Demographic surveys and family planning program strategies typically estimate unmet need only for women who are married or in union. Ruth Dixon-Mueller and Adrienne Germain have observed, however, that at least three groups of women with a need for family planning are not counted in conventional estimates of unmet need: (1) single women; (2) contraceptive users who are using an ineffective method, using a method incorrectly, or using a method that is unsafe or unsuitable for them; and (3) pregnant women whose pregnancies are mistimed or unwanted (37).

Men. Also, most family planning programs have paid little attention to men. Although men are half of the reproductive equation, family planning has been considered "women's business." The stereotype that most men do not care about family planning is false, however. Men make or strongly influence many household decisions about reproduction and family planning use (112). Research in Africa suggests that men often know more about contraceptives than women know and may have more favorable attitudes toward contraceptive use (91). In any case, men's needs for family planning cannot be met effectively by many conventional sources of family planning for women, such as maternal and child health clinics. Respondents to the Population Reports questionnaire, among others in the family planning profession, urge that programs do more to reach men (51, 112, 176 , 219, 220, 225, 236, 240, 241, 246, 258, 263, 268).

Young people. Young people have been largely left out of the family planning revolution. Few countries provide reproductive health and family planning services freely to youth (176 ). A variety of traditions, institutional and political barriers, and myths about sexuality have made it difficult to develop effective programs that provide accurate reproductive health information and useful services to young people (49, 248). Many people think that providing family planning services to youth will promote promiscuity, even though there is no evidence of this (49, 112, 219, 240).

Premarital sexual experience is becoming more common among young people in developing countries (114, 132, 164 , 176 , 209, 240, 248). As countries have become more urban and economically developed, the age at marriage has risen, and young people's sexual attitudes and behavior before marriage have been changing. Ties to extended families and adherence to traditions that governed young people's sexual behavior in the past are eroding.

The old rules may have changed, but they have not been replaced with new behavioral guidelines (88, 209, 273). Thus many young people do not know where to turn for help. "Young people find themselves caught between conflicting messages: media images urge them to promote their sensuality, while parents, educators, and religious authorities tell them to 'just say no'" (273). Young people themselves may not think that family planning is for them. In Mauritius, for example, a survey found that, although sexual activity among unmarried youth has increased, many of the unmarried perceive that "family planning is for married couples only," reports Geeta Oodit, Executive Director of the Mauritius Family Planning Association (248).

Young, unmarried people need contraceptive information and services. Surveys show that, while few unmarried teenagers have sexual relations frequently, many have some premarital sexual experience. For example, in the Young Adult Reproductive Health Surveys (YARHS), which since 1985 have interviewed people ages 15 to 24 in several Latin American cities, the mean age at first premarital intercourse is most often 15 years among men and 17 years among women (164 ). Also, in Botswana, Ghana, Kenya, Liberia, and Togo, according to DHS, more than half of women ages 15 to 19 reporting sexual experience are unmarried (132).

Because unmarried youth typically begin sexual relations without contemplating the consequences and without accurate information or contraceptive protection, many face serious or even dangerous consequences, including unwanted pregnancies, abortions, AIDS, and other sexually transmitted diseases (49, 209, 219, 253). For example, in the YARHS conducted in Curitiba and Rio de Janeiro, Brazil, more than half of the young men interviewed reported causing a pregnancy that ended in an abortion (209).

The economic and social consequences of adolescent sexuality can be enormous. Young, unmarried women who become pregnant are less likely to finish their education, face greater marital instability, and have fewer assets and lower incomes later in life than other women (114, 185, 190). In each of 11 Latin American countries studied, women who first gave birth as teenagers went on to obtain much less schooling than those who delayed motherhood. Women who first married as teenagers were much more likely than those who married later to dissolve their first marriage (185). In a vicious cycle, lack of education, family instability, and lower incomes lead to more adolescent childbearing in successive generations (49, 190, 209).

Meeting the reproductive health needs of youth requires not only providing services but also changing attitudes, overcoming opposition, building understanding, and educating adults about the problems facing youth in the 1990s (49, 90, 219, 222). Meeting the reproductive health needs of unmarried youth is different from meeting the needs of married couples (176, 249). For example, when MEXFAM began its Gente Joven program to serve young people, the staff found that they needed not just to offer services but also to overcome young people's lack of trust in adult counseling and to break the pattern of poor communication between youth and adults (273).

Programs such as Gente Joven are beginning to provide guidance about how to serve young people. For best results, programs should give young people accurate information that provides a basis for making responsible decisions; they should not lecture young people on their behavior (49, 273). Also, programs should provide services in a setting acceptable to youth, who are unlikely to visit conventional maternal and child health, family planning, or other reproductive health facilities (249, 253). "Successful programs reach out to young people on their own turf—at schools, recreational centers, work sites and on the street" (273). Programs should involve youth themselves both in planning and in delivering services (49, 90, 176 , 190, 249, 273). To communicate better with youth, for example, the Gente Joven program uses volunteers ages 15 to 20 as well as paid professional staff (273). Often, government policies or unnecessary medical barriers keep family planning and reproductive health services from adolescents. These policies include laws setting minimum ages for clients, rules requiring young people to have parental consent to obtain contraceptives, policies expelling pregnant women from school, and regulations restricting provision of family planning services to young people (49, 180). If family planning programs are to reach youth, the programs must provide confidential services to all who seek them, without regard to marital status or age (176 , 249).