Supply‐Side Versus Demand‐Side Unmet Need: Implications for Family Planning Programs

Despite its central importance to global family planning, the “unmet need for contraception” metric is frequently misinterpreted. Often conflated with a lack of access, misinterpretation of what unmet need means and how it is measured has important implications for family planning programs. We revie...

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Bibliographic Details
Published inPopulation and development review Vol. 48; no. 3; pp. 689 - 722
Main Authors Senderowicz, Leigh, Maloney, Nicole
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.09.2022
Subjects
Access
Birth control
Contraception
Contraceptives
Demand
demography
developing countries
Family planning
gender
Health surveys
Marital status
Measurement
Nonuse
Population control
Sensitivity analysis
Supply & demand
Women
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Summary:Despite its central importance to global family planning, the “unmet need for contraception” metric is frequently misinterpreted. Often conflated with a lack of access, misinterpretation of what unmet need means and how it is measured has important implications for family planning programs. We review previous examinations of unmet need, with a focus on the roles of access and demand for contraception, as well as the role of population control in shaping the indicator's priorities. We suggest that disaggregating unmet need into “demand‐side unmet need” (stemming from lack of demand) and “supply‐side unmet need” (stemming from lack of access) could allow current data to be leveraged into a more person‐centered understanding of contraceptive need. We use Demographic and Health Survey data from seven sub‐Saharan African countries to generate a proof‐of‐concept, dividing women into unmet need categories based on reason for contraceptive nonuse. We perform sensitivity analyses with varying conceptions of access and disaggregate by education and marital status. We find that demand‐side unmet need far exceeds supply‐side unmet need in all scenarios. Focusing on supply‐side rather than overall unmet need is an imperfect but productive step toward person‐centered measurement, while more sweeping changes to family planning measurement are still required.
Bibliography:Leigh Senderowicz is Health Disparities Research Scholar, Department of Obstetrics and Gynecology, University of Wisconsin‐Madison, Madison, Wisconsin, USA and Postdoctoral Affiliate, Center for Demography and Ecology, University of Wisconsin‐Madison, Madison, Wisconsin, USA. E‐mail: senderowicz@wisc.edu. Nicole Maloney is an alumna of the Rollins School of Public Health, Emory University, Atlanta, Georgia, USA. E‐mail: maloneyn12@gmail.com.
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ISSN:0098-7921
1728-4457
DOI:10.1111/padr.12478