Contraceptive Knowledge and Use

The current generation of young people in the developing world is the first to grow up with nearly universal knowledge of modern contraceptive methods, at least partly as a result of the efforts of organized family planning programs. DHS data show that, in the vast majority of surveys conducted in the last five years or so, more than 9 in 10 women ages 15-24 know about at least one contraceptive method and most know more than one (ORC Macro, 2004).

The use of contraception among young people has also been increasing. In the last 20 years, there has been a substantial improvement in overall access to family planning services of reasonable quality; it is not known the extent to which young people, particularly those who are unmarried, have experienced the same increase in access. Figures 4-6a through 4-6d show how the use of contraceptive methods among women ages 15-19 changed over roughly the last decade in developing countries in which comparable DHS surveys were conducted. Some increase in contraceptive use is evident in most countries, whatever the initial level of contraceptive prevalence. Increases tend to be smaller in surveys in sub-Saharan Africa, whereas some countries in Latin America, for example, Colombia and Bolivia, have seen a very rapid rise in contraception in this age group. Among North African and Middle Eastern and Asian countries, survey data are available only for married women. With the exception of India and the Philippines, these countries also demonstrate substantial increases in contraceptive use during the 1990s.

Levels of contraceptive use are still quite low among younger females; regional averages range from 4 to 10 percent of 15-19-year-olds (Table 4-8). This is partly because of lower levels of sexual activity among the unmarried women. Indeed, when one considers only sexually active females, the proportion using contraception at ages 15-19 doubles or triples in the regions with data. Among the never married sexually active women, prevalence rates are still higher, reaching 38 percent in South America. The use of contraception is much higher among women in their early 20s than among young people. The regional averages for Eastern and Southern Africa and Latin America and the Caribbean are around 24 percent, with higher levels of use in the former Soviet Asia and lower levels in Western and Middle Africa. In broad terms, contraceptive use increases as income level increases, although there are only two countries in the upper middle-income category, so it is not possible to draw firm conclusions.

Within regions, there are large differentials in contraceptive use by level of education (Table 4-9). These differentials are largest in sub-Saharan Africa, where contraceptive use among sexually active 20-24-year-olds with secondary or higher education is 4-5 times that among those with no educa-



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