods ranges from 3 per cent to 10 per cent. e relatively higher use of traditional methods in Europe
and Northern America (10 per cent) compared to the other three regions is due to a higher proportion of
women relying on traditional contraceptive methods in some countries of Southern and Eastern Europe.
e countries with the highest proportion (greater than 80 per cent) of demand for family planning satised
by modern methods are in Australia and New Zealand, Eastern and South-Eastern Asia, Europe and
Northern America, and Latin America and the Caribbean (gure 3).
Regions with the lowest proportion of use of modern methods among women who want to avoid pregnancy
include sub-Saharan Africa (56 per cent) and Oceania excluding Australia and New Zealand (52 per cent).
Compared to other regions, larger proportions of women who want to avoid pregnancy do not use any
method (37 per cent and 38 per cent respectively). In Northern Africa and Western Asia and in Central
and Southern Asia, among women who want to avoid pregnancy, a higher share use traditional methods
(15per cent and 12 per cent, respectively) compared to other regions.
Figure 2
Contraceptive use (modern and traditional) and unmet need for family planning among women with
a need for family planning, world and by region, 2021 (percentage)
Source: United Nations, Department of Economic and Social Aairs, Population Division. (2022). Estimates and Projections of Family
Planning Indicators 2022.
Note: Numbers may not add up to 100 due to rounding.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
6
Among the 41 countries where fewer than half of the women with a need for family planning have that
need satised with modern methods (gure 3), 22 countries are in sub-Saharan Africa. Of the 19 remaining
countries, 7 are in Northern Africa and Western Asia, 5 are in Europe and Northern America, 4 are in
Oceania excluding Australia and New Zealand, 2 are in Central and Southern Asia, and 1 is in Latin America
and the Caribbean.
Figure 3
Proportion of women of reproductive age (15-49 years) who have their need for family planning satised
with modern contraceptive methods (SDG indicator 3.7.1), 2021
Source: United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and Projections of Family
Planning Indicators 2022.
Note: e designations employed and the presentation of material on this map do not imply the expression of any opinion whatsoever
on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities,
or concerning the delimitation of its frontiers or boundaries. e dotted line represents approximately the Line of Control in Jammu and
Kashmir agreed upon by India and Pakistan. e nal status of Jammu and Kashmir has not yet been agreed upon by the parties. e
nal boundary between the Republic of Sudan and the Republic of South Sudan has not yet been determined. A dispute exists between
the Governments of Argentina and the United Kingdom of Great Britain and Northern Ireland concerning sovereignty over the Falkland
Islands (Malvinas).
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
7
Box 2
Data and methods
World Family Planning 2022 presents estimates of family planning indicators among women of
reproductive age (15-49 years), disaggregated by 5-year age groups (from 15-19 to 45-49), marital status
and method of contraceptive use.
e estimates are based on the World Contraceptive Use 2022 data compilation (United Nations, 2022b),
which includes 1,404 nationally representative survey-based observations from 197 countries or areas
for the period from 1950 to 2021. Comparable survey-based estimates are not available for all years
and all countries or areas. erefore, model-based estimates and projections of the family planning
indicators are calculated for all years from 1990 to 2030 (United Nations, 2022c) using a hierarchical
Bayesian model (Alkema and others, 2013; Kantorová and others, 2020). Estimates are calculated for all
women of reproductive age and disaggregated by 5-year reproductive age groups and by marital status.
Regional and global estimates are calculated as weighted averages where the weights are the population
of women of reproductive age derived from World Population Prospects 2022 (United Nations, 2022a).
Estimates of the proportion of women who are married or in a union by 5-year age groups are derived
from Estimates and Projections of Women of Reproductive Age Who Are Married or in a Union 2022
(United Nations, 2022d). Detailed data are available online on the United Nations Population Division
Data Portal (https://population.un.org/dataportal/home).
Method-specic estimates are based on the survey estimates compiled in World Contraceptive Use
2022 and additional tabulations are derived from microdata sets and survey reports. For each of the
197 countries, 2 survey observations are used: a) one closest to the year 1995 for the period 1990
to 1999; and b) one closest to the year 2020 since the year 2010. e distribution of contraceptive
methods among all users observed in surveys is applied to the model-based estimates of modern and
traditional contraceptive prevalence for the years 1995 and 2020 to estimate the prevalence of individual
contraceptive methods among women of reproductive age (15-49 years) by marital status. Combining
the survey-based estimates of method-specic use and the model-based estimates of contraceptive
prevalence and the number of users allows for calculating method-specic use at the regional and
global levels.
Use of modern contraception among women who want to avoid pregnancy has increased in all regions
In all regions, women who want to avoid pregnancy have increasingly used modern contraceptive methods
(gure 4). Sub-Saharan Africa experienced the largest increase in the percentage of demand for family
planning satised by modern methods, which rose from 24 per cent in 1990 to 56 per cent in 2021. In
two regions with similar levels in 2021 – Oceania excluding Australia and New Zealand (52 per cent) and
Northern Africa and Western Asia (63 per cent) – the indicator changed little since 1990. Latin America
and the Caribbean, with an increase from 67 per cent to 83 per cent over the same period, is now amongst
the regions with the highest use of modern methods among women who want to avoid pregnancy. A similar
increase occurred in Central and Southern Asia, where the indicator rose from 55 per cent in 1990 to 74 per
cent in 2021. An increase from 68 per cent to 80 per cent in Europe and Northern America over the same
period was due mainly to a shi from traditional to modern methods of contraception in Eastern Europe.
For the two regions that relied the most on modern contraception in 1990, the indicator also continued to
increase: from 80 per cent to 87 per cent in Eastern and South-Eastern Asia, and from 84 per cent to 86 per
cent in Australia and New Zealand.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
8
Figure 4
Proportion of women of reproductive age (15-49 years) who have their need for family planning
satised with modern contraceptive methods (SDG indicator 3.7.1), world and by region, 1990-2021
Source: United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and Projections of Family
Planning Indicators 2022.
Some countries with previously large gaps in meeting the need for family planning experienced rapid gains
while others are lagging behind. Between 1990 and 2021, among the 10 countries that experienced the
greatest increase in the proportion of women who have a need of family planning satised with modern
methods (indicator SDG 3.7.1), 8 were in sub-Saharan Africa (gure 5), including Ethiopia, Eswatini,
Guinea-Bissau, Madagascar, Malawi, Rwanda, Uganda and Zambia.
