Current Use of Contraceptive Methods

 

Percentage of women who currently use any method, any modern method, any traditional method and specific methods

 

Definition

 

1)     Percentage of women who currently use specific methods

2)     Percentage of women who currently use any method

3)     Percentage of women who currently use any modern method

4)     Percentage of women who currently use any traditional method

 

The percentage of currently married women who currently use any method of contraception is called the contraceptive prevalence rate (CPR).

 

Coverage:

Population base:

a)      All women (IR file)

b)     Currently married women (IR file)

c)      Sexually active unmarried women (IR file)

Time period: Current use is defined by the respondent

 

Numerators:

Number of women within each base population who:

1)     Specific methods: currently use the specific method (v312 = x), after being asked whether they or their partner are currently doing something or using any method to delay or avoid getting pregnant. Women who say they are pregnant are coded as not currently using any method

2)     Any method: use any method of contraception (v313 ≠ 0)

3)     Modern methods: use one of the following methods (v313 = 3):

a)      female sterilization (tubal ligation, laparectomy, voluntary surgical contraception for women)

b)     male sterilization (vasectomy, voluntary surgical contraception for men)

c)      the contraceptive pill (oral contraceptives)

d)     intrauterine contraceptive device (IUD)

e)     injectables (Depo-Provera), implants (Norplant)

f)       female condom

g)      male condom (prophylactic, rubber)

h)     diaphragm

i)       contraceptive foam and contraceptive jelly

j)       lactational amenorrhea method (LAM)

k)      standard days method (SDM)

l)       country-specific modern methods and respondent-mentioned other modern contraceptive methods (including cervical cap, contraceptive sponge, and others), but does NOT include abortions and menstrual regulation

4)     Traditional methods: currently use one of the following methods (v313 = 1 or 2):

a)      periodic abstinence (rhythm, calendar method)

b)     withdrawal (coitus interruptus)

c)      country-specific traditional methods of proven effectiveness, folk methods (locally described methods and spiritual methods of unproven effectiveness, such as herbs, amulets, gris-gris, etc.). In the later rounds of the DHS program, both traditional methods and folk methods have been grouped under the heading traditional methods

 

Denominator:

Number of women in each of the population bases:

a)      All women (IR file)

b)     Currently married (v502 = 1) (IR file)

c)      Sexually active unmarried women: Includes women who are not currently married or in a consensual union (single, divorced, widowed, and separated) and who had sexual intercourse within the last 30 days (v502 ≠ 1 & v528 <= 30) (IR file)

 

Variables: IR file.

v312

Current contraceptive method

v313

Current use by method type

v005

Woman’s individual sample weight

              

Calculation

 

Within each coverage category, the numerator divided by the denominator, expressed as a percentage.

 

Handling of Missing Values

 

Population bases: Missing value in whether or not currently married is not allowed in the data.

Missing value in sexual activity treated as had sexual relations (non-virgin). Missing value in time since last intercourse treated as greater than 30 days (not sexually active).

 

Numerators: Treated as does not use method for individual methods and grouped methods.

 

Denominators: All women in coverage category included, even if missing values on current use of methods.

 

Notes and Considerations

 

Breastfeeding, prolonged breastfeeding, and prolonged abstinence are NOT contraceptive methods in themselves. The lactational amenorrhea method is based on three criteria: Woman is amenorrheic since last birth; last birth occurred within six months; woman is exclusively or predominately breastfeeding. In the DHS description of LAM only the following is used: “Up to six months after childbirth, before the menstrual period has not returned, women use a method requiring frequent breastfeeding day and night.” This description varies from the official LAM criteria by not including exclusive or predominant breastfeeding (which is based on whether or not the child received complementary liquids and foods), substituting frequency of breastfeeding (it is not a requirement that frequent night-time feeding occurs) and by not including the criterion that the woman knows that another form of contraception is necessary. The DHS description may therefore include women who say yes even though they had never heard of the term LAM or of programs that instruct in the method, thus overestimating knowledge and ever use.

 

Each respondent defines current use of contraception. While some methods such as sterilization, pill, IUD, injectables, implants, and LAM involve continuous protection, other methods are coital-specific, requiring use during intercourse, such as condoms, vaginal methods, periodic abstinence, SDM and withdrawal. Current use for coital-specific methods is a difficult concept since it may mean use at last intercourse, which could have been a long time before the interview or intention to use at next intercourse.

 

The following two groups are included in the current use of contraception tables for all women, but are excluded from the tables for currently married or in union women and the sexually active unmarried women:

·        Unmarried sexually inactive women—includes women who are not currently married or in a consensual union (single, divorced, widowed and separated) and who had sexual intercourse at least once in their lives but not within the last 30 days.

 

·        Unmarried women who never had sexual intercourse—includes women who are not currently married or in a consensual union (single, divorced, widowed and separated) and who never had sexual intercourse.

 

Changes over Time

 

The list of specific methods and their categorization has changed.

 

In DHS I and II surveys, modern methods included pill, IUD, injection, vaginal methods, condom, female sterilization, and male sterilization. The vaginal methods included in a single group diaphragm, foam and jelly. Traditional methods included periodic abstinence (of any kind), withdrawal, and all respondent- mentioned other methods.

 

In DHS III surveys, modern methods included pill, IUD, injection, vaginal methods, condom, female sterilization, male sterilization, and implants. Traditional methods included periodic abstinence (of any kind), withdrawal and lactational amenorrhea. Folk methods included respondent-mentioned other methods and were categorized separately from traditional methods.

