The Potential Demographic Significance of Unmet Need

Abstract

Demographic and Health Survey data conducted in the 1990s from 27 countries are used to estimate demand for family planning among currently married women. Potential contraceptive use is measured as the sum of unmet need and contraceptive prevalence among fecund women. Three models of unmet need are constructed. In the first model all unmet need can be satisfied. Contraceptive prevalence and satisfaction of all unmet need would increase in sub-Saharan African countries from 15% to 37%. The rise in other regions was much smaller with the exception of Pakistan where increases would be from 12% to 38%. The second model is the minimum prevalence model and includes current and intended users. About 50% of all married women in the 27 countries expressed a desire to space future births or to end childbearing and an intention not to practice contraception or to be uncertain about using contraception in the future. In the second model prevalence would almost double in some countries and in most sub-Saharan African countries from 15% to 28%. The third model is the most conservative estimate of prevalence and unmet need. The mean value for sub-Saharan countries was 30%. For other countries it was 58%. The correlation between contraceptive prevalence and the fertility rate for 86 countries was 0.94 in unadjusted regression equations. In the adjusted equations fertility would be substantially reduced if unmet need were met. The reduction in sub-Saharan Africa would average 17% and would be 25% with the maximum assumption. With the most conservative fulfillment of unmet need the total fertility rate (TFR) in sub-Saharan countries would decline from 6.1 to 5.1 lifetime births per woman. The expected declines in TFR for other countries under the most realistic and conservative assumptions would average 18%. For some countries meeting unmet demand would result in near or actual replacement fertility.