PRB

Family planning programs are high-impact, cost-effective interventions that improve maternal, neonatal, and child health outcomes. Family planning offers additional benefits to young women, including protecting access to education and employment and reducing the health risks of early childbearing. Despite recent advances in expanding access to voluntary family planning, 218 million women of reproductive age in low- and middle-income countries, including 14 million adolescent girls (ages 15 to 19), would like to prevent, delay, or avoid pregnancy but are not using modern contraception. Among these women with an unmet need, an estimated 38 percent are former family planning users who have discontinued use of a modern contraceptive method.

To align with health sector and development goals, family planning programs are often structured in ways that intrinsically emphasize initiation of new users. Elevating program goals and monitoring systems that also focus on current users will enhance the quality and reach of family planning programs. Contraceptive discontinuation among women who wish to prevent, delay, or space pregnancies inhibits individuals’ reproductive intentions and contributes to unintended pregnancies and abortions. Irregular, episodic family planning use across a large segment of the population has implications for population dynamics and age structure as contraceptive discontinuation accounts for 35 percent of unintended pregnancies.

Youth ages 15 to 24 have higher rates of contraceptive discontinuation than older women. As countries work to ensure women and couples are able to choose whether, when, and how often to have children, it is critical to examine the drivers of contraceptive discontinuation that may inhibit young people from achieving their reproductive intentions. This policy brief describes patterns of contraceptive discontinuation among youth and summarizes the evidence on the drivers of discontinuation, namely method-related concerns and poor quality of care. It presents new analysis of the primary elements of dissatisfaction with family planning care among youth that may contribute to contraceptive discontinuation and outlines the policy and program strategies that may enhance continuation among young women who wish to prevent, delay, or space pregnancies.