BACKGROUND: Unintended pregnancies continue to burden many countries in sub-Saharan Africa. Our aim was to estimate the number of unintended pregnancies in the region and model the impact of expanding use of contraceptive implants at the expense of short-term hormonal birth control methods. STUDY DESIGN: For the 42 countries in mainland sub-Saharan Africa, we estimated current levels of unintended pregnancy, prevalence of hormonal contraceptive use and number of unintended pregnancies stemming from early discontinuation and typical method failure rates. Using a decision-analytic model, we estimated the potential impact of more widespread use of the contraceptive implant. RESULTS: Every year in sub-Saharan Africa, approximately 14 million unintended pregnancies occur and a sizeable proportion is due to poor use of short-term hormonal methods. If 20% of the 17.6 million women using oral contraceptives or injectables wanted long-term protection and switched to the contraceptive implant, over 1.8 million unintended pregnancies could be averted over a 5-year period. CONCLUSION: Poor patterns of short-term hormonal contraceptive use (high discontinuation rates and incorrect use) contribute significantly to the problem of unintended pregnancy in sub-Saharan Africa. More availability and widespread use of highly effective methods, such as the contraceptive implant, will improve reproductive health in the region.
BACKGROUND: Unintended pregnancies continue to burden many countries in sub-Saharan Africa. Our aim was to estimate the number of unintended pregnancies in the region and model the impact of expanding use of contraceptive implants at the expense of short-term hormonal birth control methods. STUDY DESIGN: For the 42 countries in mainland sub-Saharan Africa, we estimated current levels of unintended pregnancy, prevalence of hormonal contraceptive use and number of unintended pregnancies stemming from early discontinuation and typical method failure rates. Using a decision-analytic model, we estimated the potential impact of more widespread use of the contraceptive implant. RESULTS: Every year in sub-Saharan Africa, approximately 14 million unintended pregnancies occur and a sizeable proportion is due to poor use of short-term hormonal methods. If 20% of the 17.6 million women using oral contraceptives or injectables wanted long-term protection and switched to the contraceptive implant, over 1.8 million unintended pregnancies could be averted over a 5-year period. CONCLUSION: Poor patterns of short-term hormonal contraceptive use (high discontinuation rates and incorrect use) contribute significantly to the problem of unintended pregnancy in sub-Saharan Africa. More availability and widespread use of highly effective methods, such as the contraceptive implant, will improve reproductive health in the region.
Authors: Owain Roberts; Rajith K R Rajoli; David J Back; Andrew Owen; Kristin M Darin; Courtney V Fletcher; Mohammed Lamorde; Kimberly K Scarsi; Marco Siccardi Journal: J Antimicrob Chemother Date: 2018-04-01 Impact factor: 5.790
Authors: Kathryn E Lancaster; Cynthia Kwok; Anne Rinaldi; Josaphat Byamugisha; Tulani Magwali; Prisca Nyamapfeni; Robert A Salata; Charles S Morrison Journal: Int J Gynaecol Obstet Date: 2015-09-08 Impact factor: 3.561
Authors: Rasmané Ganaba; Tom Marshall; Issiaka Sombié; Rebecca F Baggaley; Thomas W Ouédraogo; Véronique Filippi Journal: Reprod Health Date: 2010-08-27 Impact factor: 3.223