Background: This paper presents information on needs, barriers, and approaches to access and use of contraception by adolescents in low and middle income countries (LMIC). Despite the various strategies and policies, total fertility rate still remains high at 4.6 percent, while CPR and unmet need for family planning are estimated at 46 percent and 24 percent, respectively. These are aimed at increasing contraceptive prevalence rate (CPR), reduction in both total fertility rate (TFR) and unmet need for family planning services. Methods: An electronic search of the published literature was conducted using the search terms contraceptive use”, “contraception”, “family planning”, and “Sub-Saharan Africa”. This was supplemented by including search terms for the various types of contraceptive methods, e.g., Dual Contraception, Hormonal contraception, Female Sterilization, and Barrier methods, in combination with “Sub-Saharan Africa”, “Socio-cultural”, “Socio-Economic” and then comparing the results with the main search to identify articles that may have been missed. PubMed, Google Scholar, Cochrane, Sage Journal’s, PLoS Medicine, and all indexed journals on Contraception, Family Planning, Reproductive Health, and Obstetrics and Gynecology that specifically addressed contraceptive issues in Sub-Saharan Africa were searched. The search was restricted to English language articles. Results: Contraception is one of the four important proximate determinant factors of fertility identified by Bongaarts (1978). The role of contraceptive use in population reduction and reproductive health cannot be over emphasised. However, in many countries, particularly sub-Saharan Africa, modern contraceptive use and prevalence is especially low and fertility is very high resulting in rapid population growth and high maternal and child mortality and morbidity. It is estimated that over 215 million women in the developing world have an unmet needs for modern contraceptives. Conclusions: In summary, we have shown that there is abundant information that contraceptive knowledge and awareness is high among the Sub-Saharan Africa population, but this awareness has not translated into increased contraceptive use, with the end result being very low contraceptive prevalence. This low contraceptive prevalence correlates with high levels of unplanned pregnancies and abortions, leading to increases in the maternal mortality ratios especially in the rural areas. The changes observed in some countries over the past decade indicate that selected parts of Africa have joined other regions of the developing world in a contraceptive revolution.

Contraception, Family Planning, Sub-Saharan Africa