FIGURE 1. Contraceptive use varies widely in the 52 developing countries. Modern method Traditional method LAC Haiti 31 3 Guyana 40 3 Bolivia 34 27 Dominican Republic 69 3 Honduras 64 9 Peru 52 24 Colombia 73 6

ASIA Timor-Leste 21 1 Tajikistan 26 2 Pakistan 26 9 Kyrgyz Republic 34 3 Nepal 43 7 Cambodia 35 16 Azerbaijan 14 37 Philippines 38 17 Armenia 27 28 India 49 8 Bangladesh 52 9 Jordan 42 19 Indonesia 58 4

AFRICA Guinea 5 1 Mali 10 0 Mozambique 11 0 Benin 8 5 Senegal 12 1 Niger 12 2 Nigeria 10 5 Burkina Faso 15 1 Sierra Leone 16 1 Cote d'Ivoire 12 6 Comoros 14 5 Liberia 19 1 Congo (DRC) 8 13 Burundi 18 4 Cameroon 14 9 Ghana 17 7 Ethiopia 27 1 Uganda 26 4 Gabon 19 12 Tanzania 27 7 Sao Tome & Principe 34 5 Madagascar 29 11 Congo 20 25 Kenya 39 6 Malawi 42 3 Lesotho 46 1 Zambia 44 5 Swaziland 48 3 Rwanda 45 7 Namibia 55 0 Zimbabwe 57 1 Egypt 57 2 0 20 40 60 80 100 % of married women aged 15-49 using a contraceptive method FIGURE 2. Married women can be classified as having met need, unmet need or no need for contraception. Unmet Need (not using a method) Met Need (using any method) No need % distribution of married women aged 15‐49 LAC Colombia 8 79 13 Peru 9 75 16 Honduras 11 73 16 Dominican Republic 11 72 17 Bolivia 20 61 19 Guyana 28 42 30 Haiti 35 35 30

ASIA Indonesia 11 62 27 Jordan 12 61 27 Bangladesh 13 61 25 Armenia 13 55 32 India 14 56 30 Azerbaijan 15 51 33 Cambodia 17 51 32 Philippines 17 55 28 Kyrgyz Republic 18 36 46 Pakistan 20 35 45 Tajikistan 23 28 49 Nepal 28 50 23 Timor‐Leste 31 22 46

AFRICA Egypt 13 59 29 Zimbabwe 15 59 27 Niger 16 14 70 Nigeria 16 15 69 Namibia 18 56 26 Congo 18 45 37 Madagascar 19 40 41 Rwanda 21 52 28 Zambia 21 49 30 Lesotho 23 47 30 Cameroon 24 23 53 Guinea 24 6 71 Burkina Faso 25 16 59 Swaziland 25 51 25 Sierra Leone 25 17 58 Tanzania 25 34 40 Kenya 26 45 29 Mali 26 10 64 Malawi 26 46 28 Ethiopia 26 29 45 Gabon 26 31 42 Cote d'Ivoire 27 18 55 Congo (DRC) 28 20 52 Mozambique 28 12 60 Senegal 30 13 57 Liberia 31 20 49 Comoros 32 19 48 Burundi 32 22 46 Benin 33 13 55 Uganda 34 30 36 Ghana 36 24 41 Sao Tome & Principe 38 38 24 0 20406080100 Note: "Met need" refers to women who want to avoid a pregnancy and are using a method, and "no need" refers to women who are not fecund, pregnant with an intended pregnancy, or want to have a child soon. FIGURE 3. Married women rarely have an unmet need for contraception to delay their first birth.

