Contraception – a huge cause of controversy around the world

We at CLAHRC WM are very interested in not just differences, but similarities, across the globe. Access to contraception is an important issue in both rich and poor countries  for example, it is currently one of the main causes of controversy in both the USA and Uganda.

Two years ago, the Patient Protection and Affordable Care Act (commonly known as Obamacare) was upheld in the Supreme Court, mandating that organisations above a certain size offer their employees health insurance, including access to free contraception and  to family planning services.[1] However, this mandate was modified last month when a controversial decision [2] was passed through the Supreme Court ruling that organisations with religious owners do not have to pay for their employee’s contraception as religious objection trumps federal law.[3]

Making contraception freely and easily available in order to promote choice and family planning is as controversial in the USA as it is in many countries in Africa. Some say that contraception promotes extramarital sex and abortion, but the evidence does not support this. In fact, religious beliefs in Uganda have led to the country having the highest unmet need for contraception.[4] Unplanned pregnancies are common, leading to high levels of unplanned births, unsafe abortion and maternal injuries and death.[5]

From a teleological point of view, the important thing for human societies is not to maximise the number of children born, but to capitalise on the numbers of successful and happy families.

We have argued in a previous blog that Africa seems to be experiencing a rather attenuated dividend from economic emancipation and “CLAHRC Africa” (Warwick Centre for Applied Health Research and Delivery W-CAHRD) is currently studying the availability and demand for contraception in many African countries.

— Jo Sartori, CLAHRC WM Head of Programme Delivery


  1. U.S. Department of Health & Human Services. Read the Law: The Affordable Care Act. 2012. [Online].
  2. Burwell v. Hobby Lobby Stores, Inc., 573 U.S. ­­___ (2014).
  3. Religious Freedom Restoration Act of 1993. Pub. L. No. 103-141, 107 Stat. 1488.
  4. Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala, Uganda: UBOS; and Calverton, MD: ICF International Inc., 2012.
  5. The Stakes are High: The tragic impact of unsafe abortion and inadequate access to contraception in Uganda. Nairobi, Kenya: Center for Reproductive Rights; Washington, D.C.: The International Women’s Human Rights Clinic; and Washington D.C.: The O’Neill Institute for National and Global Health Law. 2013.

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