Describe the global pattern of birth control use shown on the map.

Suggest two reasons why the percentage of women using some type of birth control is low in some countries.

Explain two reasons why the Crude Death Rate is falling in most low-income countries.

Award [1 mark] for each valid descriptive point, up to a maximum of [3 marks].

Possible descriptions include:

• high birth control use is mainly found in the Americas, Europe, Russia, China, and Australia [1 mark]
• low birth control use is seen in some parts of Sub-Saharan Africa [1 mark] (Not all of Africa)
• mid usage is shown in, for example, the Middle East, North Africa, South and South West Asia [1 mark]
• majority of the world is over 50% birth control use.

Award the final [1 mark] for valid reference to anomalies or quantification/use of data.

Award [1 mark] for each valid reason, and [1 mark] for development and/or exemplification.

Answers must be specific to birth control/contraceptive use/access.

eg for religious or cultural reasons [1 mark] the use of contraceptives amongst women is very low in Afghanistan [1 mark].

Possibilities include:

• Religious/cultural reasons – see example
• Poverty – “poorer women use contraception a lot less than wealthier women” – WHO
• Access – many women live in remote/rural regions and do not have access to any modern methods of contraception
• Lack of gender empowerment – could be very low priority and as such promotion of contraception is limited
• Aid agencies limiting funding to family planning and promoting abstinence policies instead eg Bush administration PEPFAR
• Government policies related to family planning services
• Education of women and how this could influence their choices or lack of choices re contraceptive use.

Award [1 mark] for each distinct, valid reason, and [1 mark] for development and/or exemplification.

eg access to antiretroviral therapies in many Sub-Saharan African nations [1 mark] has reduced the crude death rate amongst HIV+ individuals [1 mark].

Crude Death Rates are falling; in fact all nations according to the UN are below 20/1000.

Possibilities include:

• vaccination programmes
• water and sanitation
• increased wealth in some nations – more hospitals, better health care
• the work of civil society organizations and multinational organizations such as MSF/WHO
• improving food security and access
• education, especially of women, results in healthier families, lower infant and child mortality rates
• diet, improving due to access/distribution
• hazard mitigation strategies = less fatalities.

Accept any other valid reasons.

Most candidates were able to describe the global pattern with emphasis on areas of birth control use with quantification and reference to anomalies. However, there were some responses that looked at the pattern with no quantification. There were also some responses that failed to look at the global pattern, leaving entire continents out of their description. The best responses were very specific in location with named countries or regions and made sound use of data from the key. Some candidates lost time in attempts to explain the pattern using terms such as “MEDC” and “LEDC”.

Most candidates were able to give two distinct and valid reasons but there were some repetitive and mirrored answers. In some cases the candidates did not demonstrate how the selected reasons could influence the choices or lack of choices of some type of birth control. This was essential to get the second mark. Some weak answers were far too generalized and named examples tended to enrich responses.

There were some very good answers that examined the rollout of ARVs (antiretroviral therapies) in some Sub-Saharan African nations and the impact this has had on lowering the death rate. Other candidates were able to explain the importance of improvements in such things as: medical care; infrastructure; food security; diets; clean water and sanitation. Two distinct, valid reasons, with development and/or exemplification were required.