BMJ global health · 2026
50 years of contraception: trends in contraception prevalence rate and unmet family planning needs in twenty Arab countries (1970-2020).
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Khalis Mohamed, Bouaddi Oumnia, Ramangason Baholy, Mohamed-Wassime Diatta, Assarag Bouchra, de Brouwere Vincent, Boutayeb Saber, Belyamani Lahcen, Belouali Radouane, Haakenstad Annie, Georgi Georges
Аннотация
BACKGROUND: Arab countries have seen an increased commitment towards improving access to family planning (FP) in recent decades. We aimed to describe trends in key FP indicators in Arab countries over the past five decades with a view to understanding gaps around contraception access, unmet need and preferences and existing gaps in data collection around FP.
METHODS: We extracted data on FP from surveys published between 1970 and 2020 in 20 Arab countries. The indicators analysed were contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), traditional contraceptive prevalence rate (tCPR), unmet FP needs and demand satisfied. Data were categorised into four regions (North Africa, Fertile Crescent, Horn of Africa and Gulf region) and synthesised narratively and graphically.
RESULTS: A total of 129 surveys were included. Over the 50-year period, there was an overall increase in CPR across all four regions, from 4.6–53.8% in early surveys to 6.9–70.8% in the latest, with important gains in the Fertile Crescent and North Africa. mCPR mirrored CPR trends, rising from below 30% in early years to above 40% in most countries in the Fertile Crescent, North Africa, and Kuwait, while remaining below 40% in the remaining Gulf countries and the Horn of Africa. Overall, tCPR also showed an increase during the 50 years but remained lower compared with mCPR, ranging from 1.6% to 17.5% by the end of the period. Modern methods dominated, with the pill being the most commonly used method in countries such as Morocco, Sudan and Algeria, while the intra-uterine devices were preferred in Egypt, Tunisia and Jordan. Traditional methods, including withdrawal and periodic abstinence, were the dominant methods in some countries, with withdrawal dominating in Lebanon and periodic abstinence in Libya.
CONCLUSIONS: Significant challenges remain in uptake of contraception in Arab countries, particularly in areas facing instability, displacement, migratory flows, and under-resourced health systems. Addressing these disparities requires granular, sub-national data to identify inequalities and guide targeted interventions.
METHODS: We extracted data on FP from surveys published between 1970 and 2020 in 20 Arab countries. The indicators analysed were contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), traditional contraceptive prevalence rate (tCPR), unmet FP needs and demand satisfied. Data were categorised into four regions (North Africa, Fertile Crescent, Horn of Africa and Gulf region) and synthesised narratively and graphically.
RESULTS: A total of 129 surveys were included. Over the 50-year period, there was an overall increase in CPR across all four regions, from 4.6–53.8% in early surveys to 6.9–70.8% in the latest, with important gains in the Fertile Crescent and North Africa. mCPR mirrored CPR trends, rising from below 30% in early years to above 40% in most countries in the Fertile Crescent, North Africa, and Kuwait, while remaining below 40% in the remaining Gulf countries and the Horn of Africa. Overall, tCPR also showed an increase during the 50 years but remained lower compared with mCPR, ranging from 1.6% to 17.5% by the end of the period. Modern methods dominated, with the pill being the most commonly used method in countries such as Morocco, Sudan and Algeria, while the intra-uterine devices were preferred in Egypt, Tunisia and Jordan. Traditional methods, including withdrawal and periodic abstinence, were the dominant methods in some countries, with withdrawal dominating in Lebanon and periodic abstinence in Libya.
CONCLUSIONS: Significant challenges remain in uptake of contraception in Arab countries, particularly in areas facing instability, displacement, migratory flows, and under-resourced health systems. Addressing these disparities requires granular, sub-national data to identify inequalities and guide targeted interventions.