CONTENTS

        Chapters
  1. Unmet Need and Family Planning Programs
  2. Reasons for Unmet Need
  3. Who Has Unmet Need?
  4. Program Implications
  5. A Process to Address Unmet Need

HIGHLIGHTS

Population Reports is published by the Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202-4012, USA


Volume XXIV, Number 1
September, 1996
Analysis

Programs need several kinds of information in order to design an unmet need strategy:

  • The reasons for unmet need, including why some women with an unmet need do not intend to use contraception;
  • The characteristics of women with unmet need, both characteristics that distinguish the different subgroups from contraceptive users and those that differentiate among the unmet need subgroups;
  • The absolute sizes of unmet need subgroups and the percentage of all reproductive-age women that they represent;
  • The program resources and capabilities available for responding to unmet need;
  • The institutional constraints on implementing an unmet need strategy.
The data needed for analysis can come from several sources:

Representative sample surveys. Large-scale surveys such as the DHS and FP/RHS provide basic information on reasons for unmet need and characteristics of women with unmet need. While these surveys are conducted only every three or five years in a country, they have no substitute as a key information source. To facilitate analysis of trends, when a new survey is planned, programs can try to insure that the questions asked about unmet need are the same as those asked in earlier surveys. Also, they can propose additional questions with programmatic value—for example, questions that probe further why some women do not use contraception.

Focus groups and in-depth interviews. Qualitative data as well as survey findings help programs understand unmet need. In particular, as more studies interview both women in the unmet need group and comparable women who do not have unmet need, more insights will emerge that may be valuable for strategic design (10, 37, 186, 204, 224).

Panel and longitudinal surveys. These surveys follow a group of people over time, during which some couples will begin using contraception while others will stop using it. Some will stop because they want a child or because the woman has reached menopause, but others will stop because of side effects, poor access, poor-quality services, or other reasons. These surveys can provide insights into the dynamics of unmet need for individuals and couples. Few such panel studies have been conducted to date, but interest in them is growing, and several are underway as part of prototype efforts to develop unmet need strategies (see Prototype Studies on Addressing Unmet Need).

As noted (see Intention to use contraception in Chapter 3.2), in Morocco the Demographic and Health Surveys Project conducted a panel study in 1995 using a sample of respondents from the 1992 cross-sectional DHS. Because the panel study provides longitudinal data on respondents, researchers can compare women's reproductive attitudes and contraceptive behavior in 1992 and 1995 (48).

Field experiments. Field experiments can help show how programs are able to address unmet need most effectively. A baseline survey can establish levels of unmet need and the characteristics of women with unmet need. Programs can then carry out various activities to address the need, and repeat surveys can assess their impact. If programs try various approaches, the findings can help them choose the most successful and efficient ones.

Service and administrative statistics. All programs collect information on their clients during the course of operations. Such information often covers client characteristics, monthly activities, contraceptive supply flows, and so forth. To help analyze unmet need, programs also can collect information on who stops using each method and why, and why some clients do not switch to another method. Similarly, data on abortion complications treated, counseling provided, and adoption of contraception after abortion can provide insights into the unmet need group, because most women who have had induced abortion presumably want to avoid another unintended pregnancy.


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