Identifying inequity in family planning: The Track20 equity tool

Abstract

Background: With increases in contraceptive use in most countries in the world, within country inequities persist. Equity in family planning does not mean an equal level of contraceptive use among all groups; differences in use of contraception could reflect variation in cultural beliefs and values and therefore not inequity. Methods: Focusing on demand satisfied for modern methods and five dimensions (age, education, geography, parity, and wealth), we map inequities within 15 sub-Saharan African countries and across time. We create a “Concentration of Inequity” to highlight the intersectionality of inequities in family planning and allows for more data informed programming. Results: Inequities exist in all countries included in this analysis, though the range varies substantially. Over 85% of the countries included in this analysis had at least 1 subgroup in the population with demand satisfied 30% or more below the national level of demand satisfied. To help visualize inequities and stimulate discussion, we create an online tool to display multiple aspects of inequity. Conclusions: Using demand satisfied with modern methods to measure inequity for family planning allows us to focus attention on women with desire to delay or limit childbearing. Studying the intersections of demographic factors is fundamental for a deeper understanding of family planning equity.