Abstract:
Broad gains in contraceptive access and use
have been made in low-income countries over
the past decade while poverty has declined,
but the trends have been uneven. In light of
the Family Planning 2020 (FP2020) goals to
improve modern contraceptive uptake, and the
Sustainable Development Goals’ emphasis on
equitable progress, there is renewed interest
in monitoring fertility preferences and
family planning outcomes by poverty level.
However, studies of this topic are typically
constrained by the fact that standard poverty
measurements are relative within surveys and
cannot be compared across countries or over
time. This study develops and uses a measure
of absolute poverty in 31 of the 69 FP2020
focus countries, employing both an
unsatisfied basic needs approach and an asset
index to help differentiate among the levels
of the extremely poor. The measure of
absolute poverty enables us to compare and
test outcomes among comparable poverty groups
both within and across countries.
The study classifies married women into one
of four absolute poverty groups based on
their housing characteristics, household
level of education, and assets. We compare
results from the most recent Demographic and
Health Survey in each of the 31 selected
countries with results from an earlier survey
in each country, conducted on average 10
years earlier. The study found a
statistically significant—and in many cases
substantial—decline in absolute poverty among
married women in all 31 countries. There was
wide variation in all key indicators across
countries. On average, the ideal number of
children declined most substantially among
the poorest group of women, both in absolute
terms and relatively across the decade. In
the majority of countries there were
statistically significant increases in modern
contraceptive prevalence, demand satisfied
for modern methods, and use of long-term
versus short-term modern methods. Increases
in all three indicators were greatest and
most statistically significant among the
poorest women. On average, inequalities
between the non-poor and the poorest women
declined, but substantial disparities by
absolute poverty group remain both within and
across countries. To address these
disparities, we recommend further analysis
incorporating background characteristics and
programmatic case studies from countries that
have largely achieved a high level of demand
satisfied for modern methods while also
increasing equity among poverty groups.
Absolute Poverty, Fertility Preferences, and Family Planning Use in FP2020 Focus Countries (PDF, 1159K)