UNFPAState of World Population 2004
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HOME: STATE OF WORLD POPULATION 2004: Reproductive Health and Family Planning
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Reproductive Health and Family Planning

Family Planning and Sexual Health
Contraceptive Access and Use
Unmet Need
Choice of Methods
Sexually Transmitted Infections
Quality of Care
Stronger Voices for Reproductive Health
Securing the Supplies
Men and Reproductive Health

Choice of Methods

Modern methods today account for 90 per cent of contraceptive use worldwide. In particular, three female-oriented methods are most commonly used: female sterilization, intrauterine devices and pills. In one third of all countries, a single method, usually sterilization or the pill, accounts for at least half of all contraceptive use. Condom use has increased in the great majority of developing countries.

In the 2003 UNFPA global survey, 126 countries reported taking measures to expand contraceptive choice. Eighty-eight have taken multiple steps, including increasing the availability of emergency contraception (68 countries) and female condoms (65), improving logistics for ensuring contraceptive availability (43), and providing subsidized or free contraceptives or services (27).(21)

Emergency contraception refers to the prevention of pregnancy after unprotected sexual intercourse. Research over the past 30 years has shown that emergency contraceptive pills (special doses of ordinary contraceptive pills) are safe and effective when used within 72 hours. As stated by WHO, “Emergency contraceptive pills do not interrupt pregnancy and thus are no form of abortion.” (22)

A growing number of countries have introduced emergency contraception since the ICPD; some have made it easier for women to access it, for example, by ending restrictions on over-the-counter sales. India,Iran and Nepal provide it through the national family planning programme. In the Dominican Republic, emergency contraception can be obtained through private pharmacies, while in Malaysia and Pakistan, NGOs are supplying it.

Programmes addressing sexual violence often offer emergency contraceptive pills along with counselling to women who have been raped. In Chile, doctors and emergency rooms can distribute the pills to women who have been raped.


UNFPA supplies 40 per cent of the contraceptive commodities provided by the international donor community. It also is an important partner of governments and donors in responding to supply problems.

In 2003, 60 countries reported on service delivery points offering multiple methods of contraception, both for UNFPA programme areas and for the nation as a whole. In 24 countries, the proportion of facilities offering at least three methods was higher in UNFPA areas, and in 24 countries the service offerings were identical. In 11 other countries where the Fund focuses specifically on improving access for underserved locations (usually the poorest areas) or groups (especially adolescents), a smaller proportion of UNFPA programme sites offer at least three methods.

Twenty countries have reached and maintained universal access to at least three contraceptive methods at service delivery points in UNFPA programme areas. Reports from 26 countries show successive expansion of contraceptive choice. Access has declined in only five countries, in three of them after civil conflict. See Sources

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