Contraception usage is a crucial element in global health. With emphasis on birth control methods, we tend to think less about access to family planning health services more broadly.
Contraception, or birth control, is a way of preventing unwanted pregnancies. Birth control methods typically act on the hormones in the body and adjust the environment in the uterus. There are many categories of contraception including hormonal, physical barriers, and long lasting. While some methods prevent pregnancy, not all will prevent sexually transmitted infections (STIs).
Oral contraceptives, commonly referred to as the pill, have been in circulation since the 1960s. Shortly after they appeared on the market, long acting contraceptives including the intrauterine device (IUDs) became a game-changer in global health.
The Canadian Contraception Survey found oral contraceptives and male condoms to be the most commonly used methods of contraception in Canada. While Canadians have a myriad of family planning options, many low- middle- income countries prefer long acting methods. According to the UN, the IUD is the most popular method in Eastern and South Eastern Asia, while the injectable is most common in Sub-saharan Africa.
North Americans have access to numerous family planning methods including the newest method: the arm implant. The World Family Planning highlights from 2017 indicate that North America has the highest usage of family planning services, while low- middle- income countries are still struggling with unmet needs of family planning services.
Lack of access to contraception makes fertility decisions difficult. African women typically prefer the injection compared to North Americans. The biggest difference is their access to the injection. In Nigeria, there was no stock of injectable contraception for 226 days. There are numerous barriers that can affect women’s access to contraception. This includes lack of access to counselling and skilled healthcare practitioners as well as systemic determinants such as lack of subsidization.
When people have access to contraception, they are able to make the best possible choices for themselves and their family. Access to contraception has allowed for better education and employment opportunities for young women and girls, especially those in low- middle- income countries. In Malaysia, girls that had access to family planning clinics stayed in school for 6 months longer.
Public health measures such as social distancing, quarantine and fear of visiting health facilities have impacted access to family planning services during the COVID-19 pandemic. It is estimated that the pandemic disrupted contraceptive use for approximately 12 million women, potentially resulting in nearly 1.4 million unintended pregnancies during 2020, across 115 low- and middle-income countries. Approximately 59% of countries reported partial disruption to contraception services, while 9% report severe disruptions. The impact of COVID-19 illustrates the need for more attention and care to be placed into global access to contraception and family planning.
Upon recognition of the Sustainable Development Goals (SDGs) at the International Conference of Population and Development (ICPD), policy makers hope to achieve universal access to sexual and reproductive health services, including a commitment to support family planning and contraception by 2030. The World Fertility and Family Planning 2020 Highlights indicate the need for increased intensity in support for family planning through implementation of government policies and programmes. Meeting the demand for family planning services will improve healthcare services for all.