Contraception and Unintended Pregnancy in Sub-Saharan Africa: Explaining the Unexpected Relationship

Eliud Wekesa, Research Associate

Contraception is considered as one of the most important health innovation that enables women and couples avoid unintended pregnancies and achieve their desired fertility. Modern Contraceptive prevalence is thus expected to be negatively associated with unintended pregnancies and fertility. However, recent analysis of the relationship between contraceptive prevalence and unintended pregnancies in developing countries has produced counter-intuitive results. This paper draws on Demographic and Health Survey data from 277 country surveys to explore if this relationship holds when examined regionally. Findings show that the counter-intuitive relationship only holds for Sub-Saharan Africa (SSA). An analysis by stage of the fertility transition from SSA shows that the counter-intuitive relationship holds true at the earlier stages of the fertility transition. This implies that the counter-intuitive relationship is only temporary in the early stages of fertility transition when the demand for contraception is higher than the ability of the health system to satisfy it