How these countries increased the proportion of demand for family planning satised by modern methods
varies based on local contexts. In Romania, for instance, modern contraception and family planning
programmes were largely prohibited by the socialist government until 1990. Induced abortion (although
illegal) and traditional contraceptive methods were the only possibilities to control family size. It was
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
9
only aer the transition from socialism that the country allowed the establishment of family planning
programmes, leading to a rapid increase in the use of modern methods, particularly condoms and the
pill (Mureşan and others, 2008). In the eight sub-Saharan countries that witnessed the greatest progress
in demand for family planning satised by modern methods, governments made strong commitments to
include family planning as a component of their development agendas, particularly aer 2000. In practice,
these commitments led to the integration of family planning into local health systems, reaching rural and
other hard-to-reach populations, reducing barriers to young people and expanding contraceptive method
mixes, among others (Bongaarts and Hardee, 2019; United Nations, 2020b).
Figure 5
Ten countries with greatest increase in the proportion of women of reproductive age (15-49 years) who have
their need for family planning satised with modern methods (SDG 3.7.1) from 1990 to 2021 (percentage)
Source: United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and Projections of Family
Planning Indicators 2022.
Note: Countries are ordered by value of the indicator in 2021.
It is important to note that even in countries in which the demand for family planning satised by modern
methods increased more slowly, there were signicant increases in the numbers of users over time. In
Nigeria, for example, only 40 per cent of the demand for family planning is satised by modern methods.
Yet since 1990, the number of women using a modern method increased nearly eightfold from 0.8million
to over six million by 2021.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
10
Box 3
The impact of the COVID-19 pandemic on contraceptive use
e impact of the coronavirus disease (COVID-19) pandemic on the availability and use of family
planning services and contraception have been varied. Even in cases of severe disruptions to the
availability of services and technologies, the eects of the pandemic on the availability of family
planning services were generally short-lived (Fuseini and others, 2022; Karp and others, 2021; Wood
and others, 2021).
A recent review of studies examining the impact of the COVID-19 pandemic on access to and
utilisation of services for sexual and reproductive health (VanBenschoten and others, 2022) shows that
there was reduced availability of and access to contraceptive services (especially long-acting reversible
contraceptives), safe abortion services, in-person services for survivors of gender-based violence and
intimate partner violence, and testing for HIV and sexually transmitted infections. ese eects were
borne disproportionately by women and girls and may have curtailed progress towards the achievement
of certain SDGs.
e pandemic’s adverse eects on family planning services have been most severe in low- and middle-
income countries and among those who are most vulnerable. In low- and middle-income countries,
pandemic-related disruptions oen led to increases in the demand for family planning services,
reductions in the provision of services and greater barriers to accessing these services, even though its
eects varied considerably based on the national context, the health service provided, and the population
in question (Polis and others, 2022). While disruptions in family planning services in high-income
countries were not as widespread, research has shown that low-income families in such countries have
been disproportionately aected by pandemic-related restrictions on reproductive health care and
access to contraception and abortion (Bailey and others, 2022).
Although the impact of the COVID-19 pandemic on family planning services has been more modest
than initially predicted, the disruptions that did occur could have life-long consequences for the
aected individuals. Additional research will be needed to fully understand the pandemic’s impact on
the demand for, provision of and access to sexual and reproductive health-care services as well as the
long-term consequences for those who were unable to obtain needed services.
Use of eective methods of contraception reduces risks of unintended pregnancy
Between 2015 and 2019, there were 121 million unintended pregnancies annually worldwide – 48 per
cent of all pregnancies. Despite decreases in the rate of unintended pregnancy in all regions over the past
three decades, nearly one in 10 women in sub-Saharan Africa, Western Asia and Northern Africa, and
Oceania (excluding Australia and New Zealand) continue to experience an unintended pregnancy every
year (Bearak and others, 2020). Unintended pregnancy can have signicant adverse impacts on the lives of
women, children and families in both the short and long term, including worse socioeconomic outcomes,
poor health outcomes and complications from unsafe abortions, among others (Gipson, Koenig and Hindin,
2008; Foster and others, 2019; UNFPA, 2022). Globally, of all unintended pregnancies, 61 per cent end in
abortion, that is, 73 million abortions annually. Abortion rates are similar in countries where the procedure
is broadly legal (i.e., where it is available on request or on socioeconomic grounds) and those where abortion
is restricted – at around 40 abortions per 1,000women of reproductive age (Bearak and others, 2020). In the
latter context, however, most abortions are unsafe, leading to increased risks of health complications and
even death. Unsafe abortions cause around 39,000 deaths every year and result in millions more women
hospitalized with complications; most of these deaths are concentrated in lower-income countries (World
Health Organization, 2022).
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
11
A woman may experience an unintended pregnancy as a consequence of not using a contraceptive method
despite wanting to avoid pregnancy or as a result of the inecacy of a contraceptive method being used.
ere are various reasons why women may not be using contraception even when they do not want to
become pregnant, including ambiguous attitudes towards pregnancy, inconsistent method use, switching
between methods, or a recent discontinuation of a method due to health or other concerns. Unintended
pregnancy may also be caused by contraceptive failure, the risk of which varies widely across methods.
e inuence of method-specic dierences in failure rates on the risk of unintended pregnancy is evident
in low- and middle-income countries, where it was found that the risk of unintended pregnancy is nearly
three times higher for women who rely on traditional contraceptive methods when compared to those who
use a modern method (Bellizzi and others, 2015). Although a majority of unintended births occur when a
woman is not using and has not recently used a contraceptive method, a recent study of 36 low- and middle-
income countries found that more than 4 out of 10 unintended pregnancies occurred either following the
discontinuation of a method or due to a failure of a method (Bellizzi and others, 2020).
Modern contraceptive methods, particularly long-acting reversible methods such as IUDs and implants, are
signicantly less likely to fail than other methods (Bradley and others, 2019; Polis and others, 2016; Hatcher,
2011). Furthermore, long-acting reversible methods tend to have substantially lower discontinuation rates
than short-acting methods in a wide range of contexts (Bradley, Schwandt and Khan, 2009; Barden-O’Fallon
and others, 2018; Moreau and others, 2009; Ontiri and others, 2020).
