CONTENTS
HIGHLIGHTSPopulation 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
July, 1994 |
Meeting Unmet Need for Reproductive Health CareSuch statistics imply large potential demand for family planning services. Even though contraceptive use has risen substantially in recent years, in most surveyed countries between 20% and 30% of married women of reproductive age report that they are not using contraception but do not want any more children or else want to delay their next birth at least two years (357). Rates of abortion, even where abortion is illegal and unsafe (see Chapter 2, Family Planning Saves Lives), also testify to women's strong desire to control their own fertility. Demographers describe women who are not using contraception but want to space or limit births as having an unmet need for family planning. Using this definition, Population Reports has estimated, based on DHS data, that 120 million married women of reproductive age in developing countries have an unmet need for contraception (see Population Reports, The Reproductive Revolution: New Survey Findings, M-11, 1992). Ruth Dixon-Mueller and Adrienne Germain suggest widening the definition of unmet need to include unmarried women, women who need better or more suitable contraceptive methods, women who need abortion services, and women who need more comprehensive reproductive health services than are currently available (78). These numbers cannot be easily estimated, but they would surely add substantially to the 120 million figure. Men also have unmet needs for family planning. In DHS in Burundi, Egypt, Ghana, Kenya, and Pakistan, over half of men approve of family planning, but very few are using a contraceptive method (see Table 7). In smaller, qualitative studies as well, men have asked for more information about reproductive health services including both contraception and treatment for sexually transmitted diseases (see Chapter 5.2, Encouraging Male Responsibility). Effectively serving all who want to avoid pregnancy but are not using contraception could help reconcile the dual goals of (1) serving individual clients and (2) slowing global population growth (74, 303). Steven Sinding has suggested that family planning programs replace demographic objectives with the objective of meeting unmet need. In 9 of 12 countries studied, levels of contraceptive use would be higher if all unmet need were met than if current demographic objectives were reached (303). To translate this unmet need to control fertility into utilization of reproductive health services, policy makers must let clients know that these services are a safe and effective way to achieve their personal goals. Reproductive health programs can identify the obstacles that prevent women from using services and can design services and communication that will help overcome some of those obstacles. Obstacles may range from lack of supplies and services to dissatisfaction with current services to fears of contraceptive side effects, to social limits on women's mobility or decision-making. Beyond the need to control their own fertility, women also need other reproductive health services, and family planning programs may be able to meet these needs, as well (see Chapter 4.2, Offering Other Reproductive Health Care). |