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

doi:10.9745/GHSP-D-16-00304

Despite high rates of unintended pregnancy, access to a wide range of contraceptive methods, especially injectables and long-acting reversible contraceptives (LARCs), is severely limited in both public and private facilities. Knowledge of contraceptive choices is likewise limited, yet a substantial proportion of women are not using their preferred method among the methods they know of.

ABSTRACT

In Angola, many women want to use family planning but lack access to affordable and preferred methods. This article assesses the link between women’s choice and availability of contraceptive methods in Luanda, Angola, drawing on data from 3 surveys: a 2012 survey among women ages 15–49 and 2 retail surveys conducted in 2014 and 2015 among outlets and facilities offering contraceptive methods. Descriptive statistics for women’s contraceptive knowledge, use, and preferred methods were stratified by age group. We report the percentage of establishments offering different methods and brands of modern contraception, and the mean price, volume of units sold, and value (Angolan Kwanzas) for each brand. Data from the 2 retail surveys are compared to measure changes in availability over time. Results show that 51% of women reported having an unwanted pregnancy. Less than 40% of women knew about long-acting reversible contraceptives (LARCs). Overall, the method most commonly used was male condoms (32.1%), with a substantial proportion (17.3%) of women not using their preferred contraceptive. Trends in contraceptive use mirror availability: in 2015, condoms were available in 73.6% of outlets/facilities, while LARC methods were available in less than 10%. The availability of different methods also dropped significantly between 2014 and 2015—by up to 15 percentage points—with a subsequent price increase in many brands. To meet women’s needs for contraception and make informed choice possible, Angola should reinforce demand creation and contraceptive supply in both the public and private sectors through behavior change programs aimed at both women and providers, improved quality of services, training of health personnel on method options and delivery, and improved supply chain distribution of contraceptives. This will allow women to find the methods and brands that best suit their needs, preferences, and ability to pay.

Received: 2016 Sep 28.
Accepted: 2016 Nov 29.

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