The causes of unmet need for contraception and the social content of services

Document Type

Article (peer-reviewed)

Publication Date

1-1-1994

Abstract

Since the 1960s, survey data have indicated that substantial proportions of women who have wanted to stop or delay childbearing have not practiced contraception. This discrepancy between reproductive preferences and behavior is referred to as the “unmet need” for contraception. The traditional interpretation, that these women lack access to contraceptive supplies and services, has led in turn to an emphasis on expanding family planning programs. This study analyzes survey data and related anthropological studies on the causes of unmet need and concludes that the conventional explanation is inadequate. Although there are still many environments in which geographic access to services remains a problem, the principal reasons for nonuse among the otherwise motivated in much of the developing world are lack of knowledge, fear of side effects, and social and familial disapproval. This finding underscores the need for expanded investment in services that not only provide contraceptives, but also attend to closely related health and social needs of prospective clients. Also required are more innovative communication strategies by service providers, community workers, and popular media, as well as services that assist clients in their negotiations with sexual partners. Programs are likely to be most successful when they reach beyond the conventional boundaries of service provision to influence and alter the cultural and familial factors that limit voluntary contraceptive use.

DOI

10.2307/2137932

Language

English

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