Academic journal article International Perspectives on Sexual and Reproductive Health

Men's Data Are Needed to Estimate Unmet Need among Couples

Academic journal article International Perspectives on Sexual and Reproductive Health

Men's Data Are Needed to Estimate Unmet Need among Couples

Article excerpt

Estimates of unmet need for contraception calculated using only women's reported fertility intentions and contraceptive use may not be representative of couples' need. According to an analysis of Demographic and Health Survey (DHS) data from monogamous couples in three West African countries, the proportion of couples in which at least one partner reported having unmet need ranged from 31% to 37% (1) In fewer than half (41-49%) of such couples did both partners individually report having unmet need; unmet need was reported by the wife only in 33-40% of couples and by the husband only in 15-23%.

Typically, research studies on unmet need for contraception estimate levels among married women and assume that their reports about fertility intentions and contraceptive use represent those of couples. To directly examine rates of unmet need among couples, researchers used DHS data from three West African countries: Benin (2006), Burkina Faso (2003) and Mali (2001); West Africa was chosen because of its high level of unmet need, and the three surveys were used because they were the only ones available from West African countries with the measures to calculate unmet need among couples. The three surveys had a combined sample of 7,821 couples.

Unmet need for contraception was determined separately for women and men on the basis of their fecundity, contraceptive use and fertility intentions. Women who were currently pregnant or experiencing postpartum amenorrhea and who were not practicing contraception were considered to have unmet need if they reported that their current or last pregnancy, respectively, was mistimed or unwanted; other fecund women who were not practicing contraception were considered to have unmet need if they reported wanting to wait at least two years before becoming pregnant, not wanting any more children or being undecided about future childbearing. For men, unmet need was defined in a similar way, using their reports of their fertility intentions but their wife's reports of fecundity, pregnancy and postpartum amenorrhea. Contraceptive use among women and men was based on a couple-level measure: A couple was considered to be practicing contraception if the wife reported use of a female-controlled method, the husband reported use of a male-controlled method or both.

Unmet among couples was based on the couple-level measure of contraceptive use; wives' reports of fecundity, pregnancy and postpartum amenorrhea; and husbands' and wives' fertility intentions. Four categories of couples' unmet need were created: neither partner has unmet need, only the wife has unmet need, only the husband has unmet need and both partners have unmet need. Categories that included at least one partner with unmet need were further divided by whether the unmet need was for limiting or spacing.

For their analytic sample, the researchers selected the 3,848 monogamous couples for whom complete fertility intention data were available; couples in which either partner reported being in a polygynous union or having had an extramarital relationship in the past year were excluded. …

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