Journal Article

How the community shapes unmet need for modern contraception: An analysis of 44 Demographic and Health Surveys

Unmet need for modern contraception is a major public health concern in resource-constrained countries. Recent research supports the application of social-ecological theories to explain how characteristics of a woman’s community shape modern contraception use. However, this research focuses largely on individual countries and uses a limited number of community-level effects. We fitted three random-effects logistic regression models to examine associations between 13 community-level variables and the odds of reporting unmet need, unmet need for spacing, and unmet need for limiting for all parous, female respondents of 44 DHS surveys collected in 2010–2015 (n=528,101). Community variables explain significant variance in unmet need between communities. Associations between community variables and unmet need differ by urban and rural residence. The results highlight several commonalities in how the community shapes unmet need across resource-constrained settings and may help in designing structural-level interventions.

Published in a peer-reviewed journal of the Population Council. Nick Metheny is a doctoral students at the University of Michigan School of Nursing and Rob Stephenson is Professor, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, and Director of the Center for Sexuality and Health Disparities, University of Michigan.