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Supply-Side Versus Demand-Side Unmet Need

Implications for Family Planning Programs

Bibliographic Data

ID4121222
AuthorsLeigh Senderowicz (0000-0002-6713-1473, Emory University), Nicole Maloney, Nicole S Maloney (Emory University)
Year2022
Volume48
Issue3
Pages689-722
Publication date2022-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePopulation and Development Review (JOURNAL)
Journal identifiersISSN: 0098-7921 • E-ISSN: 1728-4457
PublisherWiley (PUBLISHER • GB)
DOI10.1111/padr.12478
PMID36578790
OpenAlexW4221092907
LanguageEN
Citations received41
References cited104

Despite its central importance to global family planning, the "unmet need for contraception" metric is frequently misinterpreted. Often conflated with a lack of access, misinterpretation of what unmet need means and how it is measured has important implications for family planning programs. We review previous examinations of unmet need, with a focus on the roles of access and demand for contraception, as well as the role of population control in shaping the indicator's priorities. We suggest that disaggregating unmet need into "demand-side unmet need" (stemming from lack of demand) and "supply-side unmet need" (stemming from lack of access) could allow current data to be leveraged into a more person-centered understanding of contraceptive need. We use Demographic and Health Survey data from seven sub-Saharan African countries to generate a proof-of-concept, dividing women into unmet need categories based on reason for contraceptive nonuse. We perform sensitivity analyses with varying conceptions of access and disaggregate by education and marital status. We find that demand-side unmet need far exceeds supply-side unmet need in all scenarios. Focusing on supply-side rather than overall unmet need is an imperfect but productive step toward person-centered measurement, while more sweeping changes to family planning measurement are still required

Business · Commerce · Demand side · Economics · Environmental economics · Operations management · Public economics · Side impact · Supply side · Engineering · Global Maternal and Child Health · Healthcare Policy and Management · Reproductive Health and Contraception

  • Contraceptive Alignment

    Open Access•Stephanie Arteaga, Ariana H Bennett et al.•Studies in Family Planning•2026

  • Preference-aligned fertility management among married adolescent girls in Northern Nigeria

    Open Access•C Rothschild, Alhaji Bulama et al.•BMJ Global Health•2024

  • “I am forced to just give it to her because she is the one who wants it”

    Open Access•Alexandra Wollum, Jessica D Gipson et al.•SSM - Qualitative Research in…•2024

  • A qualitative study on fertility preferences and barriers to fertility autonomy in rural Uganda among women with an unmet need for family planning

    Open Access•Rebecca Luttinen, Rebecca L Luttinen et al.•Global Public Health•2026

  • Dynamics of care and sector use between birth, contraception and sick child services

    Open Access•Lindsay Mallick, Nicole Bellows et al.•PLOS Global Public Health•2025

  • Unplanned pregnancy and contraceptive use in humanitarian settings

    Open Access•Samar Karout, Hani M J Khojah et al.•Conflict and Health•2026

  • Après la pilule. Le choix contraceptif des jeunes femmes à l’épreuve du rejet des hormones

    Cécile Thomé•Santé Publique•2024

  • Unmet need and intention to use as predictors of adoption of contraception in 10 Performance Monitoring for Action geographies

    Open Access•Dana O Sarnak, Phil Anglewicz et al.•SSM - Population Health•2023

  • Unravelling factors influencing demand for modern contraception and evaluating coverage progress since 2015 in Ethiopia, Kenya, and Nigeria

    Open Access•McEwen Khundi, Themba Mzembe et al.•BMC Public Health•2024

  • Measuring a Critical Component of Contraceptive Decision Making

    Open Access•Corinne H Rocca, Isabel Muñoz et al.•Maternal and Child Health Journal•2024

  • Findings from a mixed-methods journey map study of barriers to family planning in western Kenya

    Laura E Britton, Katherine Tumlinson et al.•Health Care For Women International•2022

  • The State of Person‐Centered Measurement for Family Planning Need and Use

    Open Access•Ilene S Speizer, Elizabeth Sully et al.•Studies in Family Planning•2025

  • Gender, Power, and Nonpreferred Contraceptive Use in the United States

    Open Access•Kristen Lagasse Burke, Leon Lindberg•Socius Sociological Research for…•2024

  • Intrahousehold Decision Making and Fertility Choices in Rural Senegal and Uganda

