A potential contraceptive method mix for the Ethiopian Family Planning Program

Mizanur Rahman, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B)

In many sub-Saharan African countries, there is considerable unmet need for contraceptives, resulting in continued high fertility. One reason for unmet need is the lack of proper understanding of couples’ contraceptive method choice. Family planning program managers often prefer a contraceptive method mix skewed towards long-acting and permanent methods. This is especially the case in resource-poor countries, to maximize cost-effectiveness. In this paper, I make a worldwide review of contraceptive method mixes, review Ethiopian demographic situation and health service delivery programs, and analyze contraceptive data. It is found that there is high demand for contraceptives but the demand is still fragile; demand is higher for spacing than limiting; and health infrastructure cannot support effective delivery of long-acting methods. A strategy emphasizing delivery of short-acting methods, especially pills, would be most appropriate and cost-effective for substantial increase in contraceptive use and thus in reduction of unmet need for contraceptives in Ethiopia.