It should be recognized, however, that women and their partners have diverse preferences for and experiences
using specic methods and that any method may not be satisfactory for all, even if they are highly eective
at reducing the risk of unintended pregnancy. For instance, side eects and health concerns are the most
frequently cited reasons given by women who discontinue using or opt not to use hormonal contraception,
including long-acting methods (Staveteig, Mallick and Winter, 2015). It is therefore critical to implement
policies allowing women and couples to make informed choices about family planning, taking into account
their personal circumstances and preferences as well as the potential benets and risks associated with
using or not using specic methods.Improving access to contraceptive methods and information can play
a signicant role in reducing the risk of unintended pregnancies, averting adverse impacts on the lives of
women and families in both the short and long term, including worse socioeconomic outcomes, poor health
outcomes and complications from unsafe abortions.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
12
Contraceptive use by women’s age
Generally, contraceptive use is highest among women in ages between 25 and 44 years
At the global level, as well as across all regions, the proportion of women who want to avoid pregnancy
and the proportion of women using any contraceptive method are highest among women aged 25 to 44
(gure6). e majority of women at these ages are sexually active, married or in a cohabiting union and in
the process of planning or realizing their fertility intentions of how many children to have and when to have
them. Australia and New Zealand, Latin America and the Caribbean, Eastern and South-Eastern Asia, and
Europe and Northern America stand out as the regions where high proportions of women aged 25 to 44 use
any method of contraception. In the latter two regions, the use of traditional methods is higher compared
to other regions.
Figure 6
Global and regional estimates of contraceptive prevalence, unmet need for family planning, and the
proportion of women of reproductive age who have their need for family planning satised with modern
methods (SDG 3.7.1), by 5-year age groups, world and by region, 2021
Source: United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and Projections of Family
Planning Indicators 2022.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
13
In Oceania excluding Australia and New Zealand and in sub-Saharan Africa, the proportion of women
using modern contraceptive methods is low in all age groups. High levels of unmet need for family planning
-exceeding 20 per cent of women in some age groups- indicate large gaps in meeting needs for family
planning for women of all ages.
Adolescents and young women generally have the lowest proportion of modern contraceptive use. In
all regions, less than 30 per cent of adolescents and young women aged 15-19 years use contraception.
Compared to other regions, contraceptive use is highest among adolescents in Australia and New Zealand,
and Europe and Northern America. e vast majority of these young contraceptive users are not married
nor in a cohabiting union. In these regions, less than 5 per cent of women aged 15 to 19 are married or in
a union (United Nations, 2022d). In contrast, the proportion using any contraceptive method among 15 to
19 years old is less than 5 per cent in Northern Africa and Western Asia and in Central and Southern Asia.
Sexual activity in these regions is mostly limited to those who are married. Once married, childbearing soon
follows. In Central and Southern Asia, unmet need for family planning is highest among women aged 20 to
29, indicating a large gap between fertility intentions and use of modern methods of contraception among
young women.
Young women and adolescents experience the largest gaps between needs for family planning and
modern contraceptive use
e proportion of women who have their need for family planning satised with modern methods (SDG
3.7.1) indicates potential inequalities in access to and use of modern contraception by women’s age.
In some regions, the dierences across age groups in meeting the needs for family planning are small. In Latin
America and the Caribbean, Australia and New Zealand, and Europe and Northern America the proportion
of women who have their need for family planning satised with modern methods is similar across all ages
at more than 75 per cent. In sub-Saharan Africa, another region with relatively small dierences in the need
for family planning satised with modern methods, the indicator is less than 58 per cent in all ages (with just
41per cent among adolescents), indicating large gaps in meeting needs for family planning across all ages.
Other regions have more pronounced age-specic patterns, with particularly low proportions of women
who have their need for family planning satised with modern methods among adolescents and young
women. In Central and Southern Asia, only half of the women below age 25 have their need for family
planning satised with modern methods, while it is above 80 per cent among women in ages above 40.
is pattern is connected to the high share of female sterilisation among contraceptive methods used in the
region, particularly in India.
Progress in meeting the needs for family planning with modern methods from 2000 to 2020 was most
remarkable among women aged 15 to 24 years. Globally, it increased for adolescents aged 15 to 19 from
45 per cent in 2000 to 61 per cent in 2020 and for women aged 20 to 24 from 57 per cent to 66 per cent over
the same period (gure 7). Despite this progress, the proportion of young women and adolescents who have
their need for family planning satised with modern methods remains lower compared to other ages. In
comparison, for women above age 30, it is more than 75 per cent.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
14
Figure 7
Proportion of women of reproductive age (15-49 years) who have their need for family planning satised
with modern methods (SDG 3.7.1), by 5-year age groups, world, 2000 to 2020
Source: United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and Projections of Family
Planning Indicators 2022.
Age-specic progress in demand satised with modern methods has been uneven across countries
e age pattern of the proportion of demand for family planning satised with modern methods developed
in diverse ways across countries and over time. A mix of countries was selected based on geographical
diversity and distinct patterns of change over time to depict cross-national dierences (gure 8). From 2000
to 2020, the increase in the proportion of need for family planning satised with modern methods in all of
the selected countries was most notable among women aged 15 to 24. In countries like Brazil and Colombia,
the larger increase in meeting needs for family planning with modern methods among adolescents and
young women since 2000 reduced dierences across all ages. Ethiopia and Nigeria both had low modern
contraceptive use in 2000. While in Ethiopia the use of modern contraception among women who want to
avoid pregnancy increased in all age groups, in Nigeria the progress was slow in all age groups. Bangladesh
and the Philippines experienced moderate growth in demand for family planning satised with modern
methods at all ages in the given period since 2000. Nevertheless, the youngest and oldest age groups have
larger gaps in meeting needs for family planning with modern methods compared to other ages.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
15
Figure 8
Proportion of women of reproductive age (15-49 years) who have their need for family planning satised
with modern methods (SDG 3.7.1) by 5-year age group, selected countries, 2000 to 2020
Source: United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and Projections of Family
Planning Indicators 2022.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
16
Contraceptive use by method
Female sterilisation and male condoms are the most commonly used methods worldwide
Forty-six percent of the 966 million women of reproductive age who use any method of contraception are
using short-acting methods (male condoms, the pill, injectables and other modern methods). With nearly
equal share, permanent and long-acting reversible methods (female and male sterilisation, IUDs, implants)
represent 44 per cent. Traditional methods (withdrawal, rhythm and other traditional methods) account for
a smaller share of use (less than 10 per cent) (gure 9).
