Familial correlates of unmet need for contraception among currently married women: a comparative study of three Sub-Saharan African Countries

SummaryIt is difficult to gauge the success of programmatic efforts to reduce unmet need for contraception without knowing whether individual women have had their need met and adopted contraception. However, the number of true longitudinal datasets tracking the transition of panels of individual women in and out of states of contraceptive use is limited. This study analyses changes in contraceptive use states using Demographic and Health Survey data for 22 sub-Saharan African countries. A cohort approach, tracking representative samples of five-year age groups longitudinally across surveys, as well as period-based techniques, are applied to indicate whether new users of contraception have been drawn from women who previously had no need and/or those who had unmet need for family planning. The results suggest that a greater proportion of increases in contraceptive use in recent years can be attributed to decreases in the percentage of women with no need, especially among younger women, than to decreases in the proportion with unmet need.

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Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys

Reproductive Health ◽

10.1186/s12978-020-01018-2 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Bright Opoku Ahinkorah ◽

Edward Kwabena Ameyaw ◽

Abdul-Aziz Seidu

Keyword(s):

Young Women ◽

Formal Education ◽

Economic Status ◽

Unmet Need ◽

Wealth Quintile ◽

Sub Saharan Africa ◽

African Countries ◽

Socio Economic Status ◽

Sub Saharan ◽

Unmet Need For Contraception

Abstract Introduction Globally, sub-Saharan Africa (SSA) bears the highest proportion of women with unmet need for contraception as nearly 25% of women of reproductive age in the sub-region have unmet need for contraception. Unmet need for contraception is predominant among young women. We examined the association between socio-economic and demographic factors and unmet need for contraception among young women in SSA. Methods Data for this study obtained from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 30 sub-Saharan African countries. The sample size consisted of young women (aged 15–24), who were either married or cohabiting and had complete cases on all the variables of interest (N = 59,864). Both bivariate and multivariable binary logistic regression analyses were performed using STATA version 14.0. Results The overall prevalence of unmet need for contraception among young women was 26.90% [95% CI: 23.82–29.921], ranging from 11.30% [95% CI: 5.1–17.49] in Zimbabwe to 46.7% [95% CI: 36.92–56.48] in Comoros. Results on socio-economic status and unmet need for contraception showed that young women who had primary [aOR = 1.18; CI = 1.12–1.25, p < 0.001] and secondary/higher levels of formal education [aOR = 1.27; CI = 1.20–1.35, p < 0.001] had higher odds of unmet need for contraception compared to those with no formal education. With wealth status, young women in the richest wealth quintile had lower odds of unmet need for contraception compared with those in the poorest wealth quintile [aOR = 0.89; CI = 0.81–0.97, p < 0.01]. With the demographic factors, the odds of unmet need for contraception was lower among young women aged 20–24 [aOR = 0.74; CI = 0.70–0.77, p < 0.001], compared with 15–19 aged young women. Also, young women who were cohabiting had higher odds of unmet need for contraception compared to those who were married [aOR = 1.35; CI = 1.28–1.43, p < 0.001]. Conclusion Our study has demonstrated that unmet need for contraception is relatively high among young women in SSA and this is associated with socio-economic status. Age, marital status, parity, occupation, sex of household head, and access to mass media (newspaper) are also associated with unmet need for contraception. It is therefore, prudent that organisations such as UNICEF and UNFPA and the Bill & Melinda Gates Foundation who have implemented policies and programmes on contraception meant towards reducing unmet need for contraception among women take these factors into consideration when designing interventions in sub-Saharan African countries to address the problem of high unmet need for contraception among young women.

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Currently married women with an unmet need for contraception in Eritrea: Profile and determinants

Canadian Studies in Population ◽

10.25336/p6gs4s ◽

2011 ◽

Vol 38 (1-2) ◽

pp. 61 ◽

Cited By ~ 11

Author(s):

Gebremariam Woldemicael ◽

Roderic Beaujot

Keyword(s):

Family Planning ◽

Contraceptive Use ◽

Economic Status ◽

Unmet Need ◽

Married Women ◽

Sub Saharan Africa ◽

The Status ◽

Sub Saharan ◽

Using Data ◽

Unmet Need For Contraception

Eritrea’s contraceptive prevalence rate is one of the lowest in sub-Saharan Africa and its fertility has only started to decline. Using data from the 2002 Eritrea Demographic and Health Survey (EDHS), this study examines the determinants of unmet need for family planning that is the discrepancy between fertility goals and actual contraceptive use. More than one-quarter of currently married women are estimated to have an unmet need, and this has remained unchanged since 1995. The most important reason for unmet need is lack of knowledge of methods or of a source of supply. Currently married women with higher parity, and low autonomy, low or medium household economic status, and who know no method of contraception or source of supply are identified as the most likely to have an unmet need. Addressing the unmet need for family planning entails not merely greater knowledge of or access to contraceptive services, but also the enhancement of the status of women.

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Estimating the market size for a dual prevention pill: adding contraception to pre-exposure prophylaxis (PrEP) to increase uptake

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2020-200662 ◽

2020 ◽

pp. bmjsrh-2020-200662

Author(s):

Lorna Begg ◽

Rebecca Brodsky ◽

Barbara Friedland ◽

Sanyukta Mathur ◽

Jim Sailer ◽

...

Keyword(s):

Contraceptive Method ◽

Unmet Need ◽

Health Benefit ◽

Sub Saharan Africa ◽

Market Size ◽

African Countries ◽

Oral Contraceptive Pills ◽

Sub Saharan ◽

Exposure Prophylaxis ◽

Unmet Need For Contraception

IntroductionUptake of oral pre-exposure prophylaxis (PrEP) remains low. The objective of this analysis was to estimate the potential market size in priority sub-Saharan African countries for a 28-day dual prevention pill (DPP) regimen containing the active pharmaceutical ingredients in oral PrEP and oral contraceptive pills (OCPs) for the prevention of HIV and unintended pregnancy.MethodsWe selected 15 countries in sub-Saharan Africa for analysis. Population estimates were based on United Nations Population Division data from 2017. Low, medium and high rates (range 0.25% to 25%) of estimated conversion from current contraceptive method to the DPP were applied by country based on HIV prevalence (≥10% vs <10%), current contraceptive method (OCP, condom or unmet need for contraception) and age group (15–24 or 25–49 years).ResultsIn these 15 countries, between 250 000 and 1.25 million women could switch from their current contraceptive method to the DPP. Given that current PrEP use in the 15 countries combined is estimated to be 113 250 (women and men), the most conservative market size estimate would more than double the number of women currently using PrEP.ConclusionsBy leveraging the existing market for OCPs and assuming modest conversion from condom users and women with an unmet need for contraception, the DPP could lead to a 2- to 10-fold increase in PrEP usage in these 15 sub-Saharan African countries, expanding the broader public health benefit of this proven HIV prevention strategy.

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Programmatic implications of unmet need for contraception among men and young married women in northern Nigeria

Open Access Journal of Contraception ◽

10.2147/oajc.s172330 ◽

2018 ◽

Vol Volume 9 ◽

pp. 81-90 ◽

Cited By ~ 2

Author(s):

Irit Sinai ◽

Jabulani Nyenwa ◽

Olugbenga Oguntunde

Keyword(s):

Unmet Need ◽

Married Women ◽

Northern Nigeria ◽

Unmet Need For Contraception

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Conceiving of Contraception: World Society, Cultural Resistance, and Contraceptive Use, 1970–2012

Social Forces ◽

10.1093/sf/soaa077 ◽

2020 ◽

Author(s):

Wade M Cole ◽

Claudia Geist

Keyword(s):

Contraceptive Use ◽

Unmet Need ◽

World Society ◽

Modern Contraceptive ◽

Cultural Resistance ◽

African Countries ◽

Orthodox Christian ◽

Cultural Effects ◽

Sub Saharan ◽

Using Data

Abstract Taking world society theory as our point of departure, we examine the effect of world culture on contraceptive use rates around the world. World-cultural rhetoric frames contraception as a necessity for economic development, a human rights issue, and a women’s health matter. Using data on contraceptive use among married women for a sample of 159 countries over the period from 1970 to 2012, we find that linkages to all three sets of discourses are associated with increased use of modern contraceptive methods, over and above countries’ sociocultural and economic characteristics. Nevertheless, we also find that world society influences vary across major cultural zones, defined in terms of predominant religions and geographic regions. World cultural effects are strongest in Orthodox Christian, Hindu, non-Western Protestant, and sub-Saharan African countries. There is no effect in Western and East Asian countries, where contraceptive use is comparatively high, or in zones such as non-Western Catholic nations, where the unmet need for contraception is often greatest. Compared to development and women’s rights rhetoric, health-based frames appear to have the broadest and most effective reach across cultural divides. Overall, however, we find that world society processes tend to produce cross-cultural convergence in contraceptive use rates.

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