Meeting the need: youth and family planning in sub-Saharan Africa



      The need for a concerted effort to address the gaps in family planning services for youth in sub-Saharan Africa has been underreported and underexplored.

      Study Design

      Trends in fertility, childbearing, unmet need for family planning options and contraceptive prevalence (CP) among youth are described with data from six African countries with four consecutive Demographic and Health Surveys. Estimates of exposure to risk of pregnancy and number of new contraceptives users needed to maintain and double CP in 2015 are calculated using current CP and projected youth population size in six African countries.


      The youth population is expected to range from approximately 3 to 35 million in six African countries by 2015. Accounting for population growth and current estimates of sexual activity among youth, family planning services will need to absorb more than 800,000 and 11.3 million new contraceptive users total to maintain and double CP, respectively, in 2015 in those six African countries alone.


      Our findings support existing literature that calls for a reorientation of family planning policies and programs, especially improved access to modern contraceptive methods among African youth.


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        • United Nations
        World population prospects: the 2010 revision.
        Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat. New York. United Nations, 2011
        • Bureau P.R.
        The 2011 World Population Data Sheet.
        Population Reference Bureau, Washington, DC2011
        • Velkoff V.A.
        • Kowal P.R.
        Population aging in sub-Saharan Africa: demographic dimensions 2006: US Dept. of Commerce, Economics and Statistics Administration, US Census Bureau.
        • United Nations
        World youth report. Young people's transition to adulthood: progress and challenges.
        United Nations, New York2007
        • Williamson L.
        • Parkes A.
        • Wight D.
        • Petticrew M.
        • Hart G.
        Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research.
        Reproductive Health. 2009; 6: 3
        • Blum R.W.
        Youth in sub-Saharan Africa.
        J Adolesc Health. 2007; 41: 230-238
        • Bankole A.
        • Malarcher S.
        Removing barriers to adolescents' access to contraceptive information and services.
        Stud Fam Plann. 2010; 41: 117-124
        • Bearinger L.H.
        • Sieving R.E.
        • Ferguson J.
        • Sharma V.
        Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential.
        Lancet. 2007; 369: 1220-1231
        • Boonstra H.D.
        Young people need help in preventing pregnancy and HIV; how will the world respond?.
        Guttmacher Policy Review. 2007; 10: 8
        • Molla M.
        • Berhane Y.
        • Lindtjorn B.
        Traditional values of virginity and sexual behaviour in rural Ethiopian youth: results from a cross-sectional study.
        BMC Pub Health. 2008; : 8
        • Zaba B.
        • Isingo R.
        • Wringe A.
        • Marston M.
        • Slaymaker E.
        • Urassa M.
        Influence of timing of sexual debut and first marriage on sexual behaviour in later life: findings from four survey rounds in the Kisesa cohort in northern Tanzania.
        Sex Transm Infect. 2009; 85: 120-126
        • World Health Organization
        Adolescent pregnancy: the facts.
        World Health Organization, Geneva2010
        • World Health Organization
        The sexual and reproductive health of younger adolescents: research issues in developing countries, background paper for consultation.
        World Health Organization, Geneva2011
        • Cleland J.
        • Ali M.
        • Shah I.
        Trends in protective behaviour among single vs. married young women in sub-Saharan Africa: the big picture.
        Reprod Health Matter. 2006; 14: 17-22
        • Blanc A.K.
        • Tsui A.O.
        • Croft T.N.
        • Trevitt J.L.
        Patterns and trends in adolescents' contraceptive use and discontinuation in developing countries and comparisons with adult women.
        Int Perspect Sex Reprod Health. 2009; 35: 63-71
        • Ross J.
        • Stover J.
        • Adelaja D.
        Family planning programs in 2004: new assessments in a changing environment.
        Int Fam Plan Perspect. 2007; 33: 22-30
        • Tylee A.
        • Haller D.M.
        • Graham T.
        • Churchill R.
        • Sanci L.A.
        Youth-friendly primary-care services: how are we doing and what more needs to be done?.
        Lancet. 2007; 369: 1565-1573
        • Bongaarts J.
        Fertility transitions in developing countries: progress or stagnation?.
        Stud Fam Plann. 2008; 39: 105-110
        • Potts M.
        • Fotso J.C.
        Population growth and the millennium development goals.
        Lancet. 2007; 369: 354-355
        • Cleland J.
        • Bernstein S.
        • Ezeh A.
        • Faundes A.
        • Glasier A.
        • Innis J.
        Family planning: the unfinished agenda.
        Lancet. 2006; 368: 1810-1827
        • Campbell M.
        • Cleland J.
        • Ezeh A.
        • Prata N.
        Return of the population growth factor.
        Science. 2007; 315: 1501-1502
        • All Parlimentary Group on Population DaRH
        Return of the population growth factor: its impact upon the Millenium Development Goals. All Party Parlimentary Group on Population Development and Reproductive Health, London2007: 1-74
        • Smith R.
        • Ashford L.
        • Gribble J.
        • Clifton D.
        Family planning saves lives.
        Population Reference Bureau, Washington, DC2009
        • OBAID T.
        The State of World Population 2003.
        Making 1 Billion Count: Investing in Adolescents��� Health and Rights. UNFPA, New York2003
        • Defo B.K.
        The importance for the MDG4 and MDG5 of addressing reproductive health issues during the second decade of life: review and analysis from times series data of 51 African countries.
        Afr J Reprod Health. 2011; 15: 9-30
        • Stover J.
        • Ross J.
        How increased contraceptive use has reduced maternal mortality.
        Matern Child Health J. 2010; : 1-9
        • Campbell O.G.R.
        National maternal mortality study, Egypt 2000. Report of findings and conclusions.
        Directorate of Maternal and Child Health Care, Ministry of Health and Population, Cairo2001
        • World Health Organization
        WHO guidelines on preventing early pregnancy and poor reproductive health outcomes among adolescents in developing countries.
        World Health Organization, Geneva2011
        • Paranjothy S.
        • Broughton H.
        • Adappa R.
        • Fone D.
        Teenage pregnancy: who suffers?.
        Arch Dis Child. 2009; 94: 239
        • Glasier A.
        • G��lmezoglu A.M.
        • Schmid G.P.
        • Moreno C.G.
        • Van Look P.F.A.
        Sexual and reproductive health: a matter of life and death.
        Lancet. 2006; 368: 1595-1607
        • Shah L.
        • Ahman E.
        Age patterns of unsafe abortion in developing country regions.
        Reprod Health Matters. 2004; 12: 9-17
        • Patton G.C.
        • Coffey C.
        • Sawyer S.M.
        • et al.
        Global patterns of mortality in young people: a systematic analysis of population health data.
        Lancet. 2009; 374: 881-892
        • Adetunji J.
        • Bos E.R.
        Levels and trends in mortality in sub-Saharan Africa: an overview.
        in: Jamison F.R.D.T. Makgoba M.W. Disease and Mortality in Sub-Saharan Africa. 2nd ed. World Bank, Washington, DC2006
        • Hubacher D.
        • Mavranezouli I.
        • McGinn E.
        Unintended pregnancy in sub-Saharan Africa: magnitude of the problem and potential role of contraceptive implants to alleviate it.
        Contraception. 2008; 78: 73-78
        • Likwa R.
        • Whittaker M.
        The characteristics of women presenting for abortion and complications of illegal abortions at the University Teaching Hospital, Lusaka, Zambia: an explorative study.
        Afr J Fertil Sexual Reprod Heal. 1996; 1: 42-49
        • Cadmus E.
        • Owoaje E.
        Knowledge about complications and practice of abortion among female undergraduates in the University of Ibadan, Nigeria.
        Annals of Ibadan Postgraduate Medicine. 2011; 9: 19-23
        • Olukoya A.
        • Kaya A.
        • Ferguson B.
        • AbouZahr C.
        Unsafe abortion in adolescents.
        Int J Gynaecol Obstet. 2001; 75: 137-147
        • Cleland J.
        • Ali M.M.
        Sexual abstinence, contraception, and condom use by young African women: a secondary analysis of survey data.
        Lancet. 2006; 368: 1788-1793
        • Mayhew S.H.
        • Adjei S.
        Sexual and reproductive health: challenges for priority-setting in Ghana's health reforms.
        Health Policy Plan. 2004; 19: I50-I61
        • Blanc A.K.
        • Tsui A.O.
        The dilemma of past success: insiders' views on the future of the international family planning movement.
        Stud Fam Plann. 2005; 36: 263-276
        • UNFPA
        Fact sheet: motherhood and human rights.
        Do all pregnant women have the right to live? United Nations Population Fund, New York2009
        • Izugbara C.O.
        Home-based sexuality education - Nigerian parents discussing sex with their children.
        Youth Soc. 2008; 39: 575-600
        • Hindin M.J.
        • Fatusi A.O.
        Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions.
        Int Perspect Sex Reprod Health. 2009; 35: 58-62
        • Biddlecom A.E.
        • Munthali A.
        • Singh S.
        • Woog V.
        Adolescents' views of and preferences for sexual and reproductive health services in Burkina Faso, Ghana, Malawi and Uganda.
        Afr J Reprod Health. 2007; 11: 99-110
        • Garenne M.
        • Tollman S.
        • Kahn K.
        Premarital fertility in rural South Africa: a challenge to existing population policy.
        Stud Fam Plann. 2000; 31: 47-54
        • Townsend J.W.
        • Jacobstein R.
        The changing position of IUDs in reproductive health services in developing countries: opportunities and challenges.
        Contraception. 2007; 75: S35-S40
        • Singh S.
        • Darroch J.E.
        • Bankole A.
        A, B and C in Uganda: the roles of abstinence, monogamy and condom use in HIV decline.
        Reprod Health Matter. 2004; 12: 129-135
        • Bernstein S.
        • Edouard L.
        Targeting access to reproductive health: giving contraception more prominence and using indicators to monitor progress.
        Reprod Health Matter. 2007; 15: 186-191