DO WOMEN IN LOWER-MIDDLE-INCOME-COUNTRIES(LMICs) HAVE THE RESOURCES TO PLAN FOR THEIR FUTURE?
The expansion and adoption of sexual and reproductive health rights is a critical priority within the 2030 SDG Agenda. SDG 5 target 5.6 seeks to, “ensure universal access to sexual and reproductive health and reproductive rights.” Contained within target 5.6 are a number of indicators, including: “the proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care,” and the “number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care, information, and education.” In LMICs there are currently as many as 923 million women of reproductive age who want to avoid pregnancy
Adding It Up (AIU) is an ongoing Guttmacher Institute project in which researchers estimate the need for and the use, costs and impacts of various sexual and reproductive health services in developing countries.
The Adding It Up approach starts with estimating the need, current use (or coverage), and the unmet need for care for components of sexual and reproductive health care: Need — Coverage =Unmet Need.
Unmet need is highest among the most vulnerable in society: adolescents, the poor, those living in rural areas and urban slums. It is disproportionately high among adolescents, with 43% of them being 15–19-year-old. Once pregnant, these adolescent girls often find that their journeys through education systems come to end. This makes them less likely to be able to work, placing them in a position of economic and social dependence, and increasing the likelihood that they will be victims of gender-based violence and sexual abuse. Unmet contraceptive need has a lasting impact on the health and wellbeing of these women and girls for the remainder of their lives. Beyond that, there is also a long-lasting generational impact.
Unmet needs for services are greatest in the poorest countries. For example, only 59% of women in low-income countries deliver their babies in a health facility, compared with 97% in upper-middle–income countries.
In this analysis, women aged 15–49 in each country were classified according to their risk for unintended pregnancy and contraceptive method use. These subgroups were summed to show women not wanting and wanting to avoid a pregnancy.
All currently married women are assumed to be sexually active. Because of the stigma attached to nonmarital sex, the level of sexual activity — and therefore risk for unintended pregnancy — is likely to be underestimated among unmarried women, especially in Asian and Arab countries, where stigma is especially strong. Almost all surveys in Sub-Saharan Africa and Latin America include unmarried women, although their sexual activity is likely to be somewhat underreported. However, unmarried women are largely excluded from surveys in Asia and Northern Africa, and, where they are included, underreporting of their sexual activity is likely to be extensive.
Let us look at what this means:
UNMET NEED FOR MODERN CONTRACEPTION
Women with unmet need for modern contraception are those who want to avoid a pregnancy but are currently not using a method or are using a traditional method. Women using traditional methods face higher risks of unintended pregnancy than those using modern methods and hence have been included in this category.
CONTRACEPTIVE NEED AND USE DISTRIBUTION
Not wanting to avoid a pregnancy and not in need of contraception — Unmarried women who are not sexually active (in the last three months), women who are infecund, those who want to have a child in the next two years, and those who are currently experiencing a pregnancy identify as having been intended or are experiencing postpartum amenorrhea from a pregnancy they identify as having been intended.
Wanting to avoid a pregnancy and in need of modern contraception — Women using a contraceptive method and non-users wanting to avoid a pregnancy, including women not wanting a child in the next two years (spacing) and those wanting no (more) children (limiters).
Using a modern contraceptive method (Met need) — Women relying on female or male sterilization (limiters only), IUD, implant, injectable, oral contraceptives, contraceptive patch or ring, emergency contraceptive pills, male or female condom, LAM, fertility-awareness-based method or other supply methods.
Using a traditional contraceptive method (Unmet need) — Women relying on periodic abstinence, withdrawal, or other non-supply methods.
Non-users in need (Unmet need) — Women using no contraceptive method wanting to avoid childbearing for at least two years, pregnant/in postpartum amenorrhea from an unintended pregnancy or using an ineffective method (herbs, charms, folk methods or vaginal douching).This is our target audience.
What worked for the visualization:
1. The viz gives a big picture of the data represented.
2. The data is broken down by region and is color-coded. This results in grouping of data in categories.
3. The data source is clearly stated.
4. The bar chart highlights what ‘unmet needs’ consists of and this helps in focusing on the target question of where women’s needs are not met.
What did not work for the visualization:
1. The dataset includes only 148 of 195 countries. The title of the viz suggests the use of contraceptives ‘world-wide’ which is misleading.
2. A table is a great way to store information. But is it one of the best ways to visualize data here?
3. Is there a story behind the numbers? If so, what is it? The original viz gives a lot of information but does not bring about a ‘a call to action’. What is the audience to gain out of this?
My interpretation:
1. I wanted to focus on the top 25 countries with the highest percentage of unmet needs among women wanting to avoid pregnancy.
2. I decided to use a horizontal dot plot to visualize categorical data (countries) using variables of position and color. The dot plot helps in identifying patterns much quicker than looking at the raw data of the table. It also has high scalability which means it can display plenty of data in a single chart. It is also space-efficient and a good way to show individual values across the entire distribution.
3. From the above visualization we see that Trinidad &Tobago in the Caribbean has the highest % of women with unmet needs. On the other hand, Sao Tome and Principe in Central Africa is the only country in the list where 32% of the women have met their needs in terms of access to modern contraceptives.
4. I also created a dot plot that analyzed the gap between women having met and unmet needs country-wise. The Democratic Republic of Congo has the biggest gap between those having met and unmet needs. Majority of the women do not use any method implying lack of education and age- old rituals pre -dominating their area of residence.
5. Trinidad & Tobago in the Caribbean is the only country to have nearly 32% of the women not using any contraceptive method.
6. Out of all the countries listed here, 18 of them are from Africa,1 from Latin America,2 from Asia,1 from Oceania and 1 from the Middle East.
Most women in lower middle-income countries (LMICs) do not get the kind of support that is needed to help them plan their future. What do you think?
