Should Eliminating Unmet Need for Contraception Continue to be a Program Priority?

Abstract

This study examined the implications of family planning (FP) policy and program emphasis on fulfilling unmet need in Peru. Data were obtained from the 1991-92 Demographic and Health Survey and a 1994 follow-up survey conducted in 2 regions. The sample included 1093 married women. Findings indicate that the proportion who wanted no more children and reported contraceptive use were similar in 1991-92 and 1994. The proportions of women with unmet need were 18% and 17% respectively in 1991-92 and 1994. FP programs appear to have had little impact on unmet need or prevalence; but women switch between unmet need groups. By 1994 72% of the 18% with unmet need in 1991-92 had their need satisfied. 23% shifted reproductive intentions and had more children. 39% of women in 1991-92 had unmet need for a modern method but only 17% had their need met by 1994. In 1991-92 43% with unmet need no longer had unmet need in 1994. In 1991-92 82% were without unmet need. 12% without unmet need in 1991-92 had unmet need in 1994. 61% did not have unmet need in 1991-92 but 14% did have unmet need for modern contraception in 1994. Simulations show that avoidance of unintended pregnancy among women without unmet need would reduce unintended pregnancy to 6% from 17%. Programs should emphasize willing contraceptors. A second program priority should be on noncontracepting women who desire spacing or limiting. FP programs that rely on a client-oriented approach and support the Cairo recommendations should not focus on changing womens reproductive intentions.