Trends in the contraceptive method mix in low- and middle-income countries: analysis using a new "average deviation" measure

Global Health, Science and Practice
John RossKaren Hardee

Abstract

The method mix of contraceptive use is severely unbalanced in many countries, with over half of all use provided by just 1 or 2 methods. That tends to limit the range of user options and constrains the total prevalence of use, leading to unplanned pregnancies and births or abortions. Previous analyses of method mix distortions focused on countries where a single method accounted for more than half of all use (the 50% rule). We introduce a new measure that uses the average deviation (AD) of method shares around their own mean and apply that to a secondary analysis of method mix data for 8 contraceptive methods from 666 national surveys in 123 countries. A high AD value indicates a skewed method mix while a low AD value indicates a more uniform pattern across methods; the values can range from 0 to 21.9. Most AD values ranged from 6 to 19, with an interquartile range of 8.6 to 12.2. Using the AD measure, we identified 15 countries where the method mix has evolved from a distorted one to a better balanced one, with AD values declining, on average, by 35% over time. Countries show disparate paths in method gains and losses toward a balanced mix, but 4 patterns are suggested: (1) rise of one method partially offset by changes in oth...Continue Reading

References

Jun 10, 2006·Journal of Biosocial Science·Tara M SullivanJames D Shelton
Oct 17, 2007·International Family Planning Perspectives·Eric E SeiberTara M Sullivan
Apr 7, 2011·Studies in Family Planning·Mohamed M Ali, John Cleland
Jan 10, 2012·International Perspectives on Sexual and Reproductive Health·Elizabeth G SutherlandBarbara Janowitz
Nov 16, 2012·Journal of Biosocial Science·John Ross, Karen Hardee
Oct 19, 2013·International Perspectives on Sexual and Reproductive Health·Anrudh K JainIan Askew
Mar 13, 2014·Studies in Family Planning·Karen HardeeWin Brown
Oct 2, 2014·International Perspectives on Sexual and Reproductive Health·Jane T BertrandJames D Shelton
Oct 3, 2014·Global Health, Science and Practice·Susan DuvallNomi Fuchs-Montgomery

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Citations

Nov 29, 2016·Journal of Biosocial Science·John Ross, Karen Hardee
Nov 18, 2015·Current Opinion in HIV and AIDS·Sinéad Delany-MoretlweHelen Rees
Jul 14, 2018·Contraception and Reproductive Medicine·Jim AizireTaha E Taha
Sep 9, 2020·South African Family Practice : Official Journal of the South African Academy of Family Practice/Primary Care·Shango N OlowaChristian Saidiya
Dec 29, 2020·Global Health, Science and Practice·Jane T BertrandJames D Shelton

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