Unmet need for family planning

In Bangladesh, fertility was high in the 1950s and declined to fewer than five births per woman in the early or mid-1990s like other developing countries. After that the level of fertility is stalled. The aim of this study is to assess the extent of unmet need for family planning among married women of reproductive age group in Bangladesh and to study the factors related to it. Bangladesh Demographic and Health Survey data were used for the study. The results suggest that unmet need for family planning has increased during the last 3 years from time of the survey. The percentage of total unmet need is especially high among rural women, non working women, Muslim women, and women not exposed to media messages on family planning. The regression analysis shows that age, husband-wife communication, sex composition and visitation status of satellite clinic appear to be significant predictor for limiting unmet need. If we can reduce the current unmet need to zero then current met need will be 73 percent which is the required rate of achieving replacement fertility in Bangladesh. New program strategies are required to fulfill the conventional demand for family planning program in Bangladesh.

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.

This study aims to establish the relative importance of lack of access and attitudinal resistance towards use of family planning in accounting for unmet need among different population strata in Kenya and Senegal. Using 10 DHS data from the two countries, the main analysis extends and adapt the approach used in an investigation of progress in family planning need, access and attitude in Africa (Cleland, Ndugwa et al. 2011). Preliminary results from the most surveys show that in Kenya lack of access is a minor problem and that unmet need stems largely from abandonment of hormonal methods; the central problem is health concerns and side effects. In Senegal, both unfavourable attitudes and lack of access are barriers to use; over 60% of those with unmet need have an unfavourable attitude and one-third have no access to methods. Infrequent sex is deployed as an alternative contraception. Trends in access, attitude and reasons for non-use will be assessed.

A family planning survey was conducted in Shanghai in 2011 to investigate contraceptive use and non-use among married women aged between 15 and 49. A total of 21907 participants were randomly selected and interviewed by trained field workers. Findings show that 19.3% of participants did not use any contraceptive method. Among them, 39% were due to wanting a baby, or being pregnant or breastfeeding. Divorce accounts for 23% of all non-users; infertility and menopause 18%, widows and living apart 7%, unmet needs 12% (including concerns of side-effects, health reasons, partners’ objection, etc). The prevalence of non-contraceptive use ranges from 15.7% to 27.1% between categories of district’s characteristics. The likelihood of non-use is associated with women’s age, education, type of work unit, the nature and location of women’s Hukou, family income, number of children and ideal family size. Proportions of unmet needs vary between individual’s characteristics, ranging from 4% to 27%. The older and less educated women were more likely to experience unmet needs. Family income and number of children were also important determinants of unmet needs. It can be concluded that non-contraceptive use in Shanghai was due mainly to intended pregnancy. However, some gaps of unmet needs still should be bridged.