Global Contraceptive Failure Rates: Who Is Most at Risk?

Sarah E K Bradley, Chelsea B Polis, Akinrinola Bankole, Trevor Croft, Sarah E K Bradley, Chelsea B Polis, Akinrinola Bankole, Trevor Croft

Abstract

Contraceptive failure is a major contributor to unintended pregnancy worldwide. DHS retrospective calendars, which are the most widely used data source for estimating contraceptive failure in low-income countries, vary in quality across countries and surveys. We identified surveys with the most reliable calendar data and analyzed 105,322 episodes of contraceptive use from 15 DHSs conducted between 1992 and 2014. We estimate contraceptive method-specific 12-month failure rates. We also examined how failure rates vary by age, education, socioeconomic status, contraceptive intention, residence, and marital status using multilevel piecewise exponential hazard models. Our failure rate estimates are significantly lower than results from the United States and slightly higher than previous studies that included more DHS surveys, including some with lower-quality data. We estimate age-specific global contraceptive failure rates and find strong, consistent age patterns with the youngest users experiencing failure rates up to ten times higher than older women for certain methods. Failure also varies by socioeconomic status, with the poorest, and youngest, women at highest risk of experiencing unintended pregnancy due to failure.

© 2019 The Authors. The Population Council, Inc. Published by Wiley Periodicals, Inc.

Figures

Figure 1
Figure 1
Twelve‐month failure rate estimates by contraceptive method from multiple studies
Figure 2
Figure 2
Twelve‐month failure rates by age and contraceptive method