Figure 9
Number of women of reproductive age (15-49 years) using various contraceptive methods, world, 2020
(millions and percentage)
Sources: Calculations based on United Nations, Department of Economic and Social Aairs, Population Division (2022). World
Contraceptive Use 2022; United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and
Projections of Family Planning Indicators 2022.
Note: Other methods include female condoms, vaginal barrier methods (including diaphragms, cervical caps, and spermicidal foams,
jellies, creams and sponges), lactational amenorrhea method (LAM), emergency contraception, and other modern or traditional methods
not presented separately.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
17
Female sterilisation is the most commonly used contraceptive method globally (23 per cent of contraceptive
users), followed by male condoms (22 per cent). Each of these methods has more than 200 million users
– 219 million for female sterilisation and 208 million for male condoms. e high share of use of female
sterilisation globally is largely due to its extensive use in India, which accounts for 48 per cent of the global
number of women who use female sterilisation. Female sterilisation would be the fourth most used method
and only account for 15 per cent of total use worldwide if India were not included in the calculation.
Two other methods have more than 100 million users worldwide, namely IUDs (161 million) and the
pill (150 million). Other modern methods have fewer users globally – injectables (72 million), implants
(25 million) and male sterilisation (17 million). Among traditional methods, 33 million women rely on
rhythm and 53 million on withdrawal.
Box 4
Contraceptive use as a means to fullling fertility intentions
Fertility intentions regarding how many children to have and when to have them inuence one’s
decision to use contraception as well as the type of contraception. Intentions to not have any children,
delay a rst birth, postpone a subsequent birth or stop having children altogether can also inuence
one’s choice of contraceptive method. Among women wanting to delay a rst birth or subsequent
birth, short-acting methods, such as the pill and injectable, are commonly used as they can be quickly
discontinued when women decide they would like to have a child (Pasha and others, 2015; Sedekia
and others, 2017). Postpartum women have the option to adopt the lactational amenorrhea method
for a period of up to six months following the birth of a child, the eectiveness of which depends on
following a strict protocol requiring, among other things, exclusive breastfeeding. Women intending
to stop childbearing, on the other hand, are more likely to adopt permanent and long-acting methods,
such as IUDs and sterilisation. Yet, the extent to which permanent methods are used by women in this
situation varies widely across countries and regions (Olakunde and others, 2020) and in some settings,
short-acting methods are used widely by women wishing to limit childbearing (Van Lith, Yahner and
Bakamjian, 2013).
In some countries, preference for a son or a daughter may inuence the type of contraceptive method
used. Research on the contraceptive behaviour of women in societies where many couples prefer
having sons over daughters has shown that – compared to women who have at least one son – those
who have no son are more likely to use traditional or modern reversible methods of contraception in
order to preserve their fecundity to allow them to have a son in the future (Ghosh and Chattopadhyay,
2017; Akhtar and Haque, 2014). Aer reaching a desired number of sons, women in these societies are
substantially more likely to adopt a permanent method of contraception (Channon, 2015; Jayaraman
and others, 2009).
e most common methods used by married women are dierent from those used by unmarried women
Among the 820 million married women of reproductive age who used any contraception in 2020, nearly
half used permanent and long-acting methods (48 per cent), including female sterilisation (25 per cent)
and IUDs (19 per cent) (gure 10). Among the 146 million contraceptive users who are unmarried and not
in a cohabiting union, and most of whom are young, more than two-thirds use short-acting contraceptives
(69 per cent), including male condoms (37 per cent) and the pill (25 per cent). Only, 20 per cent of unmarried
users rely on permanent and long-acting methods, and those users are mostly formerly married women.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
18
Figure 10
Number of women of reproductive age (15-49 years) using various contraceptive methods, by marital
status, world, 2020 (millions and percentage)
Sources: Calculations based on United Nations, Department of Economic and Social Aairs, Population Division. (2022). World
Contraceptive Use 2022. Additional tabulations derived from microdata sets and survey reports and estimates of contraceptive prevalence
for 2022 from Estimates and Projections of Family Planning Indicators 2022.
Note: Other methods include modern methods such as female condoms, vaginal barrier methods (including diaphragms, cervical caps
and spermicidal foams, jellies, creams and sponges), the lactational amenorrhea method (LAM), emergency contraception and other
modern and traditional methods not presented separately.
Married women
(820 million users)
Unmarried women
(146 million users)
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
19
Most-used contraceptive methods vary by region
Use of modern contraception exceeds use of traditional methods in all regions of the world (gure 11).
Short-acting methods are more commonly used than permanent and long-acting methods in ve regions,
including sub-Saharan Africa (63 per cent), Australia and New Zealand (61 per cent), Europe and Northern
America (57 per cent), Latin America and the Caribbean (55 per cent) and Northern Africa and Western
Asia (47 per cent). Within these regions there is some diversity in the type of short-acting method used.
e pill is the most widely used method in Australia and New Zealand (38 per cent), Northern Africa and
Western Asia (31 per cent) and Latin America and the Caribbean (26 per cent). e pill and male condoms
make up approximately 27 per cent of use in Europe and Northern America. Sub-Saharan Africa is the only
region in which injectables are the dominant method, accounting for 33 per cent of contraceptive use.
Figure 11
Contraceptive methods used among women of reproductive age (15-49 years), world and by region, 1995
and 2020 (percentage)
Sources: Calculations based on United Nations, Department of Economic and Social Aairs, Population Division (2022). World
Contraceptive Use 2022; United Nations, Department of Economic and Social Aairs, Population Division (2022). Estimates and
Projections of Family Planning Indicators 2022.
Note: Other methods include modern methods such as female condoms, vaginal barrier methods (including diaphragms, cervical caps
and spermicidal foams, jellies, creams, and sponges), lactational amenorrhea method (LAM), emergency contraception and other
modern and traditional methods not presented separately.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
20
Female sterilisation as a share of total contraceptive decreased in all regions. Between 1995 and 2020, it
declined the most in Eastern and South-Eastern Asia (from 31 per cent in 1995 to 17 per cent in 2020),
Latin America and the Caribbean (from 39 per cent in 1995 to 26 per cent in 2020), and Australia and New
Zealand (from 16 per cent in 1995 to 6 per cent in 2020). In Central and Southern Asia –the region where
female sterilisation is used the most among all regions– the decline in the share of female sterilisation was
limited, from 52 per cent in 1995 to 47 per cent in 2020. Globally, the share of female sterilisation declined
from 29 per cent in 1995 to 23 per cent in 2020. Due to dierences in the rates of decline in the use of female
sterilisation across regions, Central and Southern Asia had a growing share of the world’s women who were
sterilised, which led to only a modest reduction in the use of female sterilisation at the global level.
