Local health care providers and wider contraceptive options increase contraceptive use in many countries

Vox (May 20,2016): What the US can learn from Ethiopia about birth control, by Sarah Frostenson: 

The use of modern contraceptives has tripled in Ethiopia since 2005, following a government program to train women health workers to go door to door to deliver birth control.

What's more, women in Ethiopia are having fewer children (the fertility rate fell from an average of 6.5 children per woman in 2000 to 4.6 currently), maternal deaths are in decline, and more women are staying in school longer. Plus, more women are opting for long-acting reversible contraceptives (LARCs) instead of more traditional short-term methods like birth control pills or condoms.

Local health care providers can make a big difference in women's access to contraceptives as can providing a range of contraceptive options. Long acting reversible contraceptives (LARCs) play a big part in increasing effective use of contraceptives in many countries.  LARC implants last for 3 years and do not require going to a clinic to take medication or remembering to take a pill.  They also allow women to keep their contraceptive use secret.  However, LARC use can be prohibitively expensive for low-income women who would otherwise choose them.  Some poorer countries are able to provide contraceptives that are donated by NGOs and the international community, removing the cost-barrier for many women.  

Use of LARCs is increasing at a faster rate in some poorer countries than in the U.S.  About 12% of women in the U.S. use LARC methods.  Recent cuts to family planning in the U.S.  resulting in closure of local family planning clinics decrease women's options of contraceptive methods and make it more difficult and expensive for them to access birth control.  For instance in Texas,  82 of family planning clinics closed following a recent drastic cut in family planning funding.  A study found the cuts lead to an increased birth rate for low income women and a "sharp decrease " in use of LARCs.