Should eliminating unmet need for contraception continue to be a program priority? (PDF)
International Family Planning Perspectives 25(suppl) S39-S43,S49
Publication date: 1999
Estimates of unmet need for contraception derived from cross-sectional surveys are often taken as measures of a family planning program's success, and programs typically focus on eliminating unmet need. But that strategy may not be the most effective way of meeting women's total contraceptive needs.
Data on 1,093 women in Nor-Oriental del Marañón and Lima, Peru, who participated in the 1991-1992 Demographic and Health Survey and a 1994 follow-up survey are used to examine the family planning program's effectiveness in satisfying unmet need and averting unintended pregnancies.
Although aggregate-level data suggest little effect of the program between surveys, individual-level data show that 72% of women who had an unmet need in 1991-1992 no longer had an unmet need in 1994. However, between surveys, 12% of the sample went from not having an unmet need to having an unmet need. Moreover, 20% of respondents had an unintended pregnancy between surveys: 32% of those who initially had an unmet need and 17% of those who did not. Applying the proportions who had an unintended pregnancy to the distribution of women according to their unmet need status in 1991-1992 shows that if the program had focused on eliminating unmet need, the proportion having unintended pregnancies would have been 17%; if the program had emphasized eliminating unintended pregnancies among women who initially had no unmet need, the proportion would have been only 6%.
Family planning programs may be more effective if they emphasize eliminating unintended pregnancies among women who are already practicing contraception than if they focus on persuading nonusers to become users.