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Abstract
National surveys show a remarkable upsurge in the use of injectable contraceptives in east and South Africa, in contrast to central and West Africa and certain other regions. Data are analyzed here from 95 surveys conducted since 1980 in 38 sub-Saharan African countries, to determine past injectable trends in the context of alternative methods and to explore related issues. In eastern and southern countries injectable use has risen to about 15%-20% of married women, equaling about 40% of all contraceptive use, with some countries above that. Increases in total use have followed increases in injectable use; that and other evidence is clear that the injectable has not merely substituted for the use of pre-existing methods but has given a net increase to total use. Rural use patterns are not much different from urban ones; however the middle and higher wealth quintiles have especially moved toward injectable use. In west and central countries traditional methods are still paramount, with modern methods increasing slightly, but total use remains quite low there. So far no plateau has appeared in total injectable use, though one may be emerging in its share of all use as other methods also increase. Most use is supplied through the public sector, which raises long term cost issues for health ministries and donors. Many sexually active, unmarried women use the method Discontinuation rates are quite high, and alternative methods need to be kept readily available (Afr J Reprod Health 2012; 16[4]: 68-80).
Résumé
Les enquêtes nationales montrent un essor remarquable dans l'utilisation des contraceptifs injectables en Afrique de l'est et en Afrique du Sud, contrairement à l'Afrique Centrale et de l'Ouest et dans certaines autres régions. Les données sont analysées ici à partir de 95 enquêtes menées depuis 1980 dans 38 pays d'Afrique subsaharienne, afin de déterminer les tendances d'injectables dans le contexte des méthodes alternatives et d'explorer les questions qui s'y liées. Dans les pays de l'Est et du Sud de l'utilisation des injectables a augmenté d'environ 15% à 20% chez les femmes mariées, ce qui représente environ 40% de toutes les utilisations des contraceptifs, certains pays ayant des chiffres supérieurs à cela. Les augmentations de la consommation totale ont suivi l'augmentation à l'égard de l'utilisation des injectables ; cela...