Indicator 3.7.1 Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods

Goal 3: Ensure healthy lives and promote well-being for all at all ages 

Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs 

Indicator 3.7.1: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods

November 2021

Target 3.8 and Target 5.6

Uganda Bureau of Statistics

Uganda Bureau of Statistics

Johnstone Galande

Department of Demography and Social Statistics

Senior Demographer

+256 782 789787

P.O Box 7186, Kampala

galandej1@gmail.com

Definition:

The percentage of women of reproductive age (15-49 years) currently using a modern method of contraception among those who desire either to have no (additional) children or to postpone the next pregnancy. The indicator is also referred to as the demand for family planning satisfied with modern methods. 

Concepts:

The percentage of women of reproductive age (15-49 years) who have their need for family planning satisfied with modern methods is also referred to as the proportion of demand satisfied by modern methods. The components of the indicator are contraceptive prevalence (any method and modern methods) and unmet need for family planning. 

Contraceptive prevalence is the percentage of women who are currently using, or whose partner is currently using, at least one method of contraception, regardless of the method used.  

For analytical purposes, contraceptive methods are often classified as either modern or traditional. Modern methods of contraception include female and male sterilization, the intra-uterine device (IUD), the implant, injectables, oral contraceptive pills, male and female condoms, vaginal barrier methods (including the diaphragm, cervical cap and spermicidal foam, jelly, cream and sponge), lactational amenorrhea method (LAM), emergency contraception and other modern methods not reported separately (e.g., the contraceptive patch or vaginal ring). Traditional methods of contraception include rhythm (e.g., fertility awareness-based methods, periodic abstinence), withdrawal and other traditional methods not reported separately.

Unmet need for family planning is defined as the percentage of women of reproductive age who want to stop or delay childbearing but are not using any method of contraception.

Proportion.

None

The Uganda Demography and Health Survey (UDHS)

Sample Design:

The sample design for the 2016 UDHS used the sampling frame from the Uganda National Population and Housing Census (NPHC 2014). The census frame is a complete list of all census Enumeration Areas (EAs) created for the 2014 NPHC. In Uganda, an EA is a geographic area that covers an average of about 130 households.

At the time of the NPHC, Uganda was divided administratively into 112 districts, which were grouped for this survey into 15 regions. The sample for the 2016 UDHS was designed to provide estimates of key indicators for the country as a whole, for urban and rural areas separately, and for each of the 15 sub regions. Estimates are also presented for three special areas: the Lake Victoria islands, the mountainous districts, and greater Kampala.

The 2016 UDHS sample was stratified and selected in two stages. In the first stage, 697 EAs were selected from the 2014 NPHC, 162 EAs in urban areas and 535 in rural areas.

Households constituted the second stage of sampling. A listing of households was compiled in each of the 696 accessible selected EAs from April to October 2016.

To minimize the task of household listing, each large EA (that is to say more than 300 households) selected for the 2016 UDHS was segmented. Only one segment was selected for the survey with probability proportional to segment size, and the household listing was conducted only in the selected segment.

Out of the 20,880 selected households (30 households per EA), 18,506 women aged 15-49 were successfully interviewed. All women age 15-49 who were either permanent residents of the selected households or visitors who stayed in the household the night before the survey were eligible to be interviewed. In one-third of the sampled households, all men age 15-54, including both usual residents and visitors who stayed in the household the night before the interview, were eligible for individual interviews.

Recruitment and Training:

UBOS recruited and trained field staff to serve as supervisors, CAPI managers, interviewers, health technicians, and reserve interviewers for the main fieldwork. Health technicians were trained separately from interviewers. A two-day f ield practice was organized to provide trainees with additional hands on practice before the actual fieldwork. Prior to the main field work, a pre-test was conducted and best practices were adopted.

Questionnaires:

Four questionnaires were used for the 2016 UDHS: The Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. The questionnaires, based on The DHS Program’s model questionnaires, were adapted to reflect the population and health issues relevant to Uganda.

Input was solicited from all stakeholders such as; Government Ministries and Agencies, Non-governmental Organizations, and Development partners. After the finalization of the questionnaires in English, they were then translated into eight major local languages. The Household, Woman’s, and Man’s Questionnaires were programmed into a computer-assisted personal interviewing (CAPI) application for data collection purposes.

Data collection:

Data collection was conducted by 21 field teams, each consisting of one team leader, one field data Manager, three female interviewers, one male interviewer, one health technician, and a driver. The health technicians were responsible for anthropometric measurements, blood sample collection for Hemoglobin and malaria testing, and DBS specimen collection for vitamin A testing.

The, interviewers used tablets to record all questionnaire responses during the interviews. The tablets were equipped with Bluetooth technology to enable remote electronic transfer of files, such as assignments from the team supervisor to the interviewers, individual questionnaires among survey team members, and completed questionnaires from interviewers to team supervisors.

The field supervisors transferred data to the central data processing office via Internet File Streaming System (IFSS). Senior staff from the Makerere University School of Public Health, the Ministry of Health, and UBOS and a survey technical specialist from the DHS Program coordinated and supervised fieldwork activities. Data collection took place over a 6-month period from June 2016 through December 2016.