Other methods that declined globally are male sterilisation, IUDs and traditional methods. Male sterilisation
as a share of total use declined from 6 per cent in 1995 to less than 2 per cent in 2020 globally, due to declines
in Eastern and South-Eastern Asia, and Central and Southern Asia (both from 7 per cent in 1995 to 1 per
cent in 2020). From 1995 to 2020, the share of IUDs among contraceptive methods declined from 22 per
cent to 17 per cent globally, with Northern Africa and Western Asia experiencing the largest decline. Over
the same period, the share of traditional methods declined from 13 per cent to 10 per cent globally. e
largest decline, from 13 per cent to 9 per cent, was for withdrawal in Europe and Northern America due to
the move towards use of modern methods in Eastern Europe.
e contraceptive method recording the greatest relative increase in use varies across regions. In sub-Saharan
Africa, the increase in the shares of implants (from 5 per cent in 1995 to 19 per cent in 2020) and injectables
(from 21 per cent in 1995 to 33 per cent in 2020) is notable. e rapid increase of these two methods in
sub-Saharan Africa is largely the result of extensive investment by international donors and eorts by local
authorities over the past two decades (Tsui, Brown and Li, 2017). In Oceania excluding Australia and New
Zealand, the shares of overall contraceptive use increased for implants (from 11 per cent in 1995 to 22 per
cent in 2020) and for injectables (from 17 per cent in 1995 to 24 per cent in 2020). In Latin America and the
Caribbean, the largest relative increases in contraceptive use were recorded for male condoms (from 8 per
cent in 1995 to 16 per cent in 2020) and injectables (from 4 per cent in 1995 to 12 per cent in 2020). Between
1995 and 2020, the share of users relying on male condoms also increased in Eastern and South-Eastern Asia
(from 10 per cent to 29 per cent), Central and Southern Asia (from 7 per cent to 16per cent) and Europe and
Northern America (from 17 per cent to 27 per cent). Apart from implants, all methods that experienced an
increase in their share of overall contraceptive use were short-acting.
In 5 of the 10 countries that experienced the greatest increase in the value of SDG indicator 3.7.1 since 1990
(gure 5), the use of injectables played a prominent role. Injectables are now the most common method
among users in Ethiopia (57 per cent), Malawi (51 per cent), Zambia (51 per cent), Madagascar (40 per cent)
and Uganda (31 per cent). Implants are the most common method among users in Guinea-Bissau (47 per
cent) and Rwanda (43 per cent). Male condoms are the most commonly used method in Eswatini (45 per
cent) and Romania (36 per cent), while the pill is the most commonly used method in Cambodia (33 per
cent).
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
21
Box 5
Method mix in the context of family planning programmes
Method mix is the combination of dierent forms of contraceptive methods used. It is the result of the
interaction between the supply (availability, aordability and accessibility of methods) and demand
(individual and societal preferences, and cultural inuences) for specic contraceptive methods in
a country or region (Bertrand and others, 2020). e use of specic contraceptive methods varies
widely across countries. Method mix has shied over time due to changes in related policies, health-
care systems, technologies and access to the various methods. Governments at all levels have played
a strong and visible role in promoting and legitimizing the provision and use of family planning and
reproductive health-care services as well as the use of specic contraceptive methods.
Family planning programmes – typically administered by national authorities or non-governmental
organizations, or integrated into maternal and child health programmes (Seltzer, 2002) – can inuence
the method mix by educating individuals and couples and healthcare professionals about specic
methods as well as by distributing and administering contraceptive methods that are acceptable,
aordable and accessible to all (Seiber and others, 2007). Prior to 1990, programmes oen resulted in
shis towards a particular contraceptive method whereas since 2000, programmes have oen led to
the adoption of a variety of methods (Boglaeva, 2021). e eects of specic programmes and policies
are also reected in regional dierences in method-specic use. In sub-Saharan Africa, for instance,
programmatic emphasis since 1990 on the use of long-acting reversible methods has led to increase in
implants, a method typically only used by a small percentage of users in other regions.
Modern family planning programmes generally aim to diversify method mix in order to reduce
overreliance on one single method. Although a more varied method mix has not been found to be
associated with greater overall use (Ross and others, 2015; Bertrand and others, 2020), the overreliance
on a single method can leave a population vulnerable to stockouts or shortages and can point to a lack
of choice among users or coercion by governments (Seiber and others, 2007). In approximately one-
h of countries, more than 50 per cent of contraceptive use is accounted for by a single contraceptive
method (United Nations, 2019). Nevertheless, programmes in some countries have had limited success
in shiing to a more diverse mix of methods. For example, eorts to shi contraceptive prevalence
from the pill to IUDs were unsuccessful in Morocco in the 1990s (Bertrand and others, 2014). Similarly,
despite eorts to encourage the uptake of vasectomy, its use has fallen sharply where it formerly had
a signicant share of use (Bertrand and others, 2020). ere has been debate about whether family
planning programmes should focus on expanding acceptability and accessibility of less popular and
newer methods with a purpose to promote method mix or instead focus on making already accepted
methods more widely available in given settings (Ross and others, 2015).
Contraceptive methods are continuously evolving to meet the needs of women and men. e past three
decades witnessed the emergence of numerous methods which are acceptable to many users and are
cost-eective (e.g., hormonal patches, emergency contraception), and ongoing work seeks to improve
the ecacy of existing methods, for example, by lowering the dose of existing hormonal compositions in
patches and intravaginal rings and changing the material and shape of condoms, IUDs and diaphragms
(Brady and others, 2020; Logie and others, 2022; Haddad and others 2021). ere are also substantial
investments being made into new contraceptive technology to reduce the barriers associated with repeat
clinical visits and methods specically for men (Haddad and others, 2021). Whether newer methods
will signicantly inuence method mixes in the future will depend on how they are incorporated into
national strategies and programmes.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
22
e contraceptive pill and male condom are the most commonly used methods in many countries
In 118 countries, more than 30 per cent of contraceptive use is accounted for by one method (gure 12). e
pill accounts for the largest share of contraceptive use in 36 of these countries. Its use is the most extensive
in Northern Africa, where it exceeds 70 per cent of total use in Algeria and Morocco. Male condoms account
for more than 30 per cent of use in 27 countries; it is most heavily relied upon in Japan (75 per cent), Gabon
(61 per cent), Belarus (49 per cent) and Ukraine (47 per cent). Injectables account for the highest share of
contraceptive use in 18 countries and cover 50 per cent or more of total use in Ethiopia, Liberia, Malawi,
Myanmar, and Zambia. IUDs are the most commonly used method in 14 countries, particularly in Central
Asia and Eastern Asia.
