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In this blog post, Gates Open Research chats to Michelle Weinberger (Senior Associate, Avenir Health) about her work in contraceptive technologies.  

Michelle Weinberger’s Research Article projects the impact of demographic changes, evolving fertility preferences, shifts in sexual activity outside of marriage, and increased utilization of contraceptives and how this will shape the contraceptive market by 2040.

First, let’s meet the author!  

Michelle Weinberger is a demographer with nearly two decades of experience working in reproductive health. She builds quantitative models and conducts data analysis to help inform strategic policy and programmatic decision-making. Her work focuses on family planning, which explores the role of the public and private sectors on contraceptive services, understanding the effectiveness of different types of interventions, and what factors influence contraceptive use and non-use. She has been a Senior Associate at Avenir Health for seven years, working on many projects. Before joining Avenir, she led the Impact Analysis team at Marie Stopes International and has an MSc in Population and Development from the London School of Economics (LSE).  

Hello Michelle, how did this study come to fruition?  

The study built upon analysis we conducted to support the Bill and Melinda Gates Foundation’s investments in new contraceptive technologies. Early investments in new contraceptive technologies may not yield products being brought to market for another 10-20 years. So, the key question that we explored was how we expect the world to look in 20 years and what we might expect to change in terms of women’s contraceptive needs and preferences. This way, we can help to ensure that today’s investments will result in products that meet the needs of women in the future when the new products become available.   

To do this, we explored a range of measurable (e.g., data is consistently available across a vast number of countries) and projectable (e.g., we can say with at least some certainty how we think things are changing) indicators to inform the work. We settled on a framework that looked at marital status, fertility preferences among married women, and levels of pre-marital sex among never-married women. We created a model to segment all women of the world (by country) into these segments, then forward projected changes in these segments to the year 2040. 

What did you find?  

Our work produced a wide range of results. We found distinct differences in the share of women falling into each of our segments today across regions and that patterns of change as we look to 2040 will also vary.  

We found that Sub-Saharan Africa will see dramatic changes in segment sizes; married women wanting no more children have the largest projected increase (+70 million), followed by never-married sexually active women (+56 million). It’s also interesting to note that married women wanting no more children will be the single largest segment in all regions in 2040; globally, 4 in 10 women of reproductive age will be in this segment. The contraceptive needs of these women are likely to be unique, wanting long-duration methods that can help them avoid any further pregnancies.   

Did you face any challenges throughout your study?  

There are many uncertainties about how things will change between now and 2040. For many inputs to our model, we were able to rely on existing demographic projections developed by the United Nations Population Division to help bring more certainty to our trends. The area that was the hardest to project was what types of changes we might expect to see in pre-marital sexual activity. We see huge ranges worldwide, from countries with almost no pre-marital sex to countries where almost all women initiate sex before marriage.  

While we were able to gather extensive data to understand what the current patterns of pre-marital sexual activity are, a key challenge was figuring out how this might change in the future. A range of socio-cultural factors are likely to influence these patterns, and it is almost impossible to predict what might change. Ultimately, we decided on an approach where we segmented countries into 5 profiles based on their level of pre-marital sexual activity (low, med/low, med/high, high, very high). We then assumed that countries would ‘step up’ one level from where they currently are – so countries in the very low group would move up to the med/low group etc. This allowed us to build a modest level of liberalization.  

What impact do you hope your findings will have?  

We hope that our projections will help inform decisions about new investments in contraceptive technologies by providing important context about the evolution of the global family planning market. We also hope that our projections are helpful beyond the development of new contraceptive technologies by providing a valuable approach to segmenting women. By applying this segmentation consistently worldwide, we think our data can be useful to program planners and implementers.  

Why did you choose to publish your research openly?  

Publishing with Gates Open Research brings multiple benefits. First, they have an open peer review process, where reviewers’ names, full reviews, and recommendations are published alongside the article, bringing transparency and accountability to our article. Second all articles are published free of charge to users funded by the Gates Foundation, then made accessible to a wide audience as there aren’t any payment barriers. Finally, articles are put online in a timely fashion, even before they pass peer review, allowing research results to get out to the community quickly. We felt Gates Open Research was a good fit for our work for all these reasons!  

What’s next for you in this area of study?  

The demographic modeling results presented in this paper fed into the second stage of modeling, which overlaid these population segments with data we collected about contraceptive preferences among different segments of women. This allowed us to develop forecasts of what would be likely to adopt or switch to different new contraceptive methods, depending on the method’s attributes (e.g., how often you have to use it).   

Read the full Research Article today on Gates Open Research to dive deeper into Michelle Weinberger’s study and findings. You can stay up to date with her latest work and insights by following her, or Avenir Health on Twitter.