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An inequity exists when people are unfairly deprived of something they want or require to protect them from an unwanted or undesirable condition.[1] In Africa, one in 26 women of reproductive age dies from a maternal cause. The maternal mortality rate, which measures the death rate of women due to pregnancy and childbirth, is higher in Africa than on any other continent.[2] In the year 2000 alone, there were approximately 830 deaths per 100,000 live births for the continent as a whole and an average of 920 for sub-Saharan Africa..[3] Socioeconomic class constitute an inequity in relation to mortality and morbidity..[4] This economic gap between the rich and poor in the use of contraception has remained the same even though their has been general global improvements in socioeconomic status and the expansion of family planning services.[5] The poor do not have the same access to life-saving and health-maintaining interventions as the rich, yet they deserve the same healthy lives as those who are economically better off..[6]

The contraceptive use indicator called “unmet need” for contraception still remains high in Africa. This inequity is fueled by both a growing population, and a shortage of family planning services.[7] In Africa, 53% of women of reproductive age have an unmet need for modern contraception..[8] This phenomenon occurs because of limited access to contraception, cultural and religious opposition, poor quality of available services, gender based barriers, and spousal disapproval.[9] In Eastern Africa specifically, the increase in unmet need is associated with socioeconomic variables, the family planning program environment and reproductive behavior models.[10] In the 1980s and even into the 1990s, contraception and family-planning were still associated with fears of eugenic ideology and population control which narrowed the scope of behavior-change communication and distribution of contraceptive devices.[11] However in current years a new approach of promoting spousal discussion of contraception has been proposed as an effective policy strategy for narrowing the gender gap in partners' fertility intentions in developing countries.[12] Discussion between spouses is expected to increase contraceptive use, because a sizable minority of women cite their husband's disapproval of contraception as the reason for nonuse, despite having never discussed family planning with their husband. [13]

In most African countries,a limited choice of contraceptive methods are offered making it difficult for couples to choose the method that best suits their reproductive needs.[14] In fact, international program effort scores for 1994 showed that large proportions of people in most developing countries did not have ready access to a variety of contraceptive methods.Many African countries had low access scores on almost every method.[15] In the 1999 ratings for 88 countries, only 65% of countries offered the pill to at least half their population, 54% offered the IUD, 42% offered female sterilization, 26% offered male sterilization and 73% offered the condom. [16] Condom availability increased more sharply in Africa and Asia than any other developing country.[17] This is important because low levels of condom use are cause for concern, particularly in the context of generalized epidemics found in Sub-Saharan Africa.[18] The share of method mix for injectables rose from 2% to 8%, and climbed from 8% to 26% in Sub-Saharan Africa, while the share for condoms was 5–7%. [19] The most uncommon method of contraception is Women's reliance on male sterilization for contraception. This method's share of use remaining below 3%. [20] 6–20% of women in Sub-Saharan Africa used the injectable covertly, a practice that was more common in areas where contraceptive prevalence was low, particularly rural areas.[21]

With the implementation of contraceptives and family planning, unintended pregnancies would decline by two-thirds, from 80 million to 26 million.[22] There would be 26 million fewer abortions (including 16 million fewer unsafe procedures with the addition of 21 million fewer unplanned births. [23] Seven million fewer miscarriages would occur, and a dramatic decrease of 1.1 million in infant deaths.[24] Ensuring access to preferred contraceptive methods for women and couples is keyto securing the well-being and autonomy of women, while supporting the health and development of communities.[25] Family planning allows people to attain their desired number of children and determine the spacing of pregnancies. It is achieved through use of contraceptive methods and the treatment of infertility. Contraception is key to slowing unsustainable population growth and the resulting negative impacts on the economy, environment, and national and regional development efforts.[26] The prevalence of contraceptive use has risen markedly over the decades. The latest United Nations review, using surveys that cover 85% of the developing world's population, shows that "almost all of the less developed countries with trend data experienced an increase in the level of contraceptive use. [27] By region, the United Nation's estimate is highest in northern Africa (42%) and Sub-Saharan Africa (14%). [28]Increasing modern contraceptive method use requires community-wide, multifaceted interventions with the addition of education, life skills, and access to support. Interventions should aim to encourage positive perceptions of modern contraceptive methods and the dual role of condoms for contraception and STI prevention.[29] Understanding the changes in contraceptive method mix is imperative to helping policymakers, and donor agencies meet the demand and estimate future needs in developing countries.[30]

