Post on 27-Jul-2018
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Why women use unreliable methods of contracep6on-‐ the issue in Asia-‐Pacific
region ?
• Surasak Taneepanichskul MD. MPH, FRTCOG, LL.B
• Professor and Dean College of Public Health Sciences • Chulalongkorn University, Bangkok, Thailand
The world’s populaHon has increased dramaHcally in the past century
Population (in billions)
Year
1900
2000
2050 (Projected)
ContracepHves Use in
Asia Pacific Region
MODERN METHODS MATTER
Most women who want to avoid pregnancy use a modern method of birth
control; however, the relatively small group who do not account for more than eight in 10 of the 75
million unintended pregnancies worldwide
each year.
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45 55 55
16 24 29 31
50 49 58 57
68
38
50 52
37 39 49 46
76
63
45
0
20
40
60
80 Mother Health Status
More than one-‐third of pregnancies in developing countries are unintended
Induced abortions
Spontaneous abortions (miscarriages)
Wanted births
Unwanted or mistimed births
Outcomes of all pregnancies in developing countries
Most unintended pregnancies occur among women who were not using any contracepHve
Modern method
No method Traditional
method
Unintended pregnancies in developing countries, by women’s contraceptive use
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0
5
10
15
20
25
30
1975 1985 1995 2005
Year
Bangladesh
India
Maldives
Nepal Indonesia
Myanmar
Bhutan
Timor-Leste Sri Lanka
DPR Korea
Thailand
Unmet Need
in
ContracepHon
What is unmet need?
• Women have an unmet need if they
– are sexually acHve
– do not want to have a child soon or at all
– are not using any contracepHve method
– are able to conceive
Who has unmet need?
• FiQeen percent of married women in developing countries: – 24% in Sub-‐Saharan Africa – 11% in South and Southeast Asia – 10% in North Africa and West Asia
– 12% in LaHn America and the Caribbean
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The big picture
• Levels of unmet need are higher in some regions, countries and populaHon groups than in others
• In absolute numbers, unmet need is concentrated in South and Southeast Asia, the most populous regions
More than 100 million married women have an unmet need for contracepHon
Number (in millions) and % distribution of married women with unmet need
60 (56%)
29 (27%)
7 (7%)
9 (8%) 3 (3%)
Unmet need among married women
% of married women aged 15–49 with unmet need
The overall demand for contracepHon is increasing
% of married women aged 15–49
Latin America & Caribbean
North Africa & West Asia
South & Southeast Asia
Sub-Saharan Africa
The level of unmet need among married women varies widely within regions (1)
Latin America & Caribbean
Central Asia
% of married women aged 15–49 with unmet need
The level of unmet need among married women varies widely within regions (2)
South & Southeast
Asia
North Africa & West Asia
% of married women aged 15–49 with unmet need
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Among married women, the youngest are the most likely to have an unmet need
% of married women with unmet need
Unmet need is usually higher in rural areas
% of married women aged 15–49 with unmet need
Reasons Women Do Not Use or Use Unreliable ContracepHves
(Married Women)
Reasons can be grouped into a few broad categories
• Opposi6on to family planning
• Lack of knowledge
• Access and cost
• Health concerns and side effects of methods
• Misconcep6ons about pregnancy risk
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OpposiHon to family planning is moderate
% opposing, among married women aged 15–49 with unmet need
Latin America & Caribbean
North Africa & West Asia
South & Southeast Asia
Lack of knowledge about contracepHon is uncommon
% with no knowledge among married women aged 15–49 with unmet need
Latin America & Caribbean
North Africa & West Asia
South & Southeast Asia
Problems with access and cost of contracepHon are also uncommon
% citing problems among married women aged 15–49 with unmet need
Latin America & Caribbean
North Africa & West Asia
South & Southeast Asia
Concerns about health and side effects of methods are very common
% citing concerns among married women aged 15–49 with unmet need
Latin America & Caribbean
North Africa & West Asia
South & Southeast Asia
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% with misperceptions among married women aged 15–49 with unmet need
Substantial proportions have misperceptions about pregnancy
Latin America & Caribbean
North Africa & West Asia
South & Southeast Asia
The importance of some reasons has changed over Hme
% of married women aged 15–49 with unmet need
1986–1989 2002–2005
Most women with unmet need intend to use a method in the future
% of women who intend to use a method
How to solve these problems
RecommendaHons for unmet need:
• Special a\enHon should be given to populaHons in which the gap between ferHlity desires and contracepHve pracHce
RecommendaHons: Address Health and Side Effects
• To be effecHve, programs must include counseling and educaHon to help women disentangle fact from ficHon regarding health concerns and side effects of methods
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RecommendaHons: Provide ContracepHve OpHons
• It is important to ensure that women have as many contracepHve opHons as possible, to help them find a method that most closely matches their needs—for example, for a temporary or permanent method of contracepHon, or for a hormonal or barrier method—and their tolerance for side effects
RecommendaHons: Improve ContracepHve Technology
• Developing new methods and otherwise improving contracepHve technologies would make it easier for women and their partners to avoid unwanted pregnancies
RecommendaHons: Educate Women About Risk
• Women who do not seek contracepHve services because they do not believe they are at risk of ge`ng pregnant require informaHon through outreach efforts beyond a clinical se`ng.
RecommendaHons: Reduce Societal Barriers
• Efforts to promote societal acceptance of contracepHve use can help women overcome the cultural and social barriers to using contracepHves and achieving their desired family size.
Conclusion
* More women in Asia Pacific Region use unreliable
contracep6on par6cularly in developing countries
* Unmet need is the obstacle of using modern
contracep6ves
Conclusion
• Opposi6on to family planning , lack of knowledge
access and cost of services, health concerns and side
effects of methods ,
misconcep6ons about pregnancy risk,
belief, religious, and culture are reasons of using
unreliable contracep6on.