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Family planning services in Sub-Saharan Africa.


 By expanding use of family planning Sub-Saharan Africa, countries can limit the expected growth in population to below 1.8 billion by 2050: evidence for unmet needs, as well as feasible means of improving use of family planning are discussed. Government generally support family planning, but actually provide limited services, usually restricted to maternal-child health clinics. They need to expand services to adolescents, young married women and men, to offer more choices including sterilization, and to utilize other means of distribution. Evidence for unmet need for family planning, that is numbers of women who do not currently use, but who express desire for no more children, is suggested by the rising abortion rates. Educated women especially are increasingly resorting to clandestine abortions. A few areas and pilot studies indicate high contraceptive rates, when services are provided effectively. People fear contraceptives because they think they cause infertility. People fear contraceptives because they think they cause infertility, while unprotected women actually are at higher risk of infertility because of illegal abortions and problem pregnancies. Governments need to supply more choices of contraceptives, and especially female sterilization. Vasectomy is virtually unused. Community-based and non-governmental distribution are untapped resources. Clinics are known to be less effective in motivating people to come for preventive care. In contrast, community women can provide services at lower financial and psychological cost, while improving the community's sense of control over health.
