• Editors' Summary
• Credits

1. Fertility Continues to Decline
2. Contraceptive Use
3. Contraceptive Method Mix
4. Awareness and Availability of Contraception
5. Other Direct Influences on Fertility
6. Fertility Preferences
• Reproductive Intentions
• Desired Family Size
• Unmet Need for Family Planning
7. Young Women
8. Child Survival and Health
9. Maternal Health

• Figures
• Tables
• Side-bars
• Bibliography

• Is fertility decline slowing?
• The impact of contraception
• Intentions to use family planning
• Injectables becoming popular
• Desired family size falling
• Premarital sex: New findings
• How AIDS affects child survival
• Maternal care falls short

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Published by the INFO Project, Center for Communication Programs, The Johns Hopkins University Bloomberg School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland 21202, USA

Around the world more than 620 million married women were using contraception in 2000, Population Reports estimates—almost 500 million in developing countries. Millions of other women, married and unmarried, are not using contraception, however, even though they are sexually active and want to avoid pregnancy. Such women are considered to have unmet need for family planning (133, 134).

The DHS and RHS calculate unmet need somewhat differently, but these differences are small and thus data on unmet need are comparable. As calculated in the DHS, the unmet need category includes: fecund women (women who are able to produce live offspring) who are sexually active and are not using contraception but who say they want to limit or space their births; women who are pregnant but whose pregnancies are unwanted or mistimed due to lack of contraceptive use at the time of conception (not including contraceptive failures); and postpartum women who are not yet menstruating and whose pregnancies were unintended. The RHS calculation is similar but does not include women who are currently pregnant with an unintended pregnancy, nor does the calculation include postpartum women.

In 1996 an estimated 102 million married women of reproductive age in developing countries had unmet need for family planning (88). In 2000 a new estimate calculated that 105 million married women and 8 million unmarried women in developing countries had unmet need (94).

While the percentage of women with unmet need fell in many countries in the 1990s, the number of women of reproductive age increased. Thus the number of women with unmet need changed little (94, 133).

Based on DHS and RHS survey data for 60 developing countries, an estimated unweighted average of 21% of married women of reproductive age have an unmet need for family planning: 12% for limiting births and 9% for spacing. Among developing regions, the level is highest in sub-Saharan Africa, at 24%. It is lowest in Latin America and the Caribbean, at 16% (see Table 8).

Young-Mi Kim, JHU/CCP In Indonesia an outreach agent poses outside a health clinic. Despite rising levels of contraceptive use, programs need to reach millions of women with unmet need—that is, those who want to avoid pregnancy but do not use contraception.

Unmet need among married women is greatest in Haiti, at 40%, and Yemen, at 39%. At the other extreme, unmet need among married women falls below 10% in Brazil, Colombia, Costa Rica, Indonesia, Mauritius, Puerto Rico, and Vietnam.

In sub-Saharan Africa about two-thirds of unmet need among married women is for spacing births, a statistic that reflects the fact that the majority of married women want to continue having children (see chapter 6.1, Reproductive Intentions). In other developing regions levels of unmet need for spacing births are about half of total unmet need. (For more on spacing births, see Population Reports, Birth Spacing: Three to Five Saves Lives, Series L, No. 13, Summer 2002.)

Unmarried women. Among unmarried women, whether or not sexually active, unmet need for family planning is substantially higher in sub-Saharan Africa than in other regions, at 10%, compared with 1% to 2% in Asia, the Near East and North Africa, and Latin America and the Caribbean (94). Unmet need among unmarried women is lower than for married women because many unmarried women are not sexually active, while those who are sexually active tend to use contraception more than married women (94) (see chapter 2.3, Differences in Contraceptive Used Among Groups).

Trends. Among 37 countries surveyed more than once since 1990, unmet need fell an average of 14%. As noted, levels of unmet need typically rise as more and more women want to control their fertility and then fall as more and more women use contraception to do so (134). In Senegal and Uganda, for example, unmet need grew about 20% between surveys. In contrast, declines of 40% or more took place in Colombia, Egypt, Ghana, and Honduras (see Table 8).

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