Contraceptive Method Skew and Shifts in Method Mix In Low- and Middle-Income Countries

Method mix -- the percentage distribution of contraceptive users in a given country, by method -- is one measure that reflects the availability of a range of contraceptive methods. A skewed method mix -- one in which 50% or more of contraceptive users rely on a single method -- could be cause for concern as a sign of insufficiency of alternative methods or provider bias. Shifts in method mix are important to individual countries, donors and scholars studying contraceptive dynamics. To determine current patterns and recent changes in method mix, the authors examined 109 low- and middle-income countries. A variety of statistical methods were used to test four factors as correlates of skewed method mix: geographic region, family planning program effort index, modern contraceptive prevalence rate and human development index. Method mix skew is not a definitive indicator of lack of contraceptive choice or provider bias; it may instead reflect cultural preferences. In countries with a skewed method mix, investigation is warranted to identify the cause.