LAC Colombia 1 2 4 Peru 1 3 5 Honduras 1 5 4 Dominican Republic 2 5 4 Bolivia 1 5 14 Guyana 1 8 19 Haiti 3 13 20

ASIA Indonesia 0 4 7 Jordan 0 5 7 Bangladesh 1 4 8 Armenia 0 5 8 India 1 5 8 Azerbaijan 03 12 Cambodia 0 6 11 Philippines 1 6 11 Kyrgyz Republic 0 12 6 Pakistan 1 8 11 Tajikistan 1 11 11 Nepal 3 7 18 Timor-Leste 1 20 11 AFRICA Egypt 0 4 8 Zimbabwe 1 8 6 Niger 1 13 3 Nigeria 0 12 4 Namibia 1 8 8 Congo 1 14 4 Madagascar 2 8 9 Rwanda 0 11 10 Zambia 0 14 7 Lesotho 1 10 12 Cameroon 1 14 8 Guinea 0 17 7 Burkina Faso 1 17 7 Swaziland 1 6 18 Sierra Leone 1 16 8 Tanzania 0 16 9 Kenya 1 12 13 Mali 1 18 7 Malawi 1 12 14 Ethiopia 1 15 10 Gabon 1 17 8 Cote d'Ivoire 1 19 8 Congo (DRC) 1 20 7 Mozambique 1 15 13 Senegal 1 21 8 Liberia 1 21 9 Comoros 4 20 9 Burundi 0 22 10 Benin 1 21 11 Uganda 1 20 13 Ghana 1 20 14 Sao Tome & Principe 1 17 20 0 20 40 60 80 100 % of married women aged 15-49 who have an umet need: for delaying first birth for spacing births for limiting births FIGURE 4. Married women across all age‐groups have an unmet need for contraception.

% of married women aged 15‐49 with unmet need 100

90

80

70

60

50

40

30 28 27 26 25 26 26 21 20 19 20 17 16 16 17 14

10

0 Asia Africa

15‐19 20‐24 25‐29 30‐34 35‐39 40‐44 45‐49

Note: The value of each bar is an unweighted regional average of 13 countries in Asia and 32 countries in Africa. FIGURE 5. In most countries where data are available, significant proportions of never‐married women aged 15‐49 are sexually active.

LAC Honduras 13 Bolivia 16 Peru 22 Guyana 27 Dominican Republic 27 Haiti 29 Colombia 34

ASIA Philippines 5

AFRICA Rwanda 5 Zimbabwe 11 Malawi 12 Uganda 17 Kenya 18 Burkina Faso 19 Madagascar 21 Lesotho 22 Nigeria 24 Zambia 25 Tanzania 26 Ghana 27 Congo DRC 31 Benin 33 Cameroon 34 Swaziland 38 Mozambique 40 Namibia 45 Congo 50 Cote d'Ivoire 50 Gabon 54 Sierra Leone 56 Liberia 60

0 20406080100

% of never‐married women who have had sexual intercourse in the past three months FIGURE 6. Sexually active never-married women have a greater need for contraception than do married women. Unmet Need Met Need No Need

% distribution of sexually active never-married women aged 15-49 LAC Colombia 23 71 7 Peru 23 69 8 Guyana 30 60 9 Dominican Republic 33 57 10 Bolivia 34 60 6 Honduras 34 54 12 Haiti 59 32 9

ASIA Philippines 41 43 16

AFRICA Congo 17 74 10 Cameroon 27 61 12 Nigeria 27 65 7 Swaziland 31 62 7 Gabon 32 56 13 Sierra Leone 33 56 11 Zimbabwe 37 42 21 Burkina Faso 39 53 7 Tanzania 40 46 14 Lesotho 41 48 11 Uganda 43 40 17 Madagascar 44 36 20 Congo (DRC) 46 45 10 Mozambique 47 33 20 Cote d'Ivoire 48 38 14 Ghana 48 43 9 Benin 50 34 15 Kenya 51 38 11 Liberia 52 36 12 Zambia 55 30 15 Malawi 55 34 11 Rwanda 56 30 13

0 20 40 60 80 100 Note: "Met need" refers to women who want to avoid a pregnancy and are using a method, and "no need" refers to women who are not fecund, are pregnant with an intended pregnancy, or want to have a child soon. FIGURE 7. Single, sexually active women are most likely to have an unmet need for contraception to delay their first birth.