Figure 12
Most used contraceptive method among women of reproductive age (15-49 years), 2020
Source: Calculations based on United Nations, Department of Economic and Social Aairs, Population Division (2022). World
Contraceptive Use 2022.
Note: Contraceptive prevalence rate (CPR) refers to contraceptive prevalence. e most used method was only identied for countries
or areas which had an estimate of contraceptive prevalence greater than 20 per cent, as the most used method in countries with low
contraceptive prevalence only represents a small share of women of reproductive age. e boundaries and names shown and the
designations used on this map do not imply ocial endorsement or acceptance by the United Nations.
In 11 countries, female sterilisation is used by more than 30 per cent of all users of contraceptive methods.
Its share among users is greatest in India (59 per cent), El Salvador (53 per cent), Mexico (48 per cent),
Dominican Republic (45 per cent) and Nicaragua (40 per cent). Implants are the most commonly used
contraceptive method in ve countries, all of which are in sub-Saharan Africa. e share of a traditional
method exceeds that of other methods in seven countries, primarily in Western Asia.
In 18 countries, two methods account for at least 30 per cent of contraceptive use, while in 36 countries there
is no single method which accounts for such a high share. In countries in which two methods are widely
used, one of these methods is always either male condoms, the pill or injectables. Male condoms are used
in 12 of the 18 countries in which 2 methods account for more than 30 per cent of use, most commonly
in conjunction with the pill, but also with IUDs, injectables and withdrawals. ere are only two cases in
which a permanent method, female sterilisation, accounts for more than 30 per cent of use simultaneously
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
23
with another method. In Panama, female sterilisation accounts for 31 per cent of total use and injectables
account for 32 per cent of use. In ailand, female sterilisation accounts for 36 per cent of total use and the
pill for 39 per cent.
In many countries, the most commonly used methods have not changed much over time, having been
inuenced heavily by early eorts to introduce modern methods of contraception by family planning
programmes. Early family planning programmes of the 1960s and 1970s, such as those in China, Egypt, and
Tunisia, oen prioritized IUDs as the preferred reversible method (Brown, 2007; Robinson and El-Zanaty,
2007; Wang, 2012) and they continue to be the most widely used methods in these countries today. In India,
female sterilisation was at the core of early family planning eorts and, despite later emphasis on bringing a
variety of methods to the population (Harkavy and Roy, 2007), it continues to be used more than any other
method in the country. ailand’s National Family Planning Program garnered widespread acceptance of
oral contraceptives by allowing auxiliary midwives to distribute them early on (Roseneld and Min, 2007),
leading to a rapid uptake of the pill and its continued high rate of use (nearly 40 per cent of total users among
all women in 2020).
Not all countries have continued to follow the path set by early family planning programmes, however.
Family planning programmes in Morocco initially emphasized the use of IUDs, similar to neighboring
Tunisia (Brown, 2007). Yet eventually it was oral contraceptive pills which became the most used method.
In Colombia in the 1970s, the national family planning programme was successful in widely distributing the
pill, IUDs and injectables, leading to a signicant uptake of these methods (Measham and Lopez-Escobar,
2007). Over time, however, it was female sterilisation which became the most widely used method in this
country and remains so today.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
24
References
Alkema, L., and others (2013). National, regional, and global rates and trends in contraceptive prevalence
and unmet need for family planning between 1990 and 2015: A systematic and comprehensive
analysis. e Lancet, vol. 381, Issue 9878, pp. 1642–1652. Available at https://doi.org/10.1016/
S0140-6736(12)62204-1.
Bailey, M. J., L. Bart, and V. W. Lang (2022). e Missing Baby Bust: e Consequences of the COVID-19
Pandemic for Contraceptive Use, Pregnancy, and Childbirth Among Low-Income Women.
Population Research and Policy Review, vol. 41, Issue 4, pp. 1549–1569. Available at https://doi.
org/10.1007/s11113-022-09703-9.
Barden-O’Fallon, and others (2018). Women’s contraceptive discontinuation and switching behavior
in urban Senegal, 2010–2015. BMC women’s health, vol. 18, Issue 1, pp. 1-9. Available at
https://doi.org/10.1186/s12905-018-0529-9.
Bearak, J., and others (2020). Unintended pregnancy and abortion by income, region, and the legal status of
abortion: estimates from a comprehensive model for 1990–2019.e Lancet Global Health, vol. 8,
Issue 9, e1152-e1161. Available at https://doi.org/10.1016/S2214-109X(20)30315-6.
Bellizzi, S., and others (2015). Underuse of modern methods of contraception: underlying causes and
consequent undesired pregnancies in 35 low-and middle-income countries.Human Reproduction,
vol.30, Issue 4, pp. 973-986. Available at 10.1093/humrep/deu348.
---------- (2020). Reasons for discontinuation of contraception among women with a current unintended
pregnancy in 36 low and middle-income countries. Contraception, vol. 101, Issue 1, pp. 26-33.
Available at 10.1016/j.contraception.2019.09.006.
Bertrand, and others (2014). Contraceptive method skew and shis in method mix in low- and middle-
income countries. International Perspectives on Sexual and Reproductive Health, vol. 40, Issue 3,
pp. 144-153. Available at https://doi.org/10.1363/4014414.
---------- (2020). Contraceptive method mix: Updates and implications. Global Health: Science and Practice,
vol. 8, Issue 4, pp. 666–679. Available at https://doi.org/10.9745/GHSP-D-20-00229.
Boglaeva, L. V. (2021). Contraceptive method mix in the context of family planning programmes in
developing countries. Population and Economics, vol. 5, Issue 3, pp. 56–75. Available at https://doi.
org/10.3897/popecon.5.e70669.
Bongaarts, J., and K. Hardee. (2019). Trends in Contraceptive Prevalence in Sub-Saharan Africa: e roles
of Family Planning Programs and Education. African journal of reproductive health, vol. 23, Issue 3,
pp. 96-105.Available at https://europepmc.org/article/med/31782635.
