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Assessing the Suitability of Unmet Need as a Proxy for Access to Contraception and Desire to Use It

Title: Assessing the Suitability of Unmet Need as a Proxy for Access to Contraception and Desire to Use It
Authors: Senderowicz, Leigh; Bullington, Brooke W.; Sawadogo, Nathalie; Tumlinson, Katherine; Langer, Ana; Soura, Abdramane; Zabré, Pascal; Sié, Ali
Source: Studies in Family Planning, 54(1)
Publisher Information: Wiley
Publication Year: 2023
Collection: Carolina Digital Repository (UNC - University of North Carolina)
Subject Terms: Faso; use; access; lack; outcomes; concept; low sensitivity; stakeholders; contraceptive use; unmet needs; population level; lack access; planning programs; planning services; family planning programs; program; specificity; family; data; population; needs; results; levels; services; measures of unmet need; Burkina; method; pregnancy intention; measure of pregnancy intention; proxies
Description: Unmet need for contraception is a widely used but frequently misunderstood indicator. Although calculated from measures of pregnancy intention and current contraceptive use, unmet need is commonly used as a proxy measure for (1) lack of access to contraception and (2) desire to use it. Using data from a survey in Burkina Faso, we examine the extent to which unmet need corresponds with and diverges from these two concepts, calculating sensitivity, specificity, and positive/negative predictive values. Among women assigned conventional unmet need, 67 percent report no desire to use contraception and 61 percent report access to a broad range of affordable contraceptives. Results show unmet need has low sensitivity and specificity in differentiating those who lack access and/or who desire to use a method from those who do not. These findings suggest that unmet need is of limited utility to inform family planning programs and may be leading stakeholders to overestimate the proportion of women in need of expanded family planning services. We conclude that more direct measures are feasible at the population level, rendering the proxy measure of unmet need unnecessary. Where access to and/or desire for contraception are the true outcomes of interest, more direct measures should be used.
Document Type: article in journal/newspaper
Language: unknown
Relation: https://cdr.lib.unc.edu/downloads/j3860n388?file=thumbnail; https://cdr.lib.unc.edu/downloads/j3860n388
DOI: 10.17615/bay6-jd29
Availability: https://doi.org/10.17615/bay6-jd29; https://cdr.lib.unc.edu/downloads/j3860n388?file=thumbnail; https://cdr.lib.unc.edu/downloads/j3860n388
Rights: http://rightsstatements.org/vocab/InC/1.0/ ; http://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.274D22BB
Database: BASE