Congo 11 6 0 Namibia 8 6 4 Colombia 17 2 4 Peru 19 2 2 Cameroon 18 7 2 Nigeria 23 4 0 Guyana 19 8 4 Swaziland 9 8 14 Gabon 17 12 3 Sierra Leone 26 7 0 Dominican Republic 28 4 1 Bolivia 26 3 5 Honduras 25 3 6 Zimbabwe 22 9 6 Burkina Faso 35 4 0 Tanzania 29 9 2 Philippines 36 4 0 Lesotho 25 3 14 Uganda 36 6 1 Madagascar 36 7 1 Congo (DRC) 34 10 2 Mozambique 36 6 5 Cote d'Ivoire 32 15 0 Ghana 39 8 1 Benin 45 3 1 Kenya 34 10 7 Liberia 36 15 1 Zambia 41 13 1 Malawi 44 4 8 Rwanda 37 15 5 Haiti 52 6 1

0 20406080100 % of never‐married, sexually active women aged 15‐49 with an unmet need: for delaying first birth for spacing births for limiting births FIGURE 8. In developing countries, married women's reasons for not using contraception commonly fall in four categories.

100

90

80

70

60

50

40

30 26 23 24 20 20

10 5 334 0

Unaware of Cost too Subfecund* No source/ Breastfeeding/ Opposed Infrequent Side effects/ methods high access postpartum (self or or no sex health amenorrhea others) risks**

% of married women with unmet need citing specific reason for nonuse

Note: The value for each bar is an unweighted average of responses in 52 countries. *Respondent reported subfecund or infecund **Includes a small proportion of women citing inconveniece of use of method FIGURE 9. Women's reasons for not using contraception differ somewhat between Africa and Asia.

% of married women with unmet need citing specific reason for nonuse 100

90

80

70

60

50

40 34

30 26 25 26 23 24

20 18 14 8 10 6 3 4 3 1 22 0 Unaware of Cost too No source/ Subfecund* Breastfeeding/ Opposed Infrequent Side methods high access postpartum (self or or no sex effects/ amenorrhea others) health risks** Asia Africa

Notes: The value for each bar is an unweighted average of responses in 13 countries in Asia and 32 countries in Africa. *Respondent reported subfecund or infecund **Includes a small proportion of women citing inconveniece of use of method FIGURE 10. Infrequent or no sex is commonly cited in some countries as a reason for not using contraception.

LAC Haiti 16 Guyana 17 Dominican Republic 21 Colombia 27 Bolivia 41 Honduras 51 Peru 53 ASIA Timor‐Leste 2 Kyrgyz Republic 17 Indonesia 22 India 27 Tajikistan 28 Azerbaijan 30 Jordan 30 Pakistan 32 Cambodia 36 Philippines 37 Armenia 44 Bangladesh 57 Nepal 73

AFRICA Ethiopia 8 Burundi 8 Namibia 11 Swaziland 11 Comoros 11 Madagascar 12 Mali 13 Congo 14 Uganda 14 Kenya 14 Guinea 15 Benin 16 Cote d'Ivoire 16 Liberia 17 Zambia 17 Sao Tome & Principe 17 Rwanda 17 Gabon 18 Senegal 18 Tanzania 18 Nigeria 18 Congo (DRC) 19 Niger 19 Ghana 21 Malawi 22 Mozambique 23 Burkina Faso 23 Lesotho 25 Sierra Leone 25 Cameroon 29 Egypt 35 Zimbabwe 38 0 20406080100 % of married women with unmet need aged 15‐49 citing infrequent/no sex as a reason for nonuse FIGURE 11. In all countries surveyed, some proportion of married women with unmet need is not sexually active.

