Eight Countries, Thirteen Years: Who Won and Who Lost on Family Planning 

Thirteen years ago, eight countries began from different points on the same road: getting modern contraception to women who wanted it. By 2025, seven had cut the share of women whose need went unmet. One had watched it grow. In between sits a story of 26.8 million new users, a 12.2-point surge in Uganda and Burkina Faso, and a 2.4-point crawl in Nigeria, the country with the most women to reach. 

Kenya added 2.87 million women using modern contraception between 2012 and 2025 causing the share of women using a modern method rose by 8.7 percentage points, and unmet need fell by 3.5 points. Kenya is behind Uganda, Burkina Faso and Ethiopia, but far ahead of Nigeria. 

Uganda and Burkina Faso gained 12.2 points each. Ethiopia gained 11.2, Kenya 8.7 and Ghana 7.5. Bangladesh gained 3.9, Pakistan 3.2 and Nigeria just 2.4. 

Unmet need tells a similar story as it fell in seven countries, most in Burkina Faso (6.4 points), Uganda (6.1) and Ethiopia (6.0). In Nigeria it rose by 1.7 points. Nigeria is the only country in the group where more women are left without the method they need than in 2012. 

The raw numbers add a twist. Nigeria added 3.34 million users, more than Kenya, Uganda, Burkina Faso or Ghana. Yet its overall rate barely moved. The likely reason is a fast-growing population of women, though the data does not prove it. 

What women are using 

In the African countries, injectables and implants lead are the most popular forms of contraceptives. In Ethiopia, for instance, they make up 86 percent of all modern methods used. In Kenya, injectables account for 32.5 percent while and implants stand at 31.5 percent. 

South Asia, however,  looks different as in Bangladesh, half of users take the pill. In Pakistan, most rely on male condoms or female sterilisation. 

Nigeria one detail stands out: 8.6 percent of its users rely on the breastfeeding method, which works only for the first six months after birth. In Kenya the figure is 1.4 percent. That may mean women in Nigeria have fewer choices, though the data cannot confirm it. 

Stock and information 

In Ethiopia, 93 percent of primary health facilities offer at least three modern methods while in Burkina Faso it is 96 percent. In Nigeria it is only 41 percent, even though 82 percent of larger hospitals offer a wide range. The gap is in the clinics closest to communities. Nigeria also reports that 59.2 per cent of facilities had run out of emergency contraception. 

The method information index measures whether women were told about side effects and other options. Scores are low almost everywhere: Like in Bangladesh it was at 4 percent and 16 percent in Pakistan. In Kenya it stood at 19 percent. Many women appear to leave clinics without all the facts they need. 

Kenya also has a warning sign because about 37 percent of births are unintended, the second-highest rate in the group after Ghana. More women are using contraception, but many births are still not planned. 

WHO says that in 2021, 1.1 billion women worldwide needed family planning. Of these, 874 million used modern methods and 164 million had an unmet need. WHO adds that the share of need met by modern methods has stayed at about 77 per cent globally since 2015, but rose from 52 to 58 per cent in sub-Saharan Africa. 

WHO also stresses that condoms are the only method that protects against both pregnancy and infections such as HIV. It says modern methods do not cause infertility. And it treats family planning as a right: the right to decide how many children to have and when. 

WHO counts unmet need among women who use no method at all. The dashboard counts unmet need for modern methods only. The two sets of numbers should not be placed side by side. 

Generally, numbers rise where clinics stock a range of methods, staff offer real choice and women are told what to expect. Where clinics are thinly supplied, progress stalls. For Kenya, the next task is to turn higher use into planned births and to improve the advice women receive. 

Data visualization: Stanley Njihia 

Text: Yvonne Kawira