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

FigureFigure1<strong>Asia</strong> region government views on <strong>the</strong> level of fertility:1976, 1986, 1996 <strong>and</strong> 2009<strong>and</strong> percent of government provid<strong>in</strong>g direct support to contraceptive accessSource: United Nations, World Population Policies 2009<strong>the</strong> 10-year period from 1997 to 2007 is also given, as is<strong>the</strong> value of <strong>the</strong> Bongaarts <strong>in</strong>dex of contraception (Cc),which is driven by <strong>the</strong> use-effectiveness levels of <strong>the</strong>contraceptives <strong>in</strong> use.In comparison with contraceptive prevalence <strong>in</strong> o<strong>the</strong>rdevelop<strong>in</strong>g regions of <strong>the</strong> world, especially sub-SaharanAfrica, levels are high <strong>in</strong> <strong>the</strong> <strong>Asia</strong>n <strong>and</strong> <strong>Pacific</strong> region,although significant variation is apparent. Moreover, <strong>the</strong>size of <strong>the</strong> eligible population of married females 15 to 49years of age underscores a uniquely volum<strong>in</strong>ous scale ofprotection to be provided through organized services. Thisranges from 258.5 million <strong>in</strong> Ch<strong>in</strong>a <strong>and</strong> 220 million <strong>in</strong> India,to 45.4 million <strong>in</strong> Indonesia down to several thous<strong>and</strong>s <strong>in</strong>countries <strong>and</strong> territories <strong>in</strong> <strong>the</strong> <strong>Pacific</strong> region.Based on data for <strong>the</strong> years from 1994 to 2007,contraceptive methods <strong>in</strong> use are predom<strong>in</strong>antly modernacross countries <strong>in</strong> <strong>the</strong> <strong>Asia</strong>n <strong>and</strong> <strong>Pacific</strong> region, although<strong>the</strong> practice of natural (traditional) methods of familyplann<strong>in</strong>g is high <strong>in</strong> Japan, which relies significantly oncondoms (40.7%) <strong>and</strong> withdrawal (11.8%). The use ofwithdrawal is also high <strong>in</strong> Iran (11.4%), Cambodia (8.3%)<strong>and</strong> <strong>the</strong> Philipp<strong>in</strong>es (7.3%). The use of <strong>the</strong> rhythm method(periodic abst<strong>in</strong>ence) does not exceed 10 per cent <strong>in</strong> anycountry, but overall traditional method use is 10 per centor higher <strong>in</strong> Malaysia (24.6%), Turkmenistan (16.6%),Sri Lanka (15.3%), Nauru (12.6%), Viet Nam (10.8%),<strong>the</strong> Democratic People’s Republic of Korea (10.4%) <strong>and</strong><strong>the</strong> Republic of Korea (10%), <strong>in</strong> addition to <strong>the</strong> fouraforementioned countries.Male sterilization use exceeds 10 per cent <strong>in</strong> <strong>the</strong> Republicof Korea (15.7%) <strong>and</strong> Bhutan (13.6%) only, <strong>and</strong> is 6.9per cent <strong>in</strong> Ch<strong>in</strong>a <strong>and</strong> 6.3 per cent <strong>in</strong> Nepal. Femalesterilization, on <strong>the</strong> o<strong>the</strong>r h<strong>and</strong>, is a frequently adoptedmethod <strong>in</strong> India (37.3%), Ch<strong>in</strong>a (33.1%) <strong>and</strong> Thail<strong>and</strong>(26.6%). Similarly IUDs are heavily used <strong>in</strong> Uzbekistan(49.7%), Viet Nam (43.7%), <strong>the</strong> Democratic People’sRepublic of Korea (42.8%), Ch<strong>in</strong>a (39.6%), Turkmenistan(39%), Kazakhstan (36.2%), Kyrgyzstan (32%), Mongolia(28.9%) <strong>and</strong> Tajikistan (26.3%). Injectables predom<strong>in</strong>ate<strong>in</strong> Indonesia (34.6%), Cook Isl<strong>and</strong>s (20.8%), Kiribati(20.7%), Sri Lanka (15.3%), Myanmar (14.8%), Thail<strong>and</strong>(13.2%), Mongolia (11.9%) <strong>and</strong> Nepal (10.9%). The pillcaptures users <strong>in</strong> Thail<strong>and</strong> (36.7%), Bangladesh (28.5%)<strong>and</strong> Iran (25.1%), as well as <strong>in</strong> Cook Isl<strong>and</strong>s (24%) <strong>and</strong>Guam (22.6%), while also be<strong>in</strong>g a key contraceptivemethod (over 10%) for users <strong>in</strong> Cambodia, Indonesia,Laos, Malaysia, Maldives, Mongolia, Palau, <strong>the</strong> Philipp<strong>in</strong>es,S<strong>in</strong>gapore, Vanuatu <strong>and</strong> Viet Nam. In addition to Japan,condoms are a significant method of choice <strong>in</strong> Hong KongSAR (45.6%) <strong>and</strong> S<strong>in</strong>gapore (22%).It is important to evaluate <strong>the</strong> annual percentage po<strong>in</strong>tchange <strong>in</strong> CPRs between 1997 <strong>and</strong> 2007, s<strong>in</strong>ce <strong>the</strong> trendl<strong>in</strong>e between national-level TFRs <strong>and</strong> CPRs suggests that,for every 1.5 percentage po<strong>in</strong>t <strong>in</strong>crease <strong>in</strong> <strong>the</strong> latter, TFRwill decl<strong>in</strong>e by 0.1 child, or that a rise of 15 percentagepo<strong>in</strong>ts will be associated with a 1.0 child decl<strong>in</strong>e <strong>in</strong> TFR(Ross et al., 1993). Several countries approach or exceedthis figure, e.g., India (1.1), Afghanistan (1.4), Nepal (2.2)<strong>and</strong> Cambodia (2.3), while some show regression <strong>in</strong> CPRswith negative values, e.g., Kazakhstan <strong>and</strong> Kyrgyzstan47