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The total fertility rate declined from 4.9 to 4.6 children per woman between 2003 and 2008/2009. The use of contraceptives, measured as the contraceptive prevalence rate for all methods rose from 39 % to 46 % during the same period, with wide regional variations ranging from 4 % in the north east to 63.5 % in central regions.

Sociocultural factors hinder the utilization of family planning services. Inadequate resource allocation to family planning commodities, inadequate capacity to forecast family planning needs, weak supply chain management, and inadequate capacity at the facility level to provide family planning services, particularly long acting and permanent family planning methods are among the key issues.

The pregnancy rate for teenagers (defined as 15 to 19 year olds) declined from 23 % in 2003 to 18 % in 2008, thanks to increased awareness and access to sexual and reproductive health information and services. Despite this, access is still a challenge, partly due to the lack of comprehensive sexuality education in the school curriculum and low coverage of youth friendly services at 7 %.