Defining motivational intensity of need for family planning in Africa

Non-users of contraception differ greatly in their likely motivation to adopt a method or resume use. This study presents a new approach to defining high and low motivation groups by stated intention to use, past use, and unmet need, to determine how these groups differ in characteristics and in region of residence. Data come from 23 DHS surveys in sub-Saharan countries, with representation from the eastern/southern region and western/central region. The low motivation non-users, with less past use and less intention to use in the future, are more rural, less educated, and closer to poverty. Motivational intensity is lower in the western/central region, which contains far fewer intenders than the eastern/southern region and where many more report no past use and no unmet need. When used to guide planning, unmet need should be augmented with motivation, since the two classifications do not entirely overlap. Between 10 and 17% of current non-users of family planning are likely highly motivated to use, but are not captured in the unmet need classification. Program implications for these non-using groups are discussed.