The concept of unmet need points to the gap between some women's reproductive intentions and their contraceptive behavior (31, 46, 215, 234, 237, 238). In doing so, it poses a challenge to family planning programs: to reach and serve the millions of women whose reproductive attitudes resemble those of contraceptive users but who, for some reason or combination of reasons, are not using contraception (201).

Among the most common reasons for unmet need are inconvenient or unsatisfactory services, lack of information, fears about contraceptive side effects, and opposition from husbands, relatives, or others (see Chapter 2, Reasons for Unmet Need). While many women who are using contraception have similar concerns, the obstacles to contraceptive use may loom larger for women in the unmet need group, or their commitment to controlling their fertility may be less certain.

By responding to the concerns of women with unmet need, programs can serve more people and serve them better (69, 178). Programs can respond best if they have a strategy that focuses on women with unmet need as a distinct audience and clientele (66, 153, 170). To develop an unmet need strategy, programs need to:

(1) Understand the various reasons for unmet need, based on qualitative research and survey data;

(2) Determine the size and composition of the unmet need subgroups by analyzing survey findings and other data;

(3) Identify high-priority subgroups that the program will be best able to reach; and

(4) Design and deliver information and services to meet the specific needs of each selected subgroup.

An unmet need strategy does not replace efforts to serve current contraceptive users or to promote the benefits of family planning. In fact, an unmet need strategy can reinforce other strategies. By focusing more on people's needs, many activities that address unmet need also address contraceptive users. Also, an unmet need strategy may reach some women who are not using contraception because they currently desire pregnancy (245).