  1. ^ Creanga, Andreea (2011). "Low use of contraception among poor women in Africa: an equity issue". World Health Organization. {{cite web}}: More than one of |author= and |last= specified (help)
  2. ^ "Population, Family Planning, and the Future of Africa". WorldWatch Institute. Retrieved 3/18/2013. {{cite web}}: Check date values in: |accessdate= (help)
  3. ^ Creanga, Andreea (2011). "Low use of contraception among poor women in Africa: an equity issue". World Health Organization. {{cite web}}: More than one of |author= and |last= specified (help)
  4. ^ Creanga, Andreea (2011). "Low use of contraception among poor women in Africa: an equity issue". World Health Organization. {{cite web}}: More than one of |author= and |last= specified (help)
  5. ^ Creanga, Andreea (2011). "Low use of contraception among poor women in Africa: an equity issue". World Health Organization. {{cite web}}: More than one of |author= and |last= specified (help)
  6. ^ Creanga, Andreea (2011). "Low use of contraception among poor women in Africa: an equity issue". World Health Organization. {{cite web}}: More than one of |author= and |last= specified (help)
  7. ^ "Family planning". World Health Organizataion. 2012. {{cite web}}: Missing or empty |url= (help)
  8. ^ "Family planning". World Health Organizataion. 2012. {{cite web}}: Missing or empty |url= (help)
  9. ^ "Family planning". World Health Organizataion. 2012. {{cite web}}: Missing or empty |url= (help)
  10. ^ Mona Sharon. [siteresources.worldbank.org/AFRICAEXT/.../YAC_chpt_25.pdf "Family Planning Trends in Sub - Saharan Africa: Progress, Prospects, and Lessons Learned"] (PDF). World Bank. {{cite web}}: Check |url= value (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  11. ^ Warren C. Robinson (2007). Robinson, Warren C.; Ross, John A. (eds.). [The International Bank for Reconstruction and Development / The World Bank The Global Family Planning Revolution]. World Bank. doi:10.1596/978-0-8213-6951-7. ISBN 978-0-8213-6951-7. {{cite book}}: Check |url= value (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  12. ^ DeRose, Laurie (June 2004). "Does Discussion of Family Planning Improve Knowledge of Partner's Attitude Toward Contraceptives?". Guttmacher Institute. {{cite web}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  13. ^ DeRose, Laurie (June 2004). "Does Discussion of Family Planning Improve Knowledge of Partner's Attitude Toward Contraceptives?". Guttmacher Institute. {{cite web}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  14. ^ Ross, John (March 2002). "Contraceptive Method Choice in Developing Countries". Guttmacher Institute. 28 (1). {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  15. ^ Ross, John (March 2002). "Contraceptive Method Choice in Developing Countries". Guttmacher Institute. 28 (1). {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  16. ^ Ross, John (March 2002). "Contraceptive Method Choice in Developing Countries". Guttmacher Institute. 28 (1). {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  17. ^ Ross, John (March 2002). "Contraceptive Method Choice in Developing Countries". Guttmacher Institute. 28 (1). {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  18. ^ Caldwell, John C.; Caldwell, Pat (2002). "Africa: the new family planning frontier". Studies in Family Planning. 33 (1): 76–86. doi:10.1111/j.1728-4465.2002.00076.x. PMID 11974421. {{cite journal}}: Check date values in: |year= / |date= mismatch (help); Unknown parameter |month= ignored (help)
  19. ^ Seiber, Eric (September 2007). "Changes in Contraceptive Method Mix In Developing Countries". Guttmacher Institute. 33 (3). {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  20. ^ Seiber, Eric (September 2007). "Changes in Contraceptive Method Mix In Developing Countries". Guttmacher Institute. 33 (3). {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  21. ^ Sinding, S (2005). "Does 'CNN' (condoms, needles, negotiation) work better than 'ABC' (abstinence, being faithful and condom use) in attacking the AIDS epidemic?". International Family Planning Perspectives. 31 (1): 38–40. doi:10.1363/ifpp.31.38.05.
  22. ^ Singh, Susheela (2012). [, < http://www. guttmacher.org/pubs/AIU-2012-estimates.pdf> "Adding It Up: Costs and Benefits of Contraceptive Services Estimates for 2012"]. Guttmacher Institute and United Nations Population Fund (UNFPA. {{cite journal}}: Check |url= value (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  23. ^ Singh, Susheela (2012). [, < http://www. guttmacher.org/pubs/AIU-2012-estimates.pdf> "Adding It Up: Costs and Benefits of Contraceptive Services Estimates for 2012"]. Guttmacher Institute and United Nations Population Fund (UNFPA. {{cite journal}}: Check |url= value (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  24. ^ Singh, Susheela (2012). [, < http://www. guttmacher.org/pubs/AIU-2012-estimates.pdf> "Adding It Up: Costs and Benefits of Contraceptive Services Estimates for 2012"]. Guttmacher Institute and United Nations Population Fund (UNFPA. {{cite journal}}: Check |url= value (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  25. ^ "Family Planning". World Health Organization. July 2012.{{cite web}}: CS1 maint: date and year (link)
  26. ^ "Family Planning". World Health Organization. July 2012.{{cite web}}: CS1 maint: date and year (link)
  27. ^ Creanga, Andreea A.; Gillespie, Duff; Karklins, Sabrina; Tsui, Amy O. (2011). "Low use of contraception among poor women in Africa: an equity issue". Bulletin of the World Health Organization. 89 (4). Wolrd Health Organization: 258–266. doi:10.2471/BLT.10.083329. PMC 3066524. PMID 21479090.{{cite journal}}: CS1 maint: date and year (link)
  28. ^ Creanga, Andreea A.; Gillespie, Duff; Karklins, Sabrina; Tsui, Amy O. (2011). "Low use of contraception among poor women in Africa: an equity issue". Bulletin of the World Health Organization. 89 (4). Wolrd Health Organization: 258–266. doi:10.2471/BLT.10.083329. PMC 3066524. PMID 21479090.{{cite journal}}: CS1 maint: date and year (link)
  29. ^ Creanga, Andreea A.; Gillespie, Duff; Karklins, Sabrina; Tsui, Amy O. (2011). "Low use of contraception among poor women in Africa: an equity issue". Bulletin of the World Health Organization. 89 (4). Wolrd Health Organization: 258–266. doi:10.2471/BLT.10.083329. PMC 3066524. PMID 21479090.{{cite journal}}: CS1 maint: date and year (link)
  30. ^ Seiber, Eric (September 2007). "Changes in Contraceptive Method Mix In Developing Countries". Guttmacher Institute. 33 (3). {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)