Family planning is a core component of sexual and reproductive health and rights and an essential part of universal health coverage. Enabling women and couples to decide freely and responsibly whether and when to have children improves health, autonomy and broader social development, while access to effective contraception helps prevent unintended pregnancies and avoidable maternal deaths. Reflecting this importance, SDG target 3.7 calls for universal access to sexual and reproductive healthcare services, including family planning, information and education, and the broader evidence base continues to show that contraception is closely linked to better health and well-being outcomes for women and families (Starrs et al., 2018[1]).
Contraceptive use remains highly uneven across LAC, with a more than twofold gap between the countries at the top and bottom of the distribution (Figure 4.1). Nicaragua (79.3%), Brazil (78.1%) and Colombia (77.2%) report the highest prevalence, while Guyana (37.9%), Haiti (36.9%) and Trinidad and Tobago (36.5%) record the lowest levels. The LAC33 average stands at 62.1%, and most countries cluster between around 55% and 73%, suggesting that contraceptive use is widespread in much of the region but remains substantially lower in a smaller group of countries. This pattern is consistent with wider regional evidence showing that, despite important progress, inequalities in contraceptive coverage persist across and within countries (Ponce de Leon et al., 2019[2]).
Coverage of family planning with modern methods is high in much of the region, but important shortfalls persist (Figure 4.2). On average, 77.8% of women in need of contraception across LAC33 have their need satisfied with modern methods, with the highest levels in Nicaragua (90.0%), Uruguay (89.8%), Brazil (89.7%) and Colombia (87.3%). By contrast, Haiti (51.1%), Guyana (56.8%) and Trinidad and Tobago (57.1%) remain well below the regional average, and Bolivia also records a comparatively low value (60.9%). This indicator is particularly policy-relevant because it captures whether women who want to avoid pregnancy are actually protected by a modern method.
Adolescent birth rate remains a major challenge in several LAC countries, particularly among girls aged 15‑19 years, and births among very young adolescents have not been eliminated (Figure 4.3). The birth rate among 15‑19 year‑olds reaches 71.3 per 1 000 in Nicaragua, 57.6 in Guatemala, 52.1 in Belize and 51.9 in Panama, compared with an LAC18 average of 38.6. Among girls aged 10‑14, the regional average is 1.4 per 1 000, but rates are markedly higher in Nicaragua (4.69), Ecuador (2.45), Colombia (2.10), Guatemala (2.03) and Panama (2.03). By contrast, Chile records much lower rates in both age groups. WHO treats births among girls aged 10‑14 and 15‑19 as distinct indicators, and the broader literature shows that adolescent pregnancy is associated with higher risks for both mothers and newborns, especially at younger ages (Nove et al., 2014[3]).
The coexistence of lower contraceptive coverage and high adolescent fertility in other settings indicates that financial, geographic, informational and social barriers continue to limit reproductive autonomy, especially for adolescents and women in more disadvantaged circumstances. Recent evidence shows that inequalities in contraceptive coverage persist and that lower gender inequality is associated with better coverage of demand satisfied with modern methods; the literature also continues to link access to contraception with gains in maternal health and women’s well-being (Moreira et al., 2023[4]).
