A Framework for Understanding the Contraceptive Revolution

Between 1960 and 1990, the proportion of couples in Asia and Latin America who were current users of contraception rose from about 10% to 60% but the timing and pace of change varied between countries. Trends in sub-Saharan Africa have been modest in comparison. The concepts of supply of children, demand for children and costs of regulating births, derived from Easterlin, are used as a framework towards a better understanding of reproductive change. Three main categories of countries are identified: (1) those with low demand and low costs where increased use of contraception is rapid; (2) those with low demand but high costs where, initially, contraceptive use rises slowly and unmet need persists for long durations; in these settings family planning programs have been of particular importance; (3) those with high demand and high costs, where changes in contraceptive use are slow.