 

In DHS IV surveys, emergency contraception was added to the list of contraceptive methods in the contraceptive table but was not included as a separate method for current use (included in “others”). The DHS IV and following questionnaires allowed for more than one method to be currently used. For specific methods, the following hierarchy is used to tabulate current use, selecting only the highest method in the list: female sterilization, male sterilization, intrauterine contraceptive device (IUD), contraceptive injection, contraceptive implants (Norplant), contraceptive pill, condoms, emergency contraception, standard day method (SDM), vaginal methods (foam, jelly, suppository), lactational amenorrhea method (LAM), periodic abstinence, withdrawal, other methods.  Note that in DHS IV and DHS V priority was given to the contraceptive pill before IUD, injectables and implants.

 

In DHS VI the category for other methods was separated into other modern methods and other traditional methods.  In DHS 7 emergency contraception and standard days method are explicitly listed in the coding categories for current use of contraception.

 

In earlier rounds of DHS through DHS V, women who declared that they ever used female sterilization were directly coded as currently using female sterilization.  Following the removal of the questions on ever use of contraceptive methods in DHS VI this automated coding no longer applies.

 

References

 

Fabic, M.S., and Y. Choi. 2013. "Assessing the Quality of Data Regarding Use of the Lactational Amenorrhea Method." Studies in Family Planning 44(2):205-21. https://doi.org/10.1111/j.1728-4465.2013.00353.x

 

United Nations, Department of Economic and Social Affairs, Population Division. 2015. Trends in Contraceptive Use Worldwide 2015 (ST/ESA/SER.A/349).  http://www.un.org/en/development/desa/population/publications/family/contraceptive-infochart-2015.shtml

 

Wang, W., S. Staveteig, R. Winter, and C. Allen. 2017. Women's marital status, contraceptive use, and unmet need in Sub-Saharan Africa, Latin America, and the Caribbean. DHS Comparative Report No. 44. Rockville, Maryland, USA: ICF. https://dhsprogram.com/publications/publication-CR44-Comparative-Reports.cfm

 

Resources

 

DHS-7 Tabulation plan: Tables 7.3, 7.4.1, 7.4.2, and 15.14

 

DHS Family Planning Topics page: https://www.dhsprogram.com/topics/Family-Planning.cfm

 

DHS Indicator Snapshot: Contraceptive Prevalence: https://www.youtube.com/watch?v=hf9s6wdHqfw

 

API Indicator IDs:

Any method:

FP_CUSA_W_ANY, FP_CUSM_W_ANY, FP_CUSU_W_ANY

(API link, STATcompiler link)

Modern method:

FP_CUSA_W_MOD, FP_CUSM_W_MOD, FP_CUSU_W_MOD

(API link, STATcompiler link)

Traditional method (including folk method):

FP_CUSA_W_TFK, FP_CUSM_W_TFK, FP_CUSU_W_TFK

(API link, STATcompiler link)

Traditional method (excluding folk method):

FP_CUSA_W_TRA, FP_CUSM_W_TRA, FP_CUSU_W_TRA

(API link, STATcompiler link)

Individual methods (women):

FP_CUSA_W_FST, FP_CUSM_W_FST, FP_CUSU_W_FST,

FP_CUSA_W_MST, FP_CUSM_W_MST, FP_CUSU_W_MST,

FP_CUSA_W_PIL, FP_CUSM_W_PIL, FP_CUSU_W_PIL,

FP_CUSA_W_IUD, FP_CUSM_W_IUD, FP_CUSU_W_IUD,

FP_CUSA_W_INJ, FP_CUSM_W_INJ, FP_CUSU_W_INJ,

FP_CUSA_W_DFJ, FP_CUSM_W_DFJ, FP_CUSU_W_DFJ,

FP_CUSA_W_IMP, FP_CUSM_W_IMP, FP_CUSU_W_IMP,

FP_CUSA_W_MCN, FP_CUSM_W_MCN, FP_CUSU_W_MCN,

FP_CUSA_W_FCN, FP_CUSM_W_FCN, FP_CUSU_W_FCN,

FP_CUSA_W_LAM, FP_CUSM_W_LAM, FP_CUSU_W_LAM,

FP_CUSA_W_EMC, FP_CUSM_W_EMC, FP_CUSU_W_EMC,

FP_CUSA_W_DIA, FP_CUSM_W_DIA, FP_CUSU_W_DIA,

FP_CUSA_W_FOM, FP_CUSM_W_FOM, FP_CUSU_W_FOM,

FP_CUSA_W_MPL, FP_CUSM_W_MPL, FP_CUSU_W_MPL,

FP_CUSA_W_STD, FP_CUSM_W_STD, FP_CUSU_W_STD,

FP_CUSA_W_OMD, FP_CUSM_W_OMD, FP_CUSU_W_OMD,

FP_CUSA_W_RHY, FP_CUSM_W_RHY, FP_CUSU_W_RHY,

FP_CUSA_W_WTH, FP_CUSM_W_WTH, FP_CUSU_W_WTH,

FP_CUSA_W_LTA, FP_CUSM_W_LTA, FP_CUSU_W_LTA,

FP_CUSA_W_BRF, FP_CUSM_W_BRF, FP_CUSU_W_BRF,

FP_CUSA_W_OTR, FP_CUSM_W_OTR, FP_CUSU_W_OTR,

FP_CUSA_W_FLK, FP_CUSM_W_FLK, FP_CUSU_W_FLK,

FP_CUSA_W_TFK, FP_CUSM_W_TFK, FP_CUSU_W_TFK

 

WHO 100 Core Health Indicators: Contraceptive Prevalence Rate

MICS6 Indicator TM.3: Contraceptive Prevalence Rate