Abstract
This article uses two large sets of internationally comparable national surveys to analyze urban patterns of contraceptive use, access to methods, and fertility. Urban areas show higher use of contraception and lower fertility rates than rural areas, with substantial differences in the method mix. Urban women tend more toward the long-term methods of the intrauterine device (IUD), implant, and sterilization and less toward short-term, resupply methods. The overall use increases with education and with higher wealth quintiles. By regions, contraceptive use is unbalanced between urban and rural sectors especially in sub-Saharan Africa, where the overall levels of use are lowest. Overall, the urban fertility rate is only 70% of the rural rate. Across countries, the fertility rate correlates negatively with contraceptive use. National family planning programs tend to raise contraceptive use and to improve access to the methods. About half of the unmarried, sexually active women use contraception, with great diversity in which method is preferred. This holds for all married women as well: regions and countries show quite different patterns of use. Therefore, planners and donors should focus on the circumstances in individual countries.
Highlights
The conditions under which most people live have been transformed over the last seven decades by what may be termed the “urban revolution.” Since the end of World War II, the proportion of people dwelling in cities has grown from less than a third (30%) in 1950 to over half (56%) in 2020, and it is projected to exceed two-thirds (68%) by 2050
The analyses in this article draw upon a set of 87 countries included in the Demographic and Health Survey (DHS) series, a long-running program that collaborates with agencies in many countries, primarily in the developing world, to assess a range of measures for reproductive health, contraceptive use, fertility, and related items
Contraceptive use is higher in the cities, and the method mix is somewhat different from that in rural areas
Summary
The conditions under which most people live have been transformed over the last seven decades by what may be termed the “urban revolution.” Since the end of World War II, the proportion of people dwelling in cities has grown from less than a third (30%) in 1950 to over half (56%) in 2020, and it is projected to exceed two-thirds (68%) by 2050. Since the end of World War II, the proportion of people dwelling in cities has grown from less than a third (30%) in 1950 to over half (56%) in 2020, and it is projected to exceed two-thirds (68%) by 2050. The urban population grew from 750 million in 1950 to 4.4 billion in 2020, and it is projected to total 6.7 billion by 2050, nearly nine times higher than in 1950. The urban sector is projected to grow in many different ways across countries and regions. In Latin America, over the 30 years from 2020 to 2050, the urban population is projected to increase from 539 million to 685 million, an increment of 146 million for a 27% increase. Sub-Saharan Africa, starting from a smaller 2020 total of 459 million, will grow to 1.26 billion, an addition of 800 million, up by 174% [1]
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