Unmet reproductive health needs among women in some West African countries: a systematic review of outcome measures and determinants.

Martin Amogre Ayanore,Wim Groot,Milena Pavlova

doi:10.1186/s12978-015-0104-x

Martin Amogre Ayanore, Wim Groot + Show 1 more

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https://doi.org/10.1186/s12978-015-0104-x

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Abstract

BackgroundIdentifying relevant measures of women’s reproductive health needs is critical to improve women’s chances of service utilization. The study aims to systematically review and analyze the adequacy of outcome measures and determinants applied in previous studies for assessing women reproductive health needs across West Africa.MethodsEvidence on outcomes and determinants of unmet reproductive health needs among women of childbearing age in diverse multicultural, religious, and ethnic settings in West African countries was systematically reviewed. The review included recent English language publications (from January 2009 - March 2014). Clinical studies particularly on obstetric care services and reproductive services in relation to HIV/AIDS were excluded. We acknowledge the possibility to have excluded non-English publications and yet-to-be-published articles related to the study aim and objectives. Outcomes and determinants were assessed and defined at three main levels; contraceptive use, obstetric care, and antenatal care utilization.ResultsResults show increasing unmet need for women’s reproductive health needs. Socio-cultural norms and practices resulting in discontinuation of service use, economic constraints, travel distance to access services and low education levels of women were found to be key predictors of service utilization for contraception, antenatal and obstetric care services. Outcome measures were mainly assessed based on service utilization, satisfaction, cost, and quality of services available as core measures across the three levels assessed in this review.ConclusionsEvidence from this review indicates that currently applied measures of women’s reproductive health needs might be inadequate in attaining best maternal outcomes since they appear rather broad. More support and research for developing and advancing context-related measures may help to improve women’s maternal health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-015-0104-x) contains supplementary material, which is available to authorized users.

Highlights

Identifying relevant measures of women’s reproductive health needs is critical to improve women’s chances of service utilization
This paper focuses on three levels of unmet reproductive health needs: contraceptive service use, obstetric care, and antenatal care utilization
The following key words were applied in the search: unmet needs, reproductive health, contraception, contraceptive use, contraceptive service, outcome measures, determinants, abortion care, antenatal care, West Africa and women

Summary

Introduction

Identifying relevant measures of women’s reproductive health needs is critical to improve women’s chances of service utilization. An estimated 222 million women still fall within the current unmet. Ayanore et al Reproductive Health (2016) 13:5 needs estimates for contraceptives, with 90 % of these women currently in the developing world [2, 4, 5]. Women often resort to an abortion when faced with an unintended pregnancy [4]. These women are said to have an unmet need for contraception. An estimated 122 million women in developing regions needed antenatal and postnatal care in 2012 but only 55 % of these received four or more antenatal visits [7]. It is evidenced that the unmet need for antenatal care decreased in developing countries in the period 2000-2012 [8]

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