Benefits of Meeting the Contraceptive Needs of Ugandan Women
• As of 2008, an estimated 56% of all pregnancies in Uganda are unintended. Unintended pregnancy is highest in the West Nile region (64%) and lowest in the Southwest (49%).
• Seven in 10 women who want to avoid pregnancy either do not practice contraception or use an ineffective (traditional) method. These women have an unmet need for a modern method of family planning.
• Meeting just half of this unmet need would result in 519,000 fewer unintended pregnancies each year, which would lead to 152,000 fewer induced abortions and 1,600 fewer maternal deaths. Women in disadvantaged households and regions currently experience the worst maternal health outcomes and would benefit the most from reducing unmet need.
• If all unmet need for modern methods were satisfied, maternal mortality would drop by 40%, and unplanned births and induced abortions would decline by 84–85%.
• Investing in contraceptive commodities and services to fill all unmet need would result in a net savings of US$112 million (194 billion Ugandan shillings) over what would otherwise be spent on costs associated with unplanned pregnancies and births. For every dollar spent, more than three dollars would be saved.
• All stakeholders, including the Ugandan government, should increase their investment in modern contraceptive services. Particular attention should be paid to meeting the needs of poor Ugandan women to reduce inequalities in access.
*By modern contraceptives, we mean sterilization (male or
female), pills, IUDs, injectables, implants and male
*Maternal mortality is difficult to measure,
and estimates range from 435 maternal
deaths per 100,000 live births, according to
the 2006 Ugandan Demographic and Health
Survey (UDHS),4 to 550, according to the
World Health Organization (WHO).7 We use
the WHO estimate here for two reasons: First,
unlike the UDHS figure, the WHO estimate has
been adjusted for underreporting and
misclassification of maternal deaths. Second,
the 550 per 100,000 is very close to the
Ugandan Ministry of Health estimate of 541
per 100,000, which is based on routine
reporting of data from districts and health
facilities (source: unpublished 2008 data from
the Health Management Information System,
Ugandan Ministry of Health).
*This definition of unmet need differs from
the standard definition used in DHS surveys
in two ways. First, our denominator is
narrowed to women who are sexually active,
are able to become pregnant, and want to
limit or postpone childbearing, but the DHS
denominator encompasses all married women
(and, for some countries, sexually active
unmarried women as well) regardless of their
childbearing intentions; likewise, we restrict
the denominator for contraceptive prevalence
to just women who want to avoid pregnancy.
Second, we include women using traditional
methods in our definition of those with
unmet need, because traditional methods
have relatively high failure rates,16 leaving
women vulnerable to unintended pregnancy
and its negative consequences.
*We present all costs in 2008 U.S.
dollars. Net savings are also presented
in Ugandan shillings, using the average
exchange rate for the period: 1,735.67
Ugandan shillings per dollar.