The reasons behind the alarmingly low usage of modern contraceptive methods in Eastern Europe and Central Asia are examined in a study published recently by the UN Population Fund (UNFPA) and the International Planned Parenthood Federation European Network.

“Although most countries in the region are middle-income countries, usage rates for modern methods of contraception are often much lower than those in less developed parts of the world,” said Werner Haug, the Director of UNFPA’s Regional Office for Eastern Europe and Central Asia.

“Thanks to this study we now have a better picture of why many people in the region do not use modern methods of family planning, and this will allow national authorities to react accordingly,” he added.

Eleven countries in the region have a modern contraceptive usage rate of less than 50 percent. In another five (Albania, Azerbaijan, Bosnia and Herzegovina, the former Yugoslav Republic of Macedonia, and Serbia) the rate is below 20 percent, lower than the average for the world’s least developed countries which stands at 22 percent. At the same time, the region has the highest abortion rates in the world.

The report, titled "Key Factors Influencing Contraceptive Use in Eastern Europe and Central Asia", identifies seven main reasons for these low usage rates:

1. Governments are insufficiently committed to develop and implement policies and programmes ensuring access to reproductive health and contraceptive security. Concerns about low fertility levels are a key contributing factor in some countries.
2. There is a widespread belief that modern contraception methods are harmful, possibly stemming from experiences with Communist-era high-dose contraceptive pills.
3. Young people often find it difficult to get access to contraceptives. This is because they lack information, because counseling services are not youth-friendly, or because they are embarrassed to ask for contraceptives at the pharmacy.
4. Providers of contraceptives – gynaecologists and general practitioners – do not always provide correct, up-to-date information and sometimes perpetuate myths.
5. In some countries, only a limited range of methods are prescribed or available on the market.
6. The cost of modern contraceptives can be prohibitive in some countries and limits the choice available to poorer segments of society.
7. Traditional social norms and gender power dynamics dictate sexual and reproductive behaviour in a number of countries, in effect limiting access to modern birth control methods.

The report is based on focus group interviews in seven middle-income countries across the region. It includes a set of recommendations on how to address the identified barriers and obstacles related to contraceptive security, which were endorsed by high-level government officials from 16 countries at a meeting in Brussels in June 2012.

Related resources

"Key Factors Influencing Contraceptive Use in Eastern Europe and Central Asia" report (available in English and Russian)

"Increasing Contraceptive Security in Eastern Europe and Central Asia" factsheet that includes the recommendations