Every 5 years

2022

Uganda Bureau of Statistics

Uganda Bureau of Statistics, ICF

The Uganda Bureau of Statistics (UBOS) Act, 1998 provides for the development and maintenance of a National Statistical System (NSS) to ensure collection, analysis and publication of integrated, relevant, reliable and timely statistical information. It established the Bureau as the coordinating, monitoring and supervisory body for the National Statistical System.

The proportion of demand for family planning satisfied with modern methods is useful in assessing overall levels of coverage for family planning programmes and services. Access to and use of an effective means to prevent pregnancy helps enable women and their partners to exercise their rights to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so. Meeting demand for family planning with modern methods also contributes to maternal and child health by preventing unintended pregnancies and closely spaced pregnancies, which are at higher risk for poor obstetrical outcomes.

Levels of demand for family planning satisfied with modern methods of 75 per cent or more are generally considered high, and values of 50 per cent or less are generally considered as very low. The indicator has no global numerical ‘target’ value set to be achieved by 2030. Looking at the highest values of the indicator, in 22 countries representing regions such as Europe and Northern America, Latin America and the Caribbean and Eastern and South-Eastern Asia, more than 85 per cent of women who want to avoid pregnancy are using a modern contraceptive method but for no country is this estimate above 91 per cent. Even in these countries, specific sub-populations (for example, adolescents or the poor) can still face barriers to access to family planning information and services. It should also be recognized that reaching 100 per cent may not be a necessary or even desirable outcome with respect to reproductive rights. Some women may prefer to use a traditional method, even while having access to a full range of modern methods and being aware of the typical differences in effectiveness of methods in preventing pregnancies. Other women might have ambivalent preferences regarding their next pregnancy which may influence their contraceptive choice.

Differences in the survey design and implementation, as well as differences in the way survey questionnaires are formulated and administered can affect the comparability of the data. The most common differences relate to the range of contraceptive methods included and the characteristics (age, sex, marital or union status) of the persons for whom contraceptive prevalence is estimated (base population). The time frame used to assess contraceptive prevalence can also vary. In most surveys there is no definition of what is meant by “currently using” a method of contraception. 

n some surveys, the lack of probing questions, asked to ensure that the respondent understands the meaning of the different contraceptive methods, can result in an underestimation of contraceptive prevalence, in particular for traditional methods. Sampling variability can also be an issue, especially when contraceptive prevalence is measured for a specific subgroup (by age-group, level of educational attainment, place of residence, etc.) or when analyzing trends over time

When data on women aged 15 to 49 are not available, information for married or in-union women is reported. Illustrations of base populations that are sometimes presented are: married or in-union women aged 15-44, sexually active women (irrespective of marital status), or ever-married women. Notes in the data set indicate any differences between the data presented and the standard definitions of contraceptive prevalence or unmet need for family planning or where data pertain to populations that are not representative of women of reproductive age. 

The numerator is the percentage of women of reproductive age (15-49 years old) who are currently using, or whose partner is currently using, at least one modern contraceptive method. The denominator is the total demand for family planning (the sum of contraceptive prevalence (any method) and the unmet need for family planning).

Proportion of women of reproductive age (aged 15−49 years) who have their need for family planning satisfied with modern methods = (The total number of women of reproductive age (15−49 years old) who are currently using) (Number of women who are using any method of contraception or are having in ISCO 08 categories 11+12+13) ×100

A wide consultative process is undertaken to compile, assess and validate data on the indicator. The consultation process solicited feedback directly from other Government Agencies responsible for official statistics, on the compilation of the indicators, including the data sources used, and the application of internationally agreed definitions, classification and methodologies to the data from that source. The results of this Indicator consultation are reviewed by Ministry of Health and UNICEF

Non

1. The survey implementation is overseen by a Steering Committee which is constituted using a multi sectorial approach.

2. The survey report is reviewed by an experienced team at Management level who are in most cases Directors or Heads of departments and key stakeholders from Makerere School of Public Health, Molecular Laboratory of Makerere University School of Health Sciences, Ministry of Health and later reviewed by consultants

The UDHS goes through several stages before production and sharing of the final findings. During the Survey implementation. i. Consultative user needs assessment meetings are held with all key stakeholders.

ii. ICF International provided consultants to oversee the UDHS

iii. The survey and sampling design generated using scientific methods as recommended by the Census and Survey Rules and Regulations

iv. Comprehensive training sessions are carried out for all survey staff before deployment to the field.

v. The questionnaire development for different categories of the Target respondents were adapted to reflect the population and health issues relevant to Uganda. (Man’s Questionnaire, Woman’s questionnaire, Biomarker questionnaire and Field worker questionnaire. This follows a multi-stakeholder approach and pretesting helps to establish the relevancy and adequacy of the questions to be used.

vi. Senior Supervision is conducted during data collection to ensure that quality data is collected. vii. Debriefing sessions are implemented at agreed intervals to discuss operational and technical field challenges viii. Field Data editing, Secondary data cleaning and coding is undertaken before analysis and report writing

Before dissemination, the report is reviewed and quality assured by a professional team of the National Statistical System.

Quality Control is addressed at all levels during Survey implementation

Data Availability:

Data available Every 5 years

Time Series:

2011,2016.

Disaggregation: Age, marital status, geographic location, wealth quintiles 15 sub-regions.

Generally, there is no discrepancy between data presented and data published in survey reports.

Uganda Demographic and Health Survey 2016 [FR333] (ubos.org) http://measuredhs.com/Topics/Unmet-Need.cfm https://dhsprogram.com/