Bradley, S.E., H. Schwandt, and S. Khan (2009). Levels, trends, and reasons for contraceptive
discontinuation.DHS analytical studies No.20. Calverton. Available at https://cedar.wwu.edu/cgi/
viewcontent.cgi?article=1000&context=fairhaven_facpubs. Accessed on 25 November 2022.
Bradley, S. E., and others (2012). Revising Unmet Need for Family Planning. DHS Analytical Studies No.25.
Calverton, Maryland, USA: ICF International. Available at https://dhsprogram.com/pubs/pdf/
AS25/AS25%5B12June2012%5D.pdf. Accessed on 25 November 2022.
---------- (2019). Global contraceptive failure rates: who is most at risk?Studies in family planning, vol.50,
Issue 1, pp. 3-24. Available at https://doi.org/10.1111/sifp.12085.
Brady, M., and others (2020). Self-care provision of contraception: Evidence and insights from contraceptive
injectable self-administration. Best Practice & Research Clinical Obstetrics & Gynaecology, vol. 66,
pp. 95–106. Available at https://doi.org/10.1016/j.bpobgyn.2020.01.003.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
25
Brown, G.F., (2007). “Tunisia: e Debut of Family Planning”. In e Global Family Planning Revolution,
W.C. Robinson and J.A. Ross, eds. (Washington, D.C., World Bank, 2007). Available at http://hdl.
handle.net/10986/6788.
--------- (2007). “Morocco: First steps in Family Planning”. In e Global Family Planning Revolution, W.C.
Robinson and J.A. Ross, eds. (Washington, D.C., World Bank, 2007). Available at http://hdl.handle.
net/10986/6788.
Channon, M. D. (2015). Son Preference, Parity Progression and Contraceptive Use in South Asia. Population
Horizons, vol. 12, Issue 1, pp. 24–36. Available at https://ageing.ox.ac.uk/download/322.
Foster, D. G., and others (2019). Eects of carrying an unwanted pregnancy to term on women’s existing
children. e Journal of pediatrics, vol. 205, pp. 183-189. Available at https://doi.org/10.1016/j.
jpeds.2018.09.026.
Fuseini, K., and others (2022). Did COVID19 Impact Contraceptive Uptake? Evidence from Senegal.
Studies in Family Planning, sifp.12195. Available at https://doi.org/10.1111/sifp.12195.
Ghosh, S., and A. Chattopadhyay. (2017). Religion, contraceptive method mix, and son preference among
Bengali-speaking community of Indian subcontinent. Population Research and Policy Review,
vol. 36, Issue 6, pp. 929–959. Available at https://doi.org/10.1007/s11113-017-9448-y.
Gipson, J. D., M. A. Koenig, and M. J. Hindin (2008). e eects of unintended pregnancy on infant, child,
and parental health: a review of the literature.Studies in family planning, vol.39, Issue 1, pp. 18-38.
Available at https://doi.org/10.1111/j.1728-4465.2008.00148.x.
Hatcher, R. A. (2011). Contraceptive Technology. New York, NY: Ardent Media.
Haddad, L. B., J. W. Townsend, and R. Sitruk-Ware (2021). Contraceptive Technologies: Looking Ahead
to New Approaches to Increase Options for Family Planning.Clinical Obstetrics and Gynecology,
vol. 64, Issue 3, pp. 435-448. Available at https://doi.org/10.1097/GRF.0000000000000628.
Harkavy, O. and K. Roy, “Emergence of the Indian National Family Planning Program”. in e Global Family
Planning Revolution, W.C. Robinson and J.A. Ross, eds. (Washington, D.C., World Bank, 2007).
Available at http://hdl.handle.net/10986/6788.
Jayaraman, A., V. Mishra, and F. Arnold (2009). e relationship of family size and composition to fertility
desires, contraceptive adoption and method choice in South Asia. International Perspectives
on Sexual and Reproductive Health, vol. 35, Issue 01, pp. 29–38. Available at https://doi.
org/10.1363/3502909.
Kantorová, V., and others (2020). Estimating progress towards meeting women’s contraceptive needs in
185 countries: A Bayesian hierarchical modelling study. PLOS Medicine, vol. 17, Issue 2, e1003026.
Available at https://doi.org/10/ggk3cf.
Karp, C. and others (2021). Contraceptive dynamics during COVID-19 in sub-Saharan Africa: Longitudinal
evidence from Burkina Faso and Kenya. BMJ Sexual & Reproductive Health, vol. 47, Issue 4,
pp. 252–260. Available at https://doi.org/10.1136/bmjsrh-2020-200944.
Logie, C. H. and others (2022). Uptake and provision of self-care interventions for sexual and reproductive
health: Findings from a global values and preferences survey. Sexual and Reproductive Health
Matters, vol. 29, Issue 3, 2009104. Available at https://doi.org/10.1080/26410397.2021.2009104.
Measham, A. R. and G. Lopez-Escobar, “Against the Odds: Colombia’s Role in the Family Planning Revolution”.
In e Global Family Planning Revolution, W.C. Robinson and J.A. Ross, eds. (Washington, D.C.,
World Bank, 2007). Available at http://hdl.handle.net/10986/6788.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
26
Moreau, C., and others (2009). Frequency of discontinuation of contraceptive use: results from a French
population-based cohort.Human Reproduction, vol. 24, Issue 6, pp. 1387-1392. Available at https://
doi.org/10.1093/humrep/dep027.
Mureşan, C.,and others. (2008). Romania: Childbearing metamorphosis within a changing
context. Demographic Research, vol. 19, pp. 855-906.Available at https://demographic-research.org/
volumes/vol19/23/.
Olakunde, and others (2020). Individual- and country-level correlates of female permanent contraception
use in sub-Saharan Africa. PLoS One, vol. 15, Issue 12, e0243316. Available at https://doi.org/10.1371/
journal.pone.0243316.
Ontiri, S., and others (2020). Patterns and determinants of modern contraceptive discontinuation among
women of reproductive age: Analysis of Kenya Demographic Health Surveys, 2003–2014.PloS One,
vol.15, Issue, 11, e0241605. Available at https://doi.org/10.1371/journal.pone.0241605.
Pasha, O, and others (2015). Postpartum contraceptive use and unmet need for family planning in ve
low-income countries. Reproductive health, vol. 12, Issue, 2, pp. 1-7. Available at https://doi.
org/10.1186/1742-4755-12-S2-S11.
