Despite the strong evidence that increasing contraceptive use accelerates development, 570 million (30%) of the 1.9 billion women aged between 15 and 49 in the world may be regularly exposed to the risks of sex without contraception. First there are the 214 million married and partnered women in need of modern contraception, according to the Guttmacher Institute. Second, there are 900 million single women and girls. If we estimate that 360 million (40%) of these single women have an unmet need for modern contraception, the total pool of unprotected women in the world rises to 570 million – 30% of all women aged 15 to 49 years.
Global contraceptive initiatives like Family Planning 2020, studies like the 2012 Lancet Family Planning Series, and databases like World Contraceptive Use all underestimate the size of the population of exposed women because they focus only on married and partnered women. As a result, much less is known about the contraceptive status of single women and girls. It is highly likely that single women face even greater barriers to using contraception and are at a higher risk of unplanned pregnancy compared to their married and partnered peers. A 40% unmet need for modern contraception among single women may be a significant underestimate.
Single women and girls may also be at greater risk of unwanted pregnancy from forced or coerced sex. Rates of sexual violence are high across all regions, but especially in Africa and South Asia where four in 10 women will experience partner violence in their lifetimes, according to the World Health Organisation. In these regions, one third of girls will experience an incident of sexual violence before they reach 18 years of age, according to the Violence Against Children surveys supported by the Together for Girls initiative. We should not underestimate the pregnancy risks to girls and single women in societies with low modern contraceptive use and high rates of sexual violence.
It is of great concern then, that among the ten largest populations of unprotected women and girls, nine are in Asia and Africa. India is home to an estimated 85 million women and girls with an unmet need for modern contraception, China to 25 million, Pakistan to 16 million, Indonesia to 16 million, Nigeria to 15 million, Bangladesh to 10 million, the Philippines to 8 million, Ethiopia to 8 million, and the Democratic Republic of Congo to 7 million. Together, these ten countries are home to 180 million (30%) of the estimated 570 million exposed women and girls. It is important to note that the USA is the only non-Asian or African country in the top ten, with an estimated 18 million women and girls with an unmet need for modern contraception.
Of special concern are the large populations of unprotected women and girls in the countries with extremely low (<20%) modern contraceptive use, high fertility rates (more than 5 children per woman), and high adolescent birth rates (over 100 births per 1,000 15-19 year old girls). In addition to Nigeria and the Democratic Republic of Congo, Niger, Somalia, Mali, Chad, and Angola, fall into this category. Increasing modern contraceptive use in all of these countries could yield major national and regional development returns, including increased economic growth, reductions in poverty and inequality, and improvements in maternal and child health, and education.
Further, due to the “youth bulge” in many of these countries, increasing modern contraceptive use could also deliver a long-term “peace and security dividend”. By 2030 the number of young men (15 to 29 years) will have increased by more than 50% in most of the central and west African countries. The rising numbers of young men, many of whom will come of age during period of high unemployment and rapid urbanization, could become a potent force for conflict and insecurity.