Supply-Side Versus Demand-Side Unmet Need: Implications for Family Planning Programs

Area of Science:

• Global Health
• Reproductive Health
• Demography

Background:

• The "unmet need for contraception" metric is crucial for global family planning but frequently misinterpreted, often conflated with lack of access.
• Misinterpretations of this metric have significant implications for the effectiveness and direction of family planning programs worldwide.

Purpose of the Study:

• To review existing literature on unmet need for contraception, focusing on access, demand, and population control influences.
• To propose disaggregating "unmet need" into "demand-side unmet need" and "supply-side unmet need" for a more person-centered approach.
• To provide a proof-of-concept using Demographic and Health Survey data from sub-Saharan Africa.

Main Methods:

• Review of previous examinations of unmet need for contraception.
• Analysis of Demographic and Health Survey data from seven sub-Saharan African countries.
• Categorization of women based on reasons for contraceptive nonuse to differentiate between demand-side and supply-side unmet need.
• Sensitivity analyses varying conceptions of access and disaggregation by education and marital status.

Main Results:

• Demand-side unmet need for contraception substantially exceeds supply-side unmet need across all analyzed scenarios.
• The findings were consistent across different definitions of access and when disaggregated by education and marital status.
• Existing data can be utilized to better understand individual contraceptive needs.

Conclusions:

• Disaggregating unmet need into demand-side and supply-side components offers a more person-centered understanding of contraceptive needs.
• While focusing on supply-side unmet need is a step towards better measurement, comprehensive changes to family planning metrics are still necessary.
• The study underscores the importance of addressing demand-side factors in family planning interventions.