LAC Dominican Republic 8 Haiti 14 Colombia 17 Guyana 19 Bolivia 27 Peru 28 Honduras 34

Timor-Leste 8 ASIA Cambodia 12 Jordan 14 Kyrgyzstan 14 Indonesia 18 Azerbaijan 18 Pakistan 18 India 22 Philippines 27 Tajikistan 27 Armenia 35 Bangladesh 38 Nepal 47

AFRICA Burundi 4 San Tome & Principe 10 Rwanda 11 Zambia 11 Ethiopia 11 Madagascar 13 Comoros 14 Nigeria 16 Namibia 16 Tanzania 17 Congo (DRC) 18 Kenya 18 Congo 18 Uganda 18 Swaziland 18 Mali 20 Niger 21 Zimbabwe 22 Cote d'Ivoire 23 Mozambique 24 Liberia 25 Gabon 25 Malawi 26 Cameroon 26 Senegal 27 Burkina Faso 29 Lesotho 36 Benin 36 Ghana 36 Sierra Leone 42 Guinea 55 0 20 40 60 80 100 % of married women with unmet need aged 15-49 who have not had intercourse in the past three months FIGURE 12. Breastfeeding and postpartum amenorrhea is more commonly cited as a reason for nonuse in Africa than in other regions.

Guyana 3 LAC Dominican Republic 8 Colombia 9 Honduras 13 Peru 18 Haiti 19 Bolivia 24

ASIA Azerbaijan 4 Indonesia 6 Armenia 6 Philippines 9 Nepal 9 Jordan 9 Timor-Leste 11 Cambodia 11 Pakistan 16 Bangladesh 18 India 21 Tajikistan 23 Kyrgyz Republic 38

AFRICA Egypt 7 Sao Tome & Principe 9 Swaziland 9 Madagascar 12 Kenya 12 Zimbabwe 13 Tanzania 14 Ghana 14 Namibia 15 Benin 16 Gabon 17 Lesotho 17 Comoros 19 Cameroon 19 Cote d'Ivoire 22 Mali 22 Niger 23 Malawi 24 Senegal 25 Burkina Faso 26 Nigeria 26 Zambia 27 Uganda 28 Ethiopia 30 Mozambique 30 Congo 32 Liberia 33 Burundi 35 Rwanda 37 Sierra Leone 41 Congo (DRC) 42 Guinea 49 0 20 40 60 80 100 % of married women with unmet need aged 15-49 citing breastfeeding or postpartum amenorrhea as a reason for nonuse FIGURE 13. Some married women say that they or someone close to them opposes contraception.

LAC Peru 4 Colombia 8 Guyana 13 Bolivia 13 Honduras 14 Dominican Republic 17 Haiti 36

ASIA Indonesia 5 Nepal 7 Bangladesh 8 Jordan 11 Azerbaijan 16 Cambodia 16 Philippines 20 Armenia 29 Kyrgyz Republic 32 India 32 Tajikistan 45 Pakistan 49 Timor‐Leste 68

AFRICA Egypt 14 Malawi 15 Congo 15 Kenya 16 Lesotho 17 Rwanda 17 Zambia 17 Ghana 19 Swaziland 19 Gabon 19 Namibia 20 Sao Tome & Principe 20 Cameroon 21 Zimbabwe 22 Benin 22 Comoros 22 Tanzania 23 Madagascar 23 Uganda 25 Ethiopia 25 Cote d'Ivoire 26 Burkina Faso 27 Guinea 28 Congo (DRC) 28 Sierra Leone 29 Liberia 29 Senegal 33 Mozambique 33 Nigeria 38 Niger 38 Burundi 38 Mali 40 0 20406080100 % of married women with unmet need aged 15‐49 citing opposition (self or other) as a reason for nonuse FIGURE 14. Concerns about side effects or health risks are a common reason for nonuse in all three major regions.

