Couple Unmet Need for Family Planning and Application to Three West African Countries

Introduction: Unmet need is an important indicator of demand for family planning services. Unmet need is typically calculated for currently married women, but excluding husbands from the calculation may provide misleading estimates of demand since husbands’ preferences are related to reproductive behaviors.

Methods: This study proposes a method of calculating couples’ unmet need for family planning based on spouses’ independent fertility intentions among fecund nonusers of contraception. Demographic and Health Survey couple data from Benin, Burkina Faso and Mali are used.

Results: Across the three countries, less than half of the couples with unmet need had concordant unmet need (39.2-43.2%). A similar proportion of couples had wife-only unmet need (35.8-43.5%). A smaller proportion of couples had husband-only unmet need (17.3-21.0%).

Conclusions: Calculating unmet need based only on women’s fertility intentions overestimates couples’ concordant unmet need. Additionally, that approximately one-fifth of couples have husband-only unmet need suggests that men could be an entry point for contraceptive use for some couples. To calculate husbands’ unmet need, population-based surveys such as the DHS should consider collecting the necessary data consistently between men and women and across countries and survey years.