Measuring unmet need for contraception as a point prevalence

Background This study proposes a framework to address conceptual concerns with the standard indicator of unmet need for contraception. We define new point prevalence measures of current status (CS) unmet need and CS unmet demand, by linking contraceptive behaviours to pregnancy exposure and to women...

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Main Authors: Caroline Moreau, Mridula Shankar, Stephane Helleringer, Stanley Becker
Format: Article
Language:English
Published: BMJ Publishing Group 2019-07-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/4/4/e001581.full
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author Caroline Moreau
Mridula Shankar
Stephane Helleringer
Stanley Becker
author_facet Caroline Moreau
Mridula Shankar
Stephane Helleringer
Stanley Becker
author_sort Caroline Moreau
collection DOAJ
description Background This study proposes a framework to address conceptual concerns with the standard indicator of unmet need for contraception. We define new point prevalence measures of current status (CS) unmet need and CS unmet demand, by linking contraceptive behaviours to pregnancy exposure and to women’s future contraceptive intentions. We explore the difference between standard and CS unmet need and estimate the proportion of women with CS unmet demand, who may be more likely to adopt contraception.Methods We use Demographic and Health Survey data from 46 low-income and middle-income countries released between 2010 and 2018. We assess differences in women’s classification between standard and CS unmet need indicators and estimate the percentage of women with CS unmet demand for contraception, defined as the percentage of women with CS unmet need who intend to use contraception in the future.Findings We find substantial country-level differences between standard and CS estimates of unmet need, ranging from −8.3% points in Niger to +11.1% points in Nepal. The average predictive value of the standard measure across the 46 countries for identifying prevalent cases of unmet need is 53%. Regardless of indicator (standard or CS), only half of women with unmet need intend to use contraception.Interpretation The results of this study suggest that the standard measure of unmet need has low predictive value in identifying women with current unmet need. Thus, the standard indicator does not reflect a prevalence estimate of unmet need.
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spelling doaj-art-0aac2a5469e74e2ebecf754f99d85ee02024-12-14T21:05:08ZengBMJ Publishing GroupBMJ Global Health2059-79082019-07-014410.1136/bmjgh-2019-001581Measuring unmet need for contraception as a point prevalenceCaroline Moreau0Mridula Shankar1Stephane Helleringer2Stanley Becker36 Population Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USAFaculty of Medicine Nursing and Health Sciences, Department of General Practice, Monash University, Clayton, Victoria, AustraliaSchool of Public Health, Johns Hopkins University, Baltimore, Maryland, USAPopulation Family Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USABackground This study proposes a framework to address conceptual concerns with the standard indicator of unmet need for contraception. We define new point prevalence measures of current status (CS) unmet need and CS unmet demand, by linking contraceptive behaviours to pregnancy exposure and to women’s future contraceptive intentions. We explore the difference between standard and CS unmet need and estimate the proportion of women with CS unmet demand, who may be more likely to adopt contraception.Methods We use Demographic and Health Survey data from 46 low-income and middle-income countries released between 2010 and 2018. We assess differences in women’s classification between standard and CS unmet need indicators and estimate the percentage of women with CS unmet demand for contraception, defined as the percentage of women with CS unmet need who intend to use contraception in the future.Findings We find substantial country-level differences between standard and CS estimates of unmet need, ranging from −8.3% points in Niger to +11.1% points in Nepal. The average predictive value of the standard measure across the 46 countries for identifying prevalent cases of unmet need is 53%. Regardless of indicator (standard or CS), only half of women with unmet need intend to use contraception.Interpretation The results of this study suggest that the standard measure of unmet need has low predictive value in identifying women with current unmet need. Thus, the standard indicator does not reflect a prevalence estimate of unmet need.https://gh.bmj.com/content/4/4/e001581.full
spellingShingle Caroline Moreau
Mridula Shankar
Stephane Helleringer
Stanley Becker
Measuring unmet need for contraception as a point prevalence
BMJ Global Health
title Measuring unmet need for contraception as a point prevalence
title_full Measuring unmet need for contraception as a point prevalence
title_fullStr Measuring unmet need for contraception as a point prevalence
title_full_unstemmed Measuring unmet need for contraception as a point prevalence
title_short Measuring unmet need for contraception as a point prevalence
title_sort measuring unmet need for contraception as a point prevalence
url https://gh.bmj.com/content/4/4/e001581.full
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AT mridulashankar measuringunmetneedforcontraceptionasapointprevalence
AT stephanehelleringer measuringunmetneedforcontraceptionasapointprevalence
AT stanleybecker measuringunmetneedforcontraceptionasapointprevalence