Family Planning in Asia and the Pacific - International Council on ...

FigureFigureFigure3Use of modern contraception by number of liv<strong>in</strong>g children, married women aged 15-4950%40%30%20%10%0%None 1 2 3 4+2008200319981993Annual Growth5.8%5.0%2.9%1.5% 1.9%Figure4Percentage distribution of women aged 15-49 employed <strong>in</strong> <strong>the</strong> 12 months preced<strong>in</strong>g 2008 NDHSsurvey, by occupation <strong>and</strong> number of liv<strong>in</strong>g children353025201510500 1-2 3-4 5+No. of ChildrenClericalUnskilledmanualSkilledmanualDomesticserviceProfessional/technical/managerialSales <strong>and</strong>servicesAgricultureplace, chang<strong>in</strong>g place with <strong>the</strong> pill. The movement is dueto an 85 per cent <strong>in</strong>crease <strong>in</strong> pill use for <strong>the</strong> past 15 years<strong>and</strong> a 23 per cent drop <strong>in</strong> tubal ligations. The proportion ofwomen who have had tubal ligation <strong>and</strong> have moved out of<strong>the</strong> reproductive years has not been adequately replaced by<strong>the</strong> programme. Although <strong>the</strong> <strong>in</strong>crease <strong>in</strong> pill use has morethan made up for <strong>the</strong> drop <strong>in</strong> tubal ligations, <strong>the</strong> usefulnessof <strong>the</strong> latter to women who want no more children shouldnot be underestimated. Discont<strong>in</strong>uation is also a problemwith <strong>the</strong> pill. In <strong>the</strong> 2003 NDHS, more than a third ofwomen on <strong>the</strong> pill, exclud<strong>in</strong>g those who wanted to getpregnant, stopped with<strong>in</strong> 12 months: 17.4 per cent due toside effects <strong>and</strong> health reasons; 3.7 per cent due to methodfailure; <strong>and</strong> 14.6 per cent due to o<strong>the</strong>r reasons.The next three methods – IUDs, <strong>in</strong>jections (re<strong>in</strong>troduced<strong>in</strong> 1994) <strong>and</strong> condoms – make up <strong>the</strong> next cluster,account<strong>in</strong>g for some 25-27 per cent of modern methoduse <strong>in</strong> <strong>the</strong> last 15 years. All three have registered <strong>in</strong>creases<strong>in</strong> current use over <strong>the</strong> past 15 years, but <strong>the</strong> base levels <strong>in</strong>1993 are too small (3% or less), which means <strong>the</strong> measuredupward trend may not be stable. For example, from 2003to 2008, <strong>the</strong> use of IUDs had actually gone down from12.3 to 10.9 per cent, <strong>and</strong> <strong>in</strong>jections dipped from 9.3 to7.6 per cent use.The last two methods – modern NFP <strong>and</strong> male sterilization(vasectomy) – have consistently registered less than 1 percent use over <strong>the</strong> last 15 years. These methods have been302