Implications of Future Fertility Trends for Contraceptive Practice

Abstract

If the estimated contraceptive prevalence and total fertility rates for 1984 are approximately correct then it is clear that a dramatic change in reproductive behavior has taken place in most of the developing world over the past 2 decades. Aggregate total fertility has dropped from 6.0 in the early 1960s to about 4.0 at present; contraceptive prevalence increased from 9 to 43% over the same period. East Asia experienced the most rapid change which was almost entirely due to an extrordinary decline in Chinas fertility transition. Latin America and most of South Asia have also made major progress into the fertility transition. Only in Sub-Saharan Africa is there no significant trend in reproductive behavior. The most recent long-range global and regional population projections made by the UN assume that fertility will decline in all major regions of the developing world. Reducing fertility further according to the trends incorporated in the UN medium projections will require that contraceptive prevalence in the developing world be increased from 43% at present to 68% in 2025. While this will hardly be a simple task the momentum built over the past 2 decades suggests that this is an obtainable goal. This future trajectory of prevalence implies very rapid growth in the numbers practising contraception from about 256 million at present to 736 million in 2025 because both the prevalence level and the number of married women of reproductive age are increasing. During this period (1984-2025) the largest increases in contraceptive prevalence will be required in Africa (12 to 59%) while East Asia needs only a 5% point increase. Corresponding prjections of the number of women practicing contraception by region are also presented. The contraceptive methods used are likely to continue to be the modern clinical ones such as sterilization the IUD pill and injectables. As a consequence a rapid expansion of family planning services provided by both the public and private sectors will be required over the next several decades. (summaries in ENG FRE SPA)