LAC Peru 19 Honduras 21 Colombia 24 Bolivia 25 Dominican Republic 32 Guyana 38 Haiti 51

ASIA Armenia 7 Nepal 10 Tajikistan 15 Bangladesh 19 India 20 Kyrgyz Republic 21 Pakistan 25 Azerbaijan 27 Timor-Leste 31 Jordan 31 Indonesia 33 Philippines 37 Cambodia 53

AFRICA Mozambique 9 Mali 10 Niger 11 Guinea 11 Sierra Leone 13 Zimbabwe 14 Senegal 14 Burkina Faso 15 Burundi 18 Congo (DRC) 19 Congo 19 Gabon 20 Lesotho 22 Benin 22 Nigeria 23 Malawi 24 Cameroon 24 Rwanda 25 Cote d'Ivoire 25 Namibia 28 Liberia 29 Ethiopia 30 Comoros 32 Zambia 33 Uganda 36 Egypt 38 Ghana 38 Madagascar 40 Sao Tome & Principe 42 Kenya 44 Tanzania 45 Swaziland 46 0 20 40 60 80 100 % of married women with unmet need aged 15-49 citing side effect or health concerns as a reason for nonuse FIGURE 15. Never‐married women commonly cite infrequent sex as a reason for not using contraception.

LAC Haiti 36 Guyana 45 Dominican Republic 54 Bolivia 69 Colombia 71 Honduras 73 Peru 88

ASIA Philippines 35

AFRICA Swaziland 15 Cote d'Ivoire 19 Liberia 19 Benin 21 Namibia 23 Congo 25 Ghana 26 Sierra Leone 26 Lesotho 27 Gabon 27 Malawi 29 Congo (DRC) 32 Kenya 36 Madagascar 36 Burkina Faso 38 Nigeria 42 Mozambique 43 Zambia 43 Uganda 47 Tanzania 53 Rwanda 60 Cameroon 61 Zimbabwe 62

0 20406080100 % of never‐married women with unmet need citing infrequent sex a reason for nonuse FIGURE 16. Many never-married women with unmet need cite not being married as a reason for nonuse.

LAC Peru 11 Guyana 13 Colombia 16 Dominican Republic 19 Haiti 27 Honduras 48 Bolivia 58

ASIA Philippines 51

AFRICA Liberia 5 Namibia 9 Swaziland 11 Cameroon 12 Cote d'Ivoire 16 Nigeria 17 Gabon 17 Sierra Leone 18 Mozambique 24 Tanzania 25 Congo 25 Burkina Faso 29 Kenya 30 Ghana 30 Congo (DRC) 33 Rwanda 38 Benin 42 Madagascar 43 Uganda 45 Zimbabwe 49 Lesotho 54 Zambia 56 Malawi 61

0 20 40 60 80 100 % of never-married women with unmet need citing "not married" as a reason for nonuse FIGURE 17. Some never-married women with unmet need say they are opposed to contraception.

LAC Peru 1 Bolivia 1 Colombia 2 Honduras 3 Guyana 5 Dominican Republic 15 Haiti 37

ASIA Philippines 10

AFRICA Zambia 1 Rwanda 3 Tanzania 4 Swaziland 4 Namibia 7 Kenya 7 Malawi 7 Uganda 7 Burkina Faso 8 Lesotho 8 Congo 8 Zimbabwe 9 Cameroon 9 Ghana 9 Benin 11 Gabon 13 Madagascar 14 Mozambique 15 Congo (DRC) 18 Cote d'Ivoire 18 Sierra Leone 20 Nigeria 23 Liberia 32

0 20 40 60 80 100 % of never-married women with unmet need citing opposition (self or other) as a reason for nonuse FIGURE 18. Side effects or concerns about health risks are a common reason for nonuse among never‐married women with unmet need.

LAC Peru 2 Bolivia 5 Honduras 7 Colombia 8 Dominican Republic 16 Guyana 22 Haiti 35

ASIA Philippines 26

AFRICA Zimbabwe 5 Mozambique 6 Lesotho 7 Rwanda 7 Congo 7 Nigeria 8 Burkina Faso 10 Malawi 11 Zambia 13 Cameroon 15 Gabon 16 Benin 17 Congo (DRC) 18 Namibia 20 Madagascar 23 Kenya 25 Sierra Leone 28 Tanzania 29 Cote d'Ivoire 30 Uganda 31 Liberia 33 Swaziland 39 Ghana 42

0 20406080100 % of never‐married women with unmet need citing side effects or health risks as a reason for nonuse