    Kaat Van Hoyweghen, Goedele Van Den Broeck et al.•Feminist Economics•2024

  • Modeling the “who” and “how” of social influence in the adoption of health practices

    Open Access•Neelam Modi, J Koskinen et al.•Social Networks•2025

  • Violent instability and modern contraception

    Open Access•Orsola Torrisi•World Development•2024

  • Early marriage/pregnancy among Syrian refugees in Jordan in light of reproductive governance and justice

    Open Access•An Van Raemdonck•Women s Studies International Forum•2023

  • Leaving no One Behind

    Open Access•Rosanna Le Voir•Population Research and Policy…•2023

  • Small Family, Happy Family? Fertility Preferences and the Quantity–Quality Trade-Off in Sub-Saharan Africa

    Open Access•Kaat Van Hoyweghen, Janne Bemelmans et al.•Population Research and Policy…•2023

  • The Consequences of Community Violence for Contraceptive Use and Provision in Mexico

    Open Access•Signe Svallfor, M L Caudillo et al.•Demography•2025

  • Contraceptive Use and Discontinuation Among Adolescent Women in 55 Low- and Middle-Income Countries

    Open Access•Clara E Busse, Katherine Tumlinson et al.•Demography•2025

  • Meeting Preferences for Specific Contraceptive Methods

    Open Access•Kristen Lagasse Burke, J E Potter•Studies in Family Planning•2023

  • Assessing the Suitability of Unmet Need as a Proxy for Access to Contraception and Desire to Use It

    Open Access•Leigh Senderowicz, Bruce Bullington et al.•Studies in Family Planning•2023

  • Development and Validation of the Agency in Contraceptive Decisions Scale in Uganda and Nigeria

    Open Access•Sneha Challa, Ushma D Upadhyay et al.•Studies in Family Planning•2025

  • Assessing Trends in the Desire to Avoid Pregnancy

    Open Access•John B Casterline, Laila O El‐Zeini et al.•Studies in Family Planning•2024

  • Misconceptions, Misinformation, and Misperceptions

    Open Access•Rose Stevens, Kazuyo Machiyama et al.•Studies in Family Planning•2023

  • Measuring Unmet Need for Contraception Using a Person‐Centered Algorithm

    Open Access•Octavia Mulhern, Rubina Hussain et al.•Studies in Family Planning•2025

  • Measuring Contraceptive Autonomy at Two Sites in Burkina Faso

    Open Access•Leigh Senderowicz, Brooke W Bullington et al.•Studies in Family Planning•2023

  • Child Fostering and Family Size Preferences in Uganda

    Open Access•C Cotton•Studies in Family Planning•2024

  • Associations between Contraceptive Decision‐Making and Marital Contraceptive Communication and use in Rural Maharashtra, India

    Open Access•Melody Nazarbegian, Sarah Averbach et al.•Studies in Family Planning•2022

  • Preference‐Aligned Fertility Management as a Person‐Centered Alternative to Contraceptive Use‐Focused Measures

    Open Access•Kelsey Holt, Christine Galavotti et al.•Studies in Family Planning•2023

  • Un]met Need and [Un]wanted Family Planning

    Open Access•Jewel Gausman, Niranjan Saggurti et al.•Studies in Family Planning•2025

  • Authors’ Response to “‘Supply‐Side Versus Demand‐Side Unmet Need

    Open Access•Leigh Senderowicz, Nicole Maloney et al.•Population and Development Review•2024

  • Fertility Has Been Framed

    Open Access•Leigh Senderowicz, Taryn M Valley et al.•Studies in Comparative…•2025

  • Gender Equality and Armed Conflict

    Open Access•Signe Svallfor•Politics & Gender•2025

  • Assessing the Factors That Affect the Use of Modern Contraceptive Methods Among Youth and Adolescents in Traditional Authority Chimwala, Mangochi District

    Open Access•Daniel Devoted Matemba, Edmond Raphael Kautsire•Journal of Human Rights and…•2024

  • Supply-Side Versus Demand-Side Unmet Need

    Open Access•Mahesh Karra•Population and Development Review•2024

  • Fertility Desires and Contraceptive Transition

    Open Access•Sara Yeatman, Christie Sennott•Population and Development Review•2024

  • Population and Climate Change

    Open Access•Kelly Grace, Kathryn Grace et al.•Population and Development Review•2025

  • Predictive utility of key family planning indicators on dynamic contraceptive outcomes

    Open Access•Amy O Tsui, Amy Tsui et al.•Demographic Research•2024

  • Calculating contraceptive prevalence and unmet need for family planning in low-fertility countries with the Generations and Gender Survey

    Open Access•Judith Koops, Judith C Koops•Demographic Research•2023

  • Estimating Death

    Open Access•Claire L Wendland•Metrics•2016

  • The Seductions of Quantification

    Sally Engle Merry•Seductions of Quantification•2016

  • Family planning

    Open Access•John G F Cleland, John Cleland et al.•The Lancet•2006

  • “It just happens”

    Open Access•Sonya Borrero, Cara Nikolajski et al.•Contraception•2015

  • Third World Women and the Politics of Feminism

    Chandra Mohanty, Chandra Talpade Mohanty et al.•Third World women and the…•1991

  • Contentious Traditions

    Lata Mani•Contentious Traditions•1998

  • The Relationship Between Ambivalent and Indifferent Pregnancy Desires and Contraceptive Use Among Malawian Women

    Sarah Huber, Huber Huber et al.•International Perspectives on…•2017

  • Quality of Care and Contraceptive Use in Urban Kenya

    Katherine Tumlinson, Tumlinson Tumlinson et al.•International Perspectives on…•2015

  • Barriers to modern contraceptive methods uptake among young women in Kenya

    Open Access•Rhoune Ochako, Mwende Mbondo et al.•BMC Public Health•2015

  • Reasons for Contraceptive Nonuse at First Sex and Unintended Pregnancy

    A Danielle Iuliano, Ilene S Speizer et al.•American Journal of Health Behavior•2006

  • Do Ambivalent Women Have an Unmet Need for Family Planning? A Longitudinal Study from Bali, Indonesia

    Open Access•M Withers, Mellissa H Withers et al.•Women s Health Issues•2011

  • It's Not Planned, But Is It Okay? The Acceptability of Unplanned Pregnancy Among Young People

    Open Access•Anne M Gomez, Stephanie Arteaga et al.•Women s Health Issues•2018

  • Rethinking the Pregnancy Planning Paradigm

    Open Access•Abigail R A Aiken, Sonya Borrero et al.•Perspectives on Sexual and…•2016

  • The Misclassification of Ambivalence in Pregnancy Intentions

    Open Access•Anne M Gomez, Stephanie Arteaga et al.•Perspectives on Sexual and…•2019

  • Reproductive Health and Human Rights

    Jaime Todd‐Gher, Jaime Todd-Gher•Gender & Development•2010

  • Measurement Imperatives and Gender Politics

    Doris Bu, Doris Buss•Social Politics International…•2015

  • Unmet Need and Sex

    Open Access•Suzanne O Bell, David Bishai•Studies in Family Planning•2017

  • Contraceptive Autonomy

    Open Access•Leigh Senderowicz•Studies in Family Planning•2020

  • Toward a New Definition of Unmet Need for Contraception

    Open Access•Sarah D Rominski, Sarah Rominski et al.•Studies in Family Planning•2019

  • Unmet Need for Contraception

    Open Access•John G F Cleland, John Cleland et al.•Studies in Family Planning•2014

  • Factors Underlying Unmet Need for Family Planning in the Philippines

    John B Casterline, Aurora E Pérez et al.•Studies in Family Planning•1997

  • Aligning Goals, Intents, and Performance Indicators in Family Planning Service Delivery

    Open Access•Saumya RamaRao, Anrudh K Jain•Studies in Family Planning•2015

  • Reassessing Unmet Need for Family Planning in the Postpartum Period

    Open Access•Clémentine Rossier, Sarah E K Bradley et al.•Studies in Family Planning•2015

  • Incorporating Method Dissatisfaction into Unmet Need for Contraception

    Open Access•C Rothschild, Joseph Brown et al.•Studies in Family Planning•2021

  • How Gender Roles Influence Sexual and Reproductive Health Among South African Adolescents

    Open Access•Christine A Varga, Christine Varga•Studies in Family Planning•2003

  • Using Measurements of Unmet Need to Inform Program Investments for Health Service Integration

    Open Access•Shawn Malarcher, Chelsea B Polis•Studies in Family Planning•2014

  • Understanding Unmet Need

    Open Access•Sarah E K Bradley, Sarah E Bradley et al