Most women today want two, three or four children — fewer than in generations past. The use of modern contraceptive methods has increased rapidly over the past 30 years, especially in less developed countries with strong family planning programmes. However, contraceptives are used by only 60 percent of couples in these countries. Most of programs reflect a greater contraceptive use by women.
The challenge is to provide services for the remaining 40 percent, who represent unmet needs. Poverty and profound inequalities between men and women limit women's ability to plan their pregnancies. So does lack of access to effective contraceptive protection. An integral part of reproductive health is ensuring contraceptive security, by which all persons are able to choose, obtain and use high-quality contraceptives whenever they need them.
In Egypt, the latest Demographic and Health Survey (2008) acknowledged that many Egyptian women are having more births than they consider ideal. Overall, 14 percent of births in the five years prior to the survey were reported not wanted. Among these, 5 percent of births were identified as 'mistimed', meaning wanted later; while 9 percent were unwanted entirely. If Egyptian women were to have the number of children they consider ideal, the total fertility rate would fall from 3.0 births to 2.4 births per woman.
Hence, as part of that national policy goal, the Ministry of Health assigns high priority to ensuring the continuation of supply of subsidized RH commodities through a well-established system of services. Yet challenges do remain. Gaps include financial pressures on public resources, inadequate user fees, limited information for decision making, lack of appropriate collaboration between sectors and partners working toward contraceptive security, and inadequate quality control measures in commodity testing and service delivery.
Despite all these gaps, the country has a strong government-led national family planning programme that has succeeded in raising the Contraceptive Prevalence Rate (CPR), from 47.6 percent in 1991 to 60.3 percent in 2008. Also, the Total Fertility Rate (TFR) has been slowly declining from 4.4 live born children per woman in 1988 to 3 in 2008, while the gap between the urban governorates and the rural ones has been reduced.
TFR has decreased because the 'average age at first marriage', the 'average age at first birth' and the 'contraceptive prevalence rate', have all increased. Egypt considers progress in TFR and CPR indicators as a prerequisite for achieving its national policy goal of reducing population growth and for the achievement of MDG 5 b: Universal access to Reproductive Health Services.