Polis, C. B., and others (2022). Impacts of COVID-19 on contraceptive and abortion services in low- and
middle-income countries: A scoping review. Sexual and Reproductive Health Matters, vol. 30, Issue
1, 2098557. Available at https://doi.org/10.1080/26410397.2022.2098557.
Polis, C. B., and others (2016). Typical-use contraceptive failure rates in 43 countries with Demographic
and Health Survey data: Summary of a detailed report. Contraception, vol. 94, Issue 1, pp. 11–17.
Available at https://doi.org/10.1016/j.contraception.2016.03.011.
Robinson, W.C. and F. El-Zanaty, F, “e Evolution of Population Policies and Programs in the Arab
Republic of Egypt”. In e Global Family Planning Revolution, W.C. Robinson and J.A. Ross, eds.
(Washington, D.C., World Bank, 2007). Available at http://hdl.handle.net/10986/6788.
Roseneld, A.G. and C.J. Min, “e Emergence of ailand’s National Family Planning Program”. In e
Global Family Planning Revolution, W.C. Robinson and J.A. Ross, eds. (Washington, D.C., World
Bank, 2007). Available at http://hdl.handle.net/10986/6788.
Ross, J., J. Keesbury, and K. Hardee (2015). Trends in the Contraceptive Method Mix in Low- and Middle-
Income Countries: Analysis Using a New “Average Deviation” Measure. Global Health: Science and
Practice, vol. 3, Issue 1, pp. 34–55. Available at https://doi.org/10.9745/GHSP-D-14-00199.
Sedekia, Y., and others (2017). Using contraceptives to delay rst birth: A qualitative study of individual,
community and health provider perceptions in southern Tanzania. BMC Public Health, vol. 17,
Issue 1, pp. 1-13. Available at https://doi.org/10.1186/s12889-017-4759-9.
Seiber, E. E., J. T. Bertrand, and T. M. Sullivan. (2007). Changes in Contraceptive Method Mix in Developing
Countries. International Family Planning Perspectives, vol. 33, Issue 3, pp. 117–123. Available at
https://doi.org/10.1363/3311707.
Seltzer, J.R. (2002). e Origins and Evolution of Family Planning Programs in Developing Countries. RAND
Corporation. Available at https://jstor.org/stable/10.7249/mr1276wf-dlpf-rf. Accessed on 25th
November 2022.
Staveteig, S., L. Mallick, and R. Winter (2015). Uptake and discontinuation of long-acting reversible
contraceptives (LARCs) in low-income countries.DHS analytical studies No. 54. Rockville. Available
at https://dhsprogram.com/pubs/pdf/AS54/AS54.pdf. Accessed on 25th November 2022.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
27
Tsui, A. O., W. Brown, and Q. Li (2017). Contraceptive Practice in Sub-Saharan Africa. Population and
development review, vol. 43(Suppl.1), pp. 166-191. Available at https://onlinelibrary.wiley.com/
doi/10.1111/padr.12051.
United Nations Population Fund (UNFPA) (2022). Seeing the unseen: e case for action in the neglected
crisis of unintended pregnancy. State of the World Population 2022. New York. Available at https://
unfpa.org/swp2022.
United Nations Department of Economic and Social Aairs, Population Division (2022a). World Population
Prospects 2022.
--------- (2022b). World Contraceptive Use 2022 (POP/DB/CP/REV2022).
--------- (2022c). Estimates and Projections of Family Planning Indicators 2022.
--------- (2022d). Estimates and Projections of Women of Reproductive Age Who Are Married or in a Union
2022.
--------- (2020a). World fertility and Family Planning 2020. Highlights (ST/ESA/SER.A/440).
--------- (2020b). World Family Planning 2020: Highlights: Accelerating action to ensure universal access to
family planning (ST/ESA/SER.A/450).
--------- (2019). Contraceptive Use by Method 2019: Data Booklet (ST/ESA/SER.A/435).
United Nations. (1994). Programme of Action of the International Conference on Population and Development.
A/CONF.171/13.
VanBenschoten, H., and others (2022). Impact of the COVID-19 pandemic on access to and utilisation of
services for sexual and reproductive health: A scoping review. BMJ Global Health, vol. 7, Issue 10,
e009594. Available at https://doi.org/10.1136/bmjgh-2022-009594.
Van Lith, L. M., M. Yahner, and L. Bakamjian (2013). Women’s growing desire to limit births in sub-Saharan
Africa: meeting the challenge. Global Health: Science and Practice, vol.1, Issue 1, pp. 97-107.Available
at https://doi.org/10.9745/GHSP-D-12-00036.
Wang, C. (2012). History of the Chinese Family Planning program: 1970–2010. Contraception, vol. 85, Issue
6, pp. 563-569.Available at https://doi.org/10.1016/j.contraception.2011.10.013.
Wood, S. N., Karp, and others (2021). Need for and use of contraception by women before and during
COVID-19 in four sub-Saharan African geographies: Results from population-based national or
regional cohort surveys. e Lancet Global Health, vol. 9, Issue 6, pp. e793–e801. Available at https://
doi.org/10.1016/S2214-109X(21)00105-4.
World Health Organization (2022). WHO issues new guidelines on abortion to help countries deliver lifesaving
care. Departmental news: 2022. Available at https://who.int/news/item/09-03-2022-access-to-safe-
abortion-critical-for-health-of-women-and-girls. Accessed on 25th November 2022.
World Health Organization and Johns Hopkins Bloomberg School of Public Health (2022). Family Planning:
A Global Handbook for Providers. Baltimore and Geneva: CCP and WHO; 2022. www.fphandbook.org.
World Family Planning 2022
United Nations Department of Economic and Social Aairs, Population Division
28
Contraception assists individuals and couples to achieve their reproductive goals and enables
them to exercise the right to have children by choice. World Family Planning 2022 presents the
latest trends and patterns in contraceptive use at the global, regional and national level. The report
assesses levels and trends in contraceptive use and needs of women of reproductive age
between 1990 and 2021, including the proportion of women of reproductive age (aged 15-49
years) who have their need for family planning satisfied with modern methods of contraception
(SDG indicator 3.7.1). It presents trends in contraceptive use by type of method, including
regional variations in the use of specific methods. The report also examines how contraceptive
use and needs vary by women’s age and highlights gaps in meeting the need for family planning
among adolescents and young women.
ISBN 978-92-1-148376-5
