Skip to main content

Main menu

  • Home
  • Issues
    • Current Issue
    • Advance Access
    • Archive
    • Supplements
    • COVID-19 Articles
    • Topic Collections
  • For Authors
    • Instructions for Authors
    • Submit Manuscript
  • About
    • About GHSP
    • Editorial Team
    • Editorial Board
    • FAQs
    • Instructions for Reviewers
  • Sign up for Alerts
  • Webinars
    • Local Voices Webinar
    • Connecting Creators and Users of Knowledge
    • Publishing About Programs in GHSP
  • News
    • GHSP Call for Papers
  • Other Useful Sites
    • GH eLearning
    • GHJournal Search

User menu

  • My Alerts

Search

  • Advanced search
Global Health: Science and Practice
  • Other Useful Sites
    • GH eLearning
    • GHJournal Search
  • My Alerts

Global Health: Science and Practice

Dedicated to what works in global health programs

Advanced Search

  • Home
  • Issues
    • Current Issue
    • Advance Access
    • Archive
    • Supplements
    • COVID-19 Articles
    • Topic Collections
  • For Authors
    • Instructions for Authors
    • Submit Manuscript
  • About
    • About GHSP
    • Editorial Team
    • Editorial Board
    • FAQs
    • Instructions for Reviewers
  • Sign up for Alerts
  • Webinars
    • Local Voices Webinar
    • Connecting Creators and Users of Knowledge
    • Publishing About Programs in GHSP
  • News
    • GHSP Call for Papers
  • Visit GHSP on Facebook
  • Follow GHSP on Twitter
  • RSS
  • Find GHSP on LinkedIn
ORIGINAL ARTICLE
Open Access

Contraceptive Method Mix: Updates and Implications

Jane T. Bertrand, John Ross, Tara M. Sullivan, Karen Hardee and James D. Shelton
Global Health: Science and Practice December 2020, 8(4):666-679; https://doi.org/10.9745/GHSP-D-20-00229
Jane T. Bertrand
aTulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: bertrand@tulane.edu
John Ross
bIndependent consultant, New Paltz, NY, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tara M. Sullivan
cKnowledge Management Programs, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Karen Hardee
dWhat Works Association, Arlington, VA, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James D. Shelton
eIndependent consultant, Boyds, MD, USA.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
PreviousNext
  • Article
  • Figures & Tables
  • Supplements
  • Info & Metrics
  • Comments
  • PDF
Loading

Key Messages

  • Contraceptive method mix reflects both supply and demand.

  • Recent trends include a progression in hormonal methods toward implants in sub-Saharan Africa, and where HIV is common, more condom use in some countries.

  • However, dominance of 1 method in the mix remains very common, though countries and regions throughout the world are diverse as to which method is dominant.

  • Our analysis argues for continued concerted efforts of programs to increase contraceptive method choice.

  • There is no ideal method mix; client preferences are key. 

ABSTRACT

Context:

Improving contraceptive method choice is a goal of international family planning. Method mix—the percentage distribution of total contraceptive use across various methods—reflects both supply (availability of affordable methods) and demand (client preferences). We analyze changes in method mix, regional contrasts, and the relationship of the mix to contraceptive prevalence.

Methods:

We use 789 national surveys from the 1960s through 2019, from 113 developing countries with at least 1 million people and with data on use of 8 contraceptive methods. Two measures assess the “evenness” of the mix: method skew (more than 50% use is by 1 method), and the average deviation (AD) of the 8 methods’ shares from their mean value. Population weighted and unweighted results are compared because they can differ substantially.

Results:

Use of traditional methods has declined but still represents 11% of all use (population weighted) or 17% (unweighted country average). Vasectomy’s share was historically low with the exception of a few countries but is now even lower. The previous trend toward greater overall evenness in the mix has slowed recently. Sub-Saharan Africa shows a hormonal method progression from oral contraceptives to injectables to implants in a substantial number of countries. In some countries with high HIV prevalence, the condom share has increased. The leading method’s share differs by region: female sterilization in Asia (39%) and in Latin America (31%), the pill in the Middle East/North Africa (32%), and the injectable in sub-Saharan Africa (36%). Method skew persists in 30% of countries. “Evenness” of mix is not related to contraceptive prevalence.

Conclusion:

The marked diversity in predominant methods underscores the conclusion that no single method mix is ideal or appropriate everywhere. But that diversity across countries, coupled with the persisting high degree of extreme skewness in many of them, argues for continued concerted efforts for programs to increase method choice.

Footnotes

  • Received: May 20, 2020.
  • Accepted: September 22, 2020.
  • Published: December 23, 2020.
  • © Bertrand et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit http://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-20-00229

View Full Text
PreviousNext
Back to top

In this issue

Global Health: Science and Practice: 8 (4)
Global Health: Science and Practice
Vol. 8, No. 4
December 23, 2020
  • Table of Contents
  • About the Cover
  • Index by Author
  • Complete Issue (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Global Health: Science and Practice.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Contraceptive Method Mix: Updates and Implications
(Your Name) has forwarded a page to you from Global Health: Science and Practice
(Your Name) thought you would like to see this page from the Global Health: Science and Practice web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Contraceptive Method Mix: Updates and Implications
Jane T. Bertrand, John Ross, Tara M. Sullivan, Karen Hardee, James D. Shelton
Global Health: Science and Practice Dec 2020, 8 (4) 666-679; DOI: 10.9745/GHSP-D-20-00229

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Contraceptive Method Mix: Updates and Implications
Jane T. Bertrand, John Ross, Tara M. Sullivan, Karen Hardee, James D. Shelton
Global Health: Science and Practice Dec 2020, 8 (4) 666-679; DOI: 10.9745/GHSP-D-20-00229
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Statistics from Altmetric.com

Jump to section

  • Article
    • ABSTRACT
    • INTRODUCTION
    • DATA AND METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSION
    • Acknowledgments
    • Footnotes
    • Notes
    • REFERENCES
  • Figures & Tables
  • Supplements
  • Info & Metrics
  • Comments
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Behavioral Determinants of Routine Health Information System Data Use in Senegal: A Qualitative Inquiry Based on the Integrated Behavioral Model
  • The Know-Do Gap: Understanding and Improving Service Quality Among Pharmacies Providing Injectable Contraceptives Through a Mystery Client Study in Nepal
  • Lessons Learned From the Use of the Most Significant Change Technique for Adaptive Management of Complex Health Interventions
Show more ORIGINAL ARTICLE

Similar Articles

Subjects

  • Health Topics
    • Family Planning and Reproductive Health
US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

Follow Us On

  • Twitter
  • Facebook
  • LinkedIn
  • RSS

Articles

  • Current Issue
  • Advance Access Articles
  • Past Issues
  • Topic Collections
  • Most Read Articles
  • Supplements

More Information

  • Submit a Paper
  • Instructions for Authors
  • Instructions for Reviewers
  • GH Journals Database

About

  • About GHSP
  • Editorial Board
  • FAQs
  • Contact Us
  • Privacy Policy

© 2022 Creative Commons Attribution 4.0 International License. ISSN: 2169-575X

Powered by HighWire