Unpacking unmet need: reproductive health transitions

Current measures of unmet need for family planning at a single time point mask the magnitude of need women experience across their lifetimes and the disparities in unmet need faced by women of various socioeconomic backgrounds. In this study, we consider unmet need as a transitional state and propose new approaches of measuring unmet need over time. Using the contraceptive calendar data available in the Demographic and Health Surveys (DHS), we examine the number and length of unmet need episodes women experience over a five-year calendar period for 13 developing countries in Africa and Asia, and how these measures vary by household wealth, residence, and education. Our findings suggest that substantially more women experienced unmet need over the 5-year period examined than captured cross-sectionally. However, while women of all backgrounds experience unmet need, older and higher parity women, and women of low SES are more likely to experience longer episodes. Our results indicate the need to scale up family planning services and reach women multiple times across lifetimes. These longitudinal analyses unpack the complexity of unmet need women experience over time and help enable care providers to better meet women’s contraceptive needs.