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Abstract
Unintended pregnancies continue to burden many countries in sub-Saharan Africa. Our
aim was to estimate the number of unintended pregnancies in the region and model the
impact of expanding use of contraceptive implants at the expense of short-term hormonal
birth control methods.
For the 42 countries in mainland sub-Saharan Africa, we estimated current levels of
unintended pregnancy, prevalence of hormonal contraceptive use and number of unintended
pregnancies stemming from early discontinuation and typical method failure rates.
Using a decision-analytic model, we estimated the potential impact of more widespread
use of the contraceptive implant.
Every year in sub-Saharan Africa, approximately 14 million unintended pregnancies
occur and a sizeable proportion is due to poor use of short-term hormonal methods.
If 20% of the 17.6 million women using oral contraceptives or injectables wanted long-term
protection and switched to the contraceptive implant, over 1.8 million unintended
pregnancies could be averted over a 5-year period.
Poor patterns of short-term hormonal contraceptive use (high discontinuation rates
and incorrect use) contribute significantly to the problem of unintended pregnancy
in sub-Saharan Africa. More availability and widespread use of highly effective methods,
such as the contraceptive implant, will improve reproductive health in the region.