Contraceptive prevalence rate, total fertility rate, unmet need for family planning

Around 25-40% of maternal deaths could be eliminated if unplanned pregnancies are prevented. When the use of contraceptives is low in a country, the total fertility rate – average number of children per woman during her life time – is often high. Some countries in the Region have maintained a stable population growth by reaching a total fertility rate of 2.1-2.2.

Contraceptive prevalence rates (CPR) in countries with a high MMR and a low proportion of skilled care at birth are usually low, as the case in Papua New Guinea (36%), Lao People's Democratic Republic (38%) and Cambodia (40%) in 2008. China, Viet Nam and Mongolia have a high CPR, ranging from 66% to 85%, while the Philippines reached 51% in 2008. Most of the countries/areas in the Pacific islands have a CPR of less than 40%.

The total fertility rate (TFR) in countries with a low CPR is usually high, as the case in Cambodia, Lao People's Democratic Republic and Papua New Guinea at 3.3-4.1 in 2008, while the Philippines at 3.2 and Pacific Island countries with a small population mostly at 3.9-4.4. Most of the countries with a high TFR often have limited choice of contraceptive methods.

Many couples want to limit or space their pregnancies and yet do not use contraception. They are said to have an unmet need for family planning. It was highest in Lao People's Democratic Republic (27%), the Philippines (22.3%) and Cambodia (16.6%), while in Viet Nam, Mongolia and China were as low as 4.8%, 4.6% and 2.3%, respectively. The high rates of unmet need for family planning reflect low accessibility to family planning information and services and poor quality of care. Other reasons include lack of necessary knowledge on family planning, limited contraceptive choice, fear of side-effects of contraceptive methods and social and cultural issues, such as women’s unequal bargaining power in decision making related to family planning and the high cost of contraception in some countries.