Research

Contraception coverage and methods used among women in South Africa: A national household survey

M F Chersich, N Wabiri, K Risher, O Shisana, D Celentano, T Rehle, M Evans, H Rees

Abstract


Background. Globally, family planning services are being strengthened and the range of contraceptive choices expanded. Data on contraceptive coverage and service gaps could help to shape these initiatives.

Objective. To assess contraception coverage in South Africa (SA) and identify underserved populations and aspects of programming that require strengthening.

Methods. Data from a 2012 SA household survey assessed contraception coverage among 6 296 women aged 15 - 49 years and identified underserved populations.

Results. Two-thirds had an unintended pregnancy in the past 5 years, a quarter of which were contraceptive failures. Most knew of injectable (92.0%) and oral contraception (89.9%), but fewer of intrauterine devices (56.1%) and emergency contraception (47.3%). Contraceptive prevalence was 49.1%, and 41.8% women used modern non-barrier methods. About half had ever used injectable contraception. Contraception was lower in black Africans and younger women, who used a limited range of methods.

Conclusion. Contraception coverage is higher than many previous estimates. Rates of unintended pregnancy, contraceptive failure and knowledge gaps, however, demonstrate high levels of unmet need, especially among black Africans and young women.

 


Authors' affiliations

M F Chersich, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

N Wabiri, Human Sciences Research Council, Cape Town, South Africa

K Risher, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

O Shisana, Evidenced Based Solutions, Cape Town; and Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, South Africa

D Celentano, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

T Rehle, Human Sciences Research Council, Cape Town; and Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa

M Evans, Department of Anthropology, Faculty of Graduate Studies, York University, Toronto, Canada

H Rees, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and London School of Hygiene and Tropical Medicine, University of London, UK

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Keywords

Reproductive health; Contraception coverage; Hormonal contraceptives; South Africa; Family planning

Cite this article

South African Medical Journal 2017;107(4):307-314. DOI:10.7196/SAMJ.2017.v107i4.12141

Article History

Date submitted: 2017-03-29
Date published: 2017-03-29

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