Measuring Unmet Need for Contraception Using a Person-Centered Algorithm: An Application With a Community-Based...

The standard measure of unmet need for contraception is not person-centered and may not adequately represent women's contraceptive needs. To demonstrate the strength of a modified measure, we replicated the standard algorithm for unmet need, then created a person-centered algorithm that considers (1) whether nonusers want to use contraception and (2) whether users want to use a different method. We applied the standard and person-centered algorithms to a sample of 847 married Rohingya women aged 15-49 years living in camps in Cox's Bazar, Bangladesh, a population about whom little is known regarding contraceptive need. Forty-six percent of respondents were currently using contraception. Among users, 14 percent wanted to use a different method and 36 percent of nonusers wanted to use a method. Using the standard algorithm, 39 percent had "unmet need," 18 percent had "no need," and 44 percent had "met need." Using the person-centered measure, 24 percent had "unmet need," 38 percent had "no need," and 38 percent had "met need." The standard algorithm may overestimate unmet need among Rohingya nonusers, and the person-centered measure provides evidence of method dissatisfaction among users. This measure also complements existing person-centered measures of need and is an example of how incremental change can improve our understanding of women's contraceptive needs.