Incorporating Method Dissatisfaction into Unmet Need for Contraception

Implications for Measurement and Impact

Bibliographic Data

ID10796847
AuthorsC Rothschild (0000-0002-2419-9881, Claire W. Rothschild Department of Epidemiology University of Washington Seattle USA, corresponding author), Joseph Brown (0000-0002-3602-1351, Gates Foundation), Win Brown (Win Brown The Bill & Melinda Gates Foundation Seattle WA USA), Alison L Drake (0000-0002-4178-7706, Alison L. Drake Department of Global Health University of Washington Seattle USA)
Year2021
Volume52
Issue1
Pages95-102
Publication date2021-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueStudies in Family Planning (JOURNAL)
Journal identifiersISSN: 0039-3665 • E-ISSN: 1728-4465
PublisherWiley (PUBLISHER • GB)
DOI10.1111/sifp.12146
PMID33595116
OpenAlexW3131932758
LanguageEN
Citations received16
References cited25

While unmet need for contraception is commonly used to assess programmatic needs, it inadequately captures the complexity of fertility and contraceptive preferences, including women's satisfaction with their contraceptive method. In their 2019 commentary, Sarah Rominski and Rob Stephenson propose reclassifying dissatisfied current users as having an unmet need for contraception. As revising the current definition based on their proposal would require significant investment to update survey and monitoring systems, understanding the potential impact on current estimates of unmet need is critical. We estimated the impact of this approach in a Kenyan cohort of modern contraceptive users. We found the prevalence of method dissatisfaction ranges from 6.6% (95% confidence interval [CI] 5.6–7.8%) to 18.9% (95% CI 17.1–20.9%); if applied nationally, this results in a large (approximately 25–70%) increase in Kenya's current estimate of unmet need for any contraception. Our findings suggest a large impact on unmet need estimates for equivalent populations. Overall, we advocate for better measurements of method satisfaction and acceptability, with metrics developed that are robust to socioeconomic gradients and validated in low‐ and middle‐income settings to ensure women's contraceptive needs are captured equitably

Confidence interval · Developing country · Economic growth · Environmental health · Family medicine · Family planning · Fertility · Kenya · Population · Research methodology · Socioeconomic status · Adolescent Sexual and Reproductive Health · Demography · Global Maternal and Child Health · Medicine · Reproductive Health and Contraception