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Background

In 1960, few women in the developing world used contraceptives (Robinson & John, 2007). Family planning programs that started at the time across sub-Saharan Africa (SSA) made steady progress, but contraceptive prevalence rates are still very low, and unmet need for contraception in SSA is still unacceptably high (Aliyu, 2018). In 2019, it was estimated that more than 214 million women in the developing world wanted to avoid pregnancy but had an unmet need for contraceptives (Guttmacher Institute, 2017). Again, of the estimated 206 million pregnancies that occurred in 2017 in developing regions, 43% were unintended (Guttmacher Institute, 2017). Recent analysis of data from 24 SSA countries show that more than 50% of married women (15–49 years) with a need for family planning were not using modern methods (Population Reference Bureau (PRB), 2020). Contraception is a means of enabling individuals and couples to control their reproductive life (Cleland et al., 2006) and contraception allows women to be more economically active (Global Health Council, 2019). Furthermore, contraception has numerous benefits for the mother, the child and the community at large (Aliyu, 2018; Dansou, 2017). Generally, planned pregnancies are safer for the mother and produce healthier children than unplanned pregnancies. Additionally, the cost of averting unwanted births is quite insignificant compared to the cost of unwanted births (Cleland et al., 2006). Expanding access to and use of contraception and reduction of unmet need for family planning are key components of improving reproductive health (Leontine, Kantorova, Menozzi …