By: Siswanto Wilopo, Robert Mangani
In order to emphasize the principle that all women and their partners are entitled to access to family planning and other reproductive health services, many of the FP2020 “core” indicators are being measured for all women of reproductive age (WRA) as opposed to only among married women (MWRA) as has been traditionally done. Notable among indicators affected by this refinement are the Modern Contraceptive Prevalence Rate (mCPR) and the Number of Additional Users of Modern Contraception, two of the “headline” FP2020 core indicators.
While being based upon sound human rights principles, interpreting trends in key indicators measured for all WRA can be confounded by changes in the proportion of women of reproductive age that are married (and presumably exposed to risk of pregnancy). In cases where marriage patterns in a given country are changing rapidly, it can become challenging to determine what share of observed changes in mCPR is due to changes in contraceptive
behaviors, which is the intent of the indicator, versus changes in population composition with regard to proportions WRA that are married.
Such a scenario arose recently in Indonesia when the results of the 2015 PMA2020 survey revealed a modest increase in mCPR after many years of stagnation, but at the same time a marked increase in the proportion of women of reproductive age that were married. The relevant data are shown on the table 1. As may be observed, the mCPR increased by 1.6 percentage points from 2012 to 2015 among MWRA women and 3.1 percentage points among WRA. However, the 2015 PMA2020 revealed an increase in the proportion of women of reproductive age that were married from 73% to 76%.
When this increase is taken into account, the change in mCPR among WRA that is due to changes in contraceptive behaviors falls to 1.2% (with remainder being due to the increase in the proportion of women of reproductive age that were married).