References

    1. Abatih, Emmanuel , Van Oyen Herman, Bossuyt Nathalie, and Bruckers Liesbeth. 2008. “Variance estimation methods for health expectancy by relative socio‐economic status,” European Journal of Epidemiology 23(4): 243–249. 10.1007/s10654-008-9227-5.
    1. Ali, Mohamed M. , Cleland John, and Shah Iqbal H.. 2012. “Causes and Consequences of Contraceptive Discontinuation: Evidence from 60 Demographic and Health Surveys.” Geneva, Switzerland: World Health Organization.
    1. Bankole, Akinrinola , Sedgh Gilda, Oye‐Adeniran Boniface A., Adewole Isaac F., Hussain Rubina, and Singh Susheela. 2008. “Abortion‐seeking behaviour among Nigerian women,” Journal of Biosocial Science 40(2): 247–268. 10.1017/S0021932007002283.
    1. Black, Kirsten I. , Gupta Sunanda, Rassi Angela, and Kubba Ali. 2010. “Why do women experience untimed pregnancies? A review of contraceptive failure rates,” Best Practice & Research Clinical Obstetrics & Gynaecology, Abortion and Post‐abortion Care—Volume 1, 24(4): 443–455. 10.1016/j.bpobgyn.2010.02.002.
    1. Bongaarts, John . 2015. “Modeling the fertility impact of the proximate determinants: Time for a tune‐up,” Demographic Research 33(Article 19): 535–560. 10.4054/DemRes.2015.33.19.
    1. Bongaarts, John and Potter Robert G.. 1983. “Applications of an Aggregate Fertility Model,” in Fertility, Biology, and Behavior, pp. 103–126. San Diego: Academic Press.
    1. Bradley, Sarah E.K. 2015. “More Questions, More Bias? An Assessment of the Quality of Data Used for Direct Estimation of Infant and Child Mortality in the Demographic and Health Surveys.” Paper presented at the Population Association of America Annual Meeting, San Diego, CA.
    1. Bradley, Sarah E.K. , Schwandt Hilary M., and Khan Shane. 2009. “Levels, Trends, and Reasons for Contraceptive Discontinuation,” DHS Analytical Studies No. 20. Calverton, MD: ICF Macro. .
    1. Bradley, Sarah E.K. , Winfrey William, and Croft Trevor N.. 2015. “Contraceptive Use and Perinatal Mortality in the DHS: An Assessment of the Quality and Consistency of Calendars and Histories,” DHS Methodological Reports No. 17. Rockville, MD: ICF International. .
    1. Brown, Win , Druce Nel, Bunting Julia, Radloff Scott, Koroma Desmond, Gupta Srishti, Siems Brian, Kerrigan Monica, Kress Dan, and Darmstadt Gary L.. 2014. “Developing the ‘120 by 20’ goal for the Global FP2020 Initiative,” Studies in Family Planning 45(1): 73–84. 10.1111/j.1728-4465.2014.00377.x.
    1. Curtis, Sian L. and Blanc Ann K.. 1997. “Determinants of Contraceptive Failure, Switching, and Discontinuation: An Analysis of DHS Contraceptive Histories,” DHS Analytical Reports No. 6. Calverton, MD: Macro International. .
    1. Fishman, Ezra . 2015. “Variance estimation for a complex life table quantity: Disease‐free life expectancy,” Working Paper 15‐2. Population Studies Center Working Paper Series. University of Pennsylvania. .
    1. Frost, Jennifer J. and Darroch Jacqueline E.. 2008. “Factors associated with contraceptive choice and inconsistent method use, United States, 2004,” Perspectives on Sexual and Reproductive Health 40(2): 94–104. 10.1363/4009408.
    1. Fung, Brian . 2012. “The quiet racism of abortion bans,” The Atlantic, August 28, 2012. .
    1. Galati, Alanna J. 2015. “Onward to 2030: Sexual and reproductive health and rights in the context of the Sustainable Development Goals,” Guttmacher Policy Review 18(4). .
    1. Gipson, Jessica D. , Koenig Michael A., and Hindin Michelle J.. 2008. “The effects of unintended pregnancy on infant, child, and parental health: A review of the literature,” Studies in Family Planning 39(1): 18–38.
    1. Hatcher, Robert Anthony . 2011. Contraceptive Technology. New York, NY: Ardent Media.
    1. ICF . 2018. Demographic and Health Survey Interviewer's Manual. Rockville, Maryland: ICF.
    1. Joyce, Ted , Tan Ruoding, and Zhang Yuxiu. 2013. “Abortion before & after Roe,” Journal of Health Economics 32(5): 804–815. 10.1016/j.jhealeco.2013.05.004.
    1. Kost, Kathryn , Singh Susheela, Vaughan Barbara, Trussell James, and Bankole Akinrinola. 2008. “Estimates of contraceptive failure from the 2002 national survey of family growth,” Contraception 77(1): 10–21. 10.1016/j.contraception.2007.09.013.
    1. Kuhnert, B. 2004. “Reproductive functions of the ageing male,” Human Reproduction Update 10(4): 327–339. 10.1093/humupd/dmh030.
    1. Liang, J.E. 1978. “Use Effectiveness Levels and Trends in the Philippines, 1970–1976,” Research Note 14. Manila: Population Institute, University of the Philippines.
    1. Lightbourne, Robert E. 1985. “Individual preferences and fertility behavior,” in Cleland John. and Hobcraft John. (eds.), Reproductive Change in Developing Countries: Insights from the World Fertility Survey. Oxford University Press.
    1. Matorras, Roberto , Matorras Francisco, Expósito Antonia, Martinez Lorea, and Crisol Lorena. 2011. “Decline in human fertility rates with male age: A consequence of a decrease in male fecundity with aging?” Gynecologic and Obstetric Investigation 71(4): 229–235. 10.1159/000319236.
    1. MEASURE DHS . 2013. “Demographic and Health Surveys Methodology: Standard Recode Manual for DHS‐6,” Calverton, MD: ICF International.
    1. Menken, J. , Trussell J., and Larsen U.. 1986. “Age and infertility,” Science 233(4771): 1389–1394. 10.1126/science.3755843.
    1. Moreau, C. , Trussell J., Rodriguez G., Bajos N., and Bouyer J.. 2007. “Contraceptive failure rates in France: Results from a population‐based survey,” Human Reproduction 22(9): 2422–2427. 10.1093/humrep/dem184.
    1. Moreno, Lorenzo . 1993. “Differences by residence and education in contraceptive failure rates in developing countries,” International Family Planning Perspectives 19(2): 54–60, 71. 10.2307/2133420.
    1. Oehlert, Gary W. 1992. “A note on the Delta Method,” The American Statistician 46(1): 27–29. 10.1080/00031305.1992.10475842.
    1. Polis, Chelsea B. , Bradley Sarah E.K., Bankole Akinrinola, Onda Tsuyoshi, Croft Trevor, and Singh Susheela. 2016. “Contraceptive failure rates in the developing world: An analysis of demographic and health survey data in 43 countries,” New York: Guttmacher Institute.
    1. Preston, Samuel , Heuveline Patrick, and Guillot Michel. 2000. Demography: Measuring and Modeling Population Processes. London: Wiley; .
    1. Rabe‐Hesketh, Sophia and Skrondal Anders. 2012. Multilevel and Longitudinal Modeling Using Stata. Third Edition. 2 volumes. College Station, Texas: Stata Press.
    1. Rasch, Vibeke and Kipingili Rose. 2009. “Unsafe abortion in urban and rural Tanzania: Method, provider and consequences,” Tropical Medicine & International Health 14(9): 1128–1133. 10.1111/j.1365-3156.2009.02327.x.
    1. Rutstein, Shea O. and Johnson Kiersten. 2004. “The DHS Wealth Index,” DHS Comparative Report No. 6. Calverton, MD: ORC Macro. .
    1. Sundaram, Aparna , Juarez Fatima, Bankole Akinrinola, and Singh Susheela. 2012. “Factors associated with abortion‐seeking and obtaining a safe abortion in Ghana,” Studies in Family Planning 43(4): 273–286. 10.1111/j.1728-4465.2012.00326.x.
    1. Sundaram, Aparna , Vaughan Barbara, Kost Kathryn, Bankole Akinrinola, Finer Lawrence, Singh Susheela, and Trussell James. 2017. “Contraceptive failure in the United States: Estimates from the 2006–2010 National Survey of Family Growth,” Perspectives on Sexual and Reproductive Health 49(1): 7–16. 10.1363/psrh.12017.
    1. Westoff, Charles F. 1974. “Coital frequency and contraception,” Family Planning Perspectives 6(3): 136–141. 10.2307/2134122.
    1. WHO Task Force . 1980. “User preferences for contraceptive methods in India, Korea, the Philippines, and Turkey,” Studies in Family Planning 11(9/10): 267–273. 10.2307/1966364.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere