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ORIGINAL ARTICLE
Open Access

Women's Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015

Benjamin Nieto-Andrade, Eva Fidel, Rebecca Simmons, Dana Sievers, Anya Fedorova, Suzanne Bell, Karen Weidert and Ndola Prata
Global Health: Science and Practice March 2017, 5(1):75-89; https://doi.org/10.9745/GHSP-D-16-00304
Benjamin Nieto-Andrade
aPopulation Services International/Angola, Luanda, Angola.
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  • For correspondence: benjamin@psiangola.org
Eva Fidel
aPopulation Services International/Angola, Luanda, Angola.
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Rebecca Simmons
bInstitute for Reproductive Health at Georgetown University, Washington, DC, USA.
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Dana Sievers
cPopulation Services International, Washington, DC, USA.
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Anya Fedorova
aPopulation Services International/Angola, Luanda, Angola.
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Suzanne Bell
dJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Karen Weidert
eBixby Center for Population, Health, and Sustainability, University of California, Berkeley, Berkeley, CA, USA.
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Ndola Prata
eBixby Center for Population, Health, and Sustainability, University of California, Berkeley, Berkeley, CA, USA.
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    TABLE 1.

    Demographic and Behavioral Characteristics of Women of Reproductive Age in Luanda, Angola, 2012

    VariablesAge Groups
    15–19 (N=451)20–24 (N=361)≥25 (N=729)All (N=1545)
    Sociodemographics
    Age, medianNANANA24.0
    Marital status
        Single98.281.739.466.5
        Married/cohabiting1.818.356.031.3
        Divorced/widowed0.00.04.12.2
    Education
        High school or less55.328.845.344.4
        More than high school44.771.254.755.6
    Sexual Behavior and Fertility Preferences
    Ever had sex55.090.991.480.6
    Ever been pregnant11.549.990.457.9
    Intention to get pregnant at last pregnancya
        Wanted it at that moment17.327.857.749.3
        Wanted it later53.856.128.135.2
        Did not want more children28.816.114.315.5
    Ideal number of children, meanb3.83.74.34.2
    Knowledge of modern contraceptives
        Condoms96.795.693.795.0
        Oral contraceptive pills68.984.287.479.7
        Injectable47.265.784.168.9
        Female condoms34.242.154.745.6
        IUD19.136.354.239.6
        Implants18.235.752.738.6
        Female sterilization14.626.639.429.1
        Emergency oral contraceptive pills10.321.632.823.5
        Male sterilization5.312.522.215.0
    Contraceptive Usec
    Current prevalence of any modern contraception58.564.955.958.7
    Current prevalence of:
        Condoms52.046.017.732.1
        Injectables2.06.118.812.1
        Oral contraceptive pills3.211.014.111.1
        Implants0.41.52.61.9
        IUD0.00.01.40.7
        Female sterilization0.80.00.80.6
        Female condoms0.00.30.60.4
        Male sterilization0.00.00.00.0
    Ever used emergency contraceptive pillsd1.16.45.84.5
    Current contraceptive users not using their preferred methode15.120.716.017.3
    Preferred contraceptive method among women not using their preferred methodf
        Injectables13.625.031.025.6
        Condom31.822.78.617.6
        Implants13.64.627.616.8
        Oral contraceptive pills4.613.612.112.0
        Rhythm method4.60.01.71.6
        Female condom4.60.00.00.8
        Female sterilization0.00.01.70.8
        None13.620.50.09.6
        Other13.613.617.215.2
    • Abbreviation: IUD, intrauterine device.

    • All data are reported as percentages unless otherwise noted.

    • ↵a Among women ever pregnant (N=52 among 15–19-year-olds; N=180 among 20–24-year-olds; N=659 among ≥25-year-olds; and N=891 among the entire sample of women).

    • ↵b Among women who have given birth (N=25 among 15–19-year-olds; N=128 among 20–24-year-olds; N=608 among ≥25-year-olds; and N=764 among the entire sample of women).

    • ↵c Among women who have had sex (N=248 among 15–19-year-olds; N=328 among 20–24-year-olds; N=666 among ≥25-year-olds; and N=1245 among the entire sample of women).

    • ↵d The survey did not explicitly include emergency contraceptive pills as an option for current method but included a question on ever use of emergency contraceptive pills.

    • ↵e Among fecund women who have had sex and who are currently using contraception (N=146 among 15–19-year-olds; N=213 among 20–24-year-olds; N=363 among ≥25-year-olds; and N=722 among the entire sample of women).

    • ↵f N=22 among 15–19-year-olds; N=44 among 20–24-year-olds; N=58 among ≥25-year-olds; and N=125 among the entire sample of women.

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    TABLE 2.

    Availability of Contraceptive Methods by Sector, Luanda, Angola, 2014–2015

    MethodPrivate SectorPublic SectorTotal
    2014 (N=1782)2015 (N=739)Difference2014 (N=51)2015 (N=27)Difference2014 (N=1833)2015 (N=766)Difference
    Any methoda97.686.9−10.7***84.359.3−25.0*97.285.9−11.3***
    Male condom82.375.1−7.3***49.033.3−15.781.473.6−7.8***
    Oral contraceptive pillsb58.743.8−14.9***54.129.6−24.5*58.643.3−15.3***
    Emergency contraceptive pillsb43.335.8−7.5**11.811.1−0.742.434.4−7.5**
    Injectablesb13.16.6−7.56.5***19.618.5−1.113.37.3−6.0***
    • All data for 2014 and 2015 reported as percentages; the differences between 2014 and 2015 are percentage points.

    • ↵*P<.05;

    • ↵** P<.01;

    • ↵*** P<.001.

    • ↵a Any method includes at least one of the following: condoms, oral contraceptive pills, emergency contraceptive pills, injectable methods, hormonal patches, spermicides, intrauterine devices (IUDs), mini-mola or Essure (a non-surgical permanent method for women), and Vasalgel (a long-acting gel similar to no-scalpel vasectomy but likely more reversible). Less than 5% of the outlets overall reported having hormonal patches, female condoms, spermicides, IUDs, vaginal rings, or implants. Only 0.1% reported providing mini-mola or Essure or Vasalgel.

    • ↵b Gas stations, hotels, and bars were not included in the calculation of oral contraceptive pills, emergency contraceptive pills, or injectable availability, since those outlets mainly distribute or sell condoms.

    • View popup
    TABLE 3.

    Brand Market Share by Type of Contraceptive Among Outlets Selling the Respective Contraceptive Method, Luanda, Angola, 2015

    Contraceptive Method and Brand% Outlets Offering the BrandUnits Sold Last Montha% UnitsValue (AKZ) Sold
    Last Month
    % Value
    Condoms (N=635 outlets)
    Sensual51.817,71622.81,295,65025.6
    Legal37.317,09222.0845,00016.7
    Davigra15.612,10315.6535,53010.6
    Boss Man11.83,1534.1176,2403.5
    Kamasutra9.62,1932.86,3000.1
    Control6.04,7116.1611,99412.1
    Durex3.38,57611.0948,36518.7
    Generic1.37,5279.7293,1505.8
    Other brands (+40)<5.0 each4,5575.9358,7957.1
    Total for condomsNA77,628100.05,071,024100.0
    Oral contraceptive pills (N=357 outlets)
    Microgynon76.62,88566.01,058,30340.6
    Microlut27.745710.4141,3945.4
    Yasmin8.62345.3434,36616.4
    Diane 357.81082.5167,4426.4
    Other brands (+10)b<5.0 each69015.8802,64231.2
    Total for oral contraceptive pillsNA4,374100.02,604,147100.0
    Emergency contraceptive pills (N=255 outlets)
    Pilula S45.41,06438.4656,10022.7
    Ella24.359521.5554,20019.1
    IPL7220.446316.7330,70011.4
    Norlevo14.160.21,086,70737.5
    Other brands (7)c<5.0 each64323.2266,5189.3
    Total for emergency contraceptive pillsNA2,771100.02,894,225100.0
    Injectables (N=54 outlets)
    Depo-provera83.326097.721,70094.1
    Mesignya1.9n/an/an/an/a
    Other brands<1.0 each62.31,3605.9
    Total for injectablesNA266100.023,060100.0
    • Abbreviation: AKZ, Angolan Kwanzas.

    • ↵a Units are individual condoms for condoms; cycles for oral contraceptive pills; packs for emergency contraceptive pills; and individual units for injectables.

    • ↵b Other brands of oral contraceptive pills included Cezarette, Climen, Ella, Gynera, Marvelon, Minygesty, etc.

    • ↵c Other brands of emergency contraceptive pills included CO-Pill, Plan Fam, Levo 72, etc.

    • View popup
    TABLE 4.

    Mean Price (Angolan Kwanzas)a for Main Brands of Contraceptives, Luanda, Angola, 2014–2015

    Method and Brand [No. of outlets selling the method in 2014, 2015]Mean Price per Unitb (95% CI)% Change
    20142015
    Condoms
    Sensual [N=697; N=359]69.5 (44.3, 72.7)73.4 (71.2, 75.6)+5.6%
    Legal [N=529; N=237]36.1 (33.2, 39.0)46.8 (42.8, 50.8)+29.8%̂
    Davigra [N=267; N=99]59.5 (55.5, 63.5)58.9 (45.0, 72.7)−1.0%
    Durex [N=57; N=21]119.3 (90.8, 147.8)200.9 (145.1, 256.8)+68.4%
    Boss Man [N=264; N=71]54.1 (51.2, 57.0)60.4 (55.7, 65.2)+11.7%
    Oral contraceptive pills
    Microgynon [N=840; N=261]238.8 (231.7, 245.9)498.5 (448.3, 548.8)+108.8%̂
    Microlut [N=365; N=82]278.8 (264.5, 293.2)394.8 (346.0, 443.6)+41.6%̂
    Yasmin [N=51; N=43]705.5 (651.8, 759.3)2300.2 (2017.5, 2583.0)+226.0%̂
    Diane 35 [N=69; N=22]1068.5 (952.9, 1184.0)1830.7 (1200.3, 2461.1)+71.3%̂
    Emergency contraceptive pills
    Pilula S [N=325; N=108]453.4 (427.3, 479.5)579.2 (536.0, 622.4)+27.7%̂
    Ella [N=225; N=63]699.3 (657.5, 741.1)959.0 (659.5, 1258.6)+37.1%̂
    IPL72 [N=113; N=46]509.6 (456.0, 563.3)700.5 (602.8, 798.2)+37.5%̂
    Norlevo [N=109; N=30]2026.9 (1814.3, 2239.4)2950.9 (2502.3, 3399.6)+45.6%^
    Injectables
    Depo-provera [N=213; N=45]351.0 (321.0, 281.1)482.2 (323.0, 641.5)+37.4%^
    • ̂ Indicates significant changes based on 95% confidence intervals not overlapping between 2014 and 2015.

    • ↵a Prices reflect mostly the private sector. According to the National Health Care System, the public sector must offer health services and medicines for free. The exchange rate as of October 30, 2014, was 99 Angolan Kwanzas for US$1.26

    • ↵b Units are individual condoms for condoms; cycles for oral contraceptive pills; packs for emergency contraceptive pills; and individual units for injectables.

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Women's Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015
Benjamin Nieto-Andrade, Eva Fidel, Rebecca Simmons, Dana Sievers, Anya Fedorova, Suzanne Bell, Karen Weidert, Ndola Prata
Global Health: Science and Practice Mar 2017, 5 (1) 75-89; DOI: 10.9745/GHSP-D-16-00304

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Women's Limited Choice and Availability of Modern Contraception at Retail Outlets and Public-Sector Facilities in Luanda, Angola, 2012–2015
Benjamin Nieto-Andrade, Eva Fidel, Rebecca Simmons, Dana Sievers, Anya Fedorova, Suzanne Bell, Karen Weidert, Ndola Prata
Global Health: Science and Practice Mar 2017, 5 (1) 75-89; DOI: 10.9745/GHSP-D-16-00304
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