Measuring unmet need for contraception as a point prevalence

Area of Science:

• Reproductive Health
• Demography
• Public Health

Background:

• Conceptual concerns exist with the standard indicator of unmet need for contraception.
• A new framework proposes current status (CS) measures of unmet need and demand.
• These measures link contraceptive behaviors to pregnancy exposure and future intentions.

Purpose of the Study:

• To address conceptual concerns with the standard unmet need indicator.
• To define and explore new point prevalence measures of current status (CS) unmet need and demand.
• To estimate the proportion of women with CS unmet demand who may be more likely to adopt contraception.

Main Methods:

• Utilized Demographic and Health Survey data from 46 low- and middle-income countries (2010-2018).
• Assessed classification differences between standard and CS unmet need indicators.
• Estimated the percentage of women with CS unmet demand intending future contraception use.

Main Results:

• Substantial country-level differences observed between standard and CS unmet need estimates.
• The standard measure's average predictive value for identifying unmet need cases is 53%.
• Approximately half of women with unmet need, regardless of indicator, intend to use contraception.

Conclusions:

• The standard unmet need indicator demonstrates low predictive value for current unmet need.
• The standard indicator does not accurately reflect a prevalence estimate of unmet need.
• Current status measures offer a more refined approach to understanding contraceptive needs.