Evolução temporal na demanda de planejamento familiar satisfeita por métodos contraceptivos modernos em países de baixa e média renda

Abstract

Universal access to sexual and reproductive health is addressed on The Sustainable Development Goals (SDGs) 3 and 5. Family planning provides many benefits to women, families and societies. Empowering women and enabling couples to time pregnancies, it also gave whole countries the opportunity to hit population targets and to benefit from the demographic dividend. We used data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys to track progress in the demand for family planning satisfied with modern methods (mDFPS) and its inequalities between 1993 and 2016 in 69 low- and middle-income countries. Average annual change in mDFPS and in wealth-based inequalities in mDFPS were estimated among married women aged 15-49 years by country and world region. Global analyses were disaggregated by wealth quintiles, area of residence and woman’s age. Considering SDGs targets, we also predicted country’s level of mDFPS in 2030 using a linear model. Although increases on mDFPS and reduction in wealth-based inequalities were observed for most regions, progress was uneven. The faster increase was observed in Eastern & Southern Africa, which showed an average increase of 1.7 percentage points (p.p.) a year, while West & Central Africa, which still with less than 40% of coverage, had an increase of 0.8 p.p. a year in mDFPS and almost no change in inequalities. At country level, fastest progress in national coverage was observed in Rwanda (mDFPS increased by 5 p.p.) and Lesotho was the country with the fastest reduction in inequalities in mDFPS (3.4 p.p. a year). Inequalities by area of residence were also reduced, but large gaps remain. Trends for young adolescents are not accompanying the other age groups, with inequalities increasing overtime. 42 countries will not achieve universal coverage by 2030 if the current trend is not accelerated. Our results suggest that countries where policies and programs were properly designed and implemented achieved great progress overtime and efforts to increase family planning coverage and reduce inequalities must be prioritized in countries where progress is slower or inexistent.