Need and Demand for Family Planning

 

Percentage of women with a) unmet need for family planning, b) met need for family planning, c) total demand for family planning by whether for spacing, limiting, and total, and the percentage of the demand for family planning that is satisfied

 

Definition

 

Percentage of currently married women, all women, and sexually active unmarried women with:

1)     unmet need for family planning,

2)     met need for family planning,

3)     total demand for family planning

by whether for spacing, limiting, and total,

and

4)     Percentage of total demand for family planning that is satisfied

5)     Percentage of total demand for family planning that is satisfied by modern methods

 

Coverage:

Population base:

a)      All women (IR file)

b)     Currently married (IR file)

c)      Sexually active unmarried women (IR file)

Time period: Current status at time of survey

 

Numerators:

1)     Unmet need for contraception: Number of women who are not using a method of contraception and are:

a)      For spacing (v626a = 1):

·        fecund and say they want to wait two or more years for their next birth;

·        fecund and are unsure whether they want another child;

·        fecund, want another child, but are unsure when to have the birth;

·        pregnant and wanted current pregnancy later; or

·        postpartum amenorrheic and wanted last birth later

b)     For limiting (v626a = 2):

·        fecund and do not want any more children;

·        pregnant and did not want current pregnancy; or

·        postpartum amenorrheic and did not want the last birth

c)      Total unmet need: Number of women with an unmet need for family planning for spacing or limiting (v626a = 1 or v626a = 2)

 

2)     Met need for contraception: Number of women who are using a method of contraception and are

a)      For spacing (v626a = 3):

·        not considered to be limiting (see below)

b)     For limiting (v626a = 4):

·        want no more children;

·        are sterilized; or

·        say they cannot get pregnant when asked about the desire for future children

c)      Total met need (v626a = 3 or v626a = 4): Number of women with met need for spacing or limiting

 

3)     Total demand for contraception: Number of women who have a met need or unmet need:

a)      For spacing (v626a = 1 or v626a = 3)

b)     For limiting (v626a = 2 or v626a = 4)

c)      Total (v626a in 1, 2, 3, 4)

 

4)     Demand satisfied: Number of women who are using any contraceptive method (v626a in 3,4)

 

5)     Demand satisfied by modern methods: Number of women who are using any modern contraceptive method including female sterilization, male sterilization, pill, IUD, injectables, implants, male condom, female condom, emergency contraception, vaginal methods, lactational amenorrhea method, or other modern methods (v313 = 3)

 

Denominators:

Unmet need, met need, and total demand indicators:

Number of

a)      All women age 15-49

b)     Currently married women (v502 = 1)

c)      Sexually active unmarried women – including women who are not currently married or in a consensual union (single, divorced, widowed, and separated) and who had sexual intercourse within the last 30 days (v502 ≠ 1 & v528 in 0:30)

 

Demand satisfied indicators:

Number of

a)      All women age 15-49

b)     Currently married women (v502 = 1)

c)      Sexually active unmarried women – including women who are not currently married or in a consensual union (single, divorced, widowed, and separated) and who had sexual intercourse within the last 30 days (v502 ≠ 1 & v528 in 0:30)

that have either unmet need for family planning or met need for family planning (v626a in 1, 2, 3, 4)

 

Variables: IR file.

v626a

Unmet need for contraception (Definition 3)

v313

Current use by method type

v502

Currently/formerly/never in union

v528

Time since last sex (in days)

v005

Woman’s individual sample weight

 

Calculation

 

Unmet need, met need, and total demand indicators:
 

Numerator divided by the denominator, multiplied by 100.

 

The calculation of numerators for the met and unmet need indicators first takes into account a woman’s contraceptive status. Women who are using contraception are considered to have a met need for family planning.

 

For women who are not using contraception, the determination of the need for family planning involves several additional steps. Nonusers are separated into those who are currently married and those who are not married but who are sexually active. An unmarried woman is considered to be sexually active if the woman had sexual intercourse within 30 days prior to the survey. Unmarried women who are not sexually active are considered not to be exposed to the risk of pregnancy and, therefore, have no need for family planning.

 

To assign need status to married and sexually active unmarried nonusers, these women are separated into two groups: (1) those who are pregnant or postpartum amenorrheic and (2) those who are not pregnant or postpartum amenorrheic. Women are considered to be postpartum amenorrheic if their period had not returned since their last live birth in the two-year period prior to the survey.

 

Married and sexually active unmarried nonusers who are not pregnant or postpartum amenorrheic are further separated into those who are considered fecund and those who are infecund. Women are classified as infecund if they fall into any of the following categories:

·        married 5+ years, had no children in the past 5 years and never used contraception;

·        responded “can’t get pregnant” to question on desire for future children;

·        responded “menopausal/hysterectomy” on reason for not using contraception;

·        response to time since last period is > 6 months and not postpartum amenorrheic (0-59 months);

·        response to time since last period is “menopausal/hysterectomy” or “never menstruated”; or

·        response to time since last period is “last period was before last birth” and last birth was 5+ years ago.

 

Infecund women have no need for family planning. Other women who have no need include married or sexually active unmarried women who are not using contraception and are:

·        pregnant and wanted the current pregnancy;

·        postpartum amenorrheic and wanted their last birth; or

·        fecund and want another child within 2 years. 

 

Married and sexually active unmarried nonusers have unmet need for spacing if they are:

·        pregnant and wanted the pregnancy later;

·        postpartum amenorrheic and wanted their last birth later; or

·        fecund and want the next child in 2+ years, want another child but are undecided on the timing or are undecided if they want another child.

 

Married and sexually active unmarried nonusers have an unmet need for limiting if they are:

·        pregnant and did not want the current pregnancy at all;

·        postpartum amenorrheic and did not want their last birth at all their last birth; or

·        fecund and want no more children. 

 

The calculation of unmet need for currently married women is summarized in the diagram below:

 

Demand satisfied indicators:

 

Numerator divided by the denominator, multiplied by 100.

 

The numerator for the proportion of demand satisfied include the number of women currently using any contraceptive method while the numerator for the demand satisfied by modern methods include the number of women using any modern contraceptive method.

 

The denominators include those women with a met need (those using contraception irrespective whether the method is a modern method or a traditional method) and those with an unmet need for family planning.

 

Notes and Considerations

 

Details of the calculation of the unmet need variable can be found on the Unmet Need page of the DHS Program website at https://www.dhsprogram.com/topics/Unmet-Need.cfm, including survey-specific code in Stata and SPSS for the construction of v626a for surveys that do not have the variable in the dataset. The results of the change in Definition are also summarized in Revising Unmet Need: In Brief at https://www.dhsprogram.com/pubs/pdf/OD63/OD63[12June2012_English].pdf

 

The proportion of demand satisfied by modern methods indicator corresponds to SDG indicator 3.7.1 and UNAIDS indicator 5.2.

 

Handling of Missing Values

 

If responses are missing on questions with respect to the wantedness of births or the current pregnancy, women are assigned a value of missing on the unmet need variable. This represents a change from the previous practice of assuming that pregnant, postpartum amenorrheic, or fecund nonusers for whom information on the wantedness of the current pregnancy/last birth was missing had an unmet need for family planning (Bradley et al. 2012).

 

Changes over Time

 

The Definition of unmet need for family planning was simplified during the DHS VI project to improve comparability over time and between surveys within the DHS Program and to facilitate comparability with data collected in other surveys including the MICS surveys undertaken in many countries with UNICEF support. Bradley et al. (2012) detail the changes involved in revising the unmet need Definition in DHS Analytical Study No. 25.

 

Several changes have occurred over time in the calculation of unmet need for family planning. Due to these changes, comparisons of unmet need and demand for family planning between surveys may not be valid if based on country reports.

 

References


Bradley, S.E.K., T.N. Croft, J.D. Fishel, and C. Westoff. 2012. Revising Unmet Need for Family Planning. DHS Analytical Studies No. 25. Calverton, Maryland, USA, ICF International. https://www.dhsprogram.com/publications/publication-AS25-Analytical-Studies.cfm

 

MacQuarrie, K.L.D. 2014. Unmet need for family planning among young women: levels and trends. DHS Comparative Reports No. 34. Rockville, Maryland, USA: ICF International. https://www.dhsprogram.com/publications/publication-CR34-Comparative-Reports.cfm

 

Wang, W., S. Staveteig, R. Winter, and C. Allen. 2017. Women’s Marital Status, Contraceptive Use, and Unmet Need in Sub-Saharan Africa, Latin America, and the Caribbean. DHS Comparative Reports No. 44. Rockville, Maryland, USA: ICF. https://www.dhsprogram.com/publications/publication-CR44-Comparative-Reports.cfm

 

Westoff, C.F. 2012. Unmet need for modern contraceptive methods. DHS Analytical Studies No. 28. Calverton, Maryland, USA: ICF International. https://www.dhsprogram.com/publications/publication-AS28-Analytical-Studies.cfm

 

Westoff, C.F. 2006. New estimates of unmet need and the demand for family planning. DHS Comparative Reports No. 14. Calverton, Maryland, USA: Macro International. https://www.dhsprogram.com/publications/publication-CR14-Comparative-Reports.cfm

 

Westoff, C.F. 2001. Unmet need at the end of the century. DHS Comparative Reports No. 1. Calverton, Maryland, USA: ORC Macro. https://www.dhsprogram.com/publications/publication-CR1-Comparative-Reports.cfm

 

Westoff, C.F. and A. Bankole. 1995. Unmet need: 1990-1994. DHS Comparative Studies No. 16. Calverton, Maryland, USA: Macro International. https://www.dhsprogram.com/publications/publication-CS16-Comparative-Reports.cfm

 

Westoff, C.F. and L.H. Ochoa. 1991. Unmet need and the demand for family planning. DHS Comparative Studies No. 5. Columbia, Maryland, USA: Institute for Resource Development. https://www.dhsprogram.com/publications/publication-CS5-Comparative-Reports.cfm

 

UNAIDS. 2017. Global AIDS Monitoring 2018: Indicators for monitoring the 2016 United Nations Political Declaration on Ending AIDS http://www.unaids.org/en/resources/documents/2018/Global-AIDS-Monitoring

 

Resources

 

DHS-7 Tabulation plan: Tables 7.13.1, 7.13.2 and 15.15

 

API Indicator IDs:

Currently married women:

FP_NADM_W_UNS, FP_NADM_W_UNL, FP_NADM_W_UNT, FP_NADM_W_MNS, FP_NADM_W_MNL, FP_NADM_W_MNT,

FP_NADM_W_TDS, FP_NADM_W_TDL, FP_NADM_W_TDT, FP_NADM_W_PDS, FP_NADM_W_PDM

(API link, STATcompiler link)

All women:

FP_NADA_W_UNS, FP_NADA_W_UNL, FP_NADA_W_UNT, FP_NADA_W_MNS, FP_NADA_W_MNL, FP_NADA_W_MNT,

FP_NADA_W_TDS, FP_NADA_W_TDL, FP_NADA_W_TDT, FP_NADA_W_PDS, FP_NADA_W_PDM

(API link, STATcompiler link)

Sexually active unmarried women:

FP_NADU_W_UNS, FP_NADU_W_UNL, FP_NADU_W_UNT, FP_NADU_W_MNS, FP_NADU_W_MNL, FP_NADU_W_MNT,

FP_NADU_W_TDS, FP_NADU_W_TDL, FP_NADU_W_TDT, FP_NADU_W_PDS, FP_NADU_W_PDM

(API link, STATcompiler link)

 

SDG Indicator 3.7.1: Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods

WHO 100 Core Health Indicators: Demand for family planning satisfied with modern methods

MICS6 Indicator TM.4: Need for family planning satisfied with modern contraception

UNAIDS Indicator 5.2: Demand for family planning satisfied by modern methods

DHS Program website: Unmet Need: https://www.dhsprogram.com/topics/Unmet-Need.cfm

DHS Indicator Snapshot: Demand Satisfied by Modern Methods: https://www.youtube.com/watch?v=RceOuLjJwKY