Contraceptive failure rates in the developing world: an analysis of Demographic and Health Survey data in 43 countries

Chelsea Polis, Sarah EK Bradley, Akinrinola Bankole, Tsuyoshi Onda, Trevor N Croft, Susheela Singh the most comprehensive study to date of contraceptive failure rates in the developing world, researchers found that overall, failure rates are lowest for users of longer-acting contraceptive methods (IUDs, implants or injectables), intermediate for users of shorter-acting methods (oral contraceptive pills or male condoms) and highest for users of traditional methods (withdrawal or calendar rhythm). The report expands on previous research on failure rates by contraceptive method. “Of the 74 million unintended pregnancies each year in the developing world, a significant proportion – 30% – are due to contraceptive failure among women using traditional or modern methods,” lead author Chelsea Polis said.The data cover 17 countries in Africa, 16 in Asia, two in Eastern Europe and eight in Latin America and the Caribbean. The study estimated the contraceptive prevalence and the method mix for each country and the seven sub-regions in the analysis. It found that while the Northern Africa/Western Asia sub-region has relatively high contraceptive prevalence, a significant proportion of users rely on less effective traditional methods. By contrast, in Western Africa, contraceptive prevalence is relatively low, but the majority of users rely on modern methods.The study found that women younger than 25 generally have higher contraceptive failure rates than their older counterparts for all contraceptive methods except the implant, for which the failure rate did not vary by age. The authors call for expanded availability of youth-friendly counselling and services and recommend that service providers make available a wide range of contraceptive methods, comprehensive counselling and clear information about risks and benefits, including possible side effects, of each method.