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July 4, 2026BMJ Public HealthOpen Access

Contraception and unintended pregnancy: explaining the unexpected relationship in Sub-Saharan Africa using demographic and health survey data

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Authors

EWEliud WekesaASArsène Brunelle SandieANAnne Njeri

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Overview

Cross-sectional analyses reveal unexpected positive correlation between contraception and unintended pregnancy in Sub-Saharan Africa, suggesting implications for family planning strategies.

Key Points

  • This research aims to examine the unexpected relationship between modern contraceptive rates and unintended pregnancy rates in Sub-Saharan Africa.
  • Analyzed Demographic and Health Survey data from 271 country surveys.
  • Conducted both cross-sectional analyses using linear regression and longitudinal analyses with random and fixed effects models.
  • Disaggregated results by major world regions and stages of fertility transition.
  • A strong positive correlation between modern contraceptive prevalence and unintended pregnancy is observed in Sub-Saharan Africa.
  • This counterintuitive relationship is more pronounced in countries lagging in the fertility transition.
  • As countries progress through the fertility transition, the relationship trends towards the expected negative association.

Cite This Study

Wekesa et al. (2026) studied this question.

synapsesocial.com/papers/6a48a83589561a0c2d78ef45https://doi.org/10.1136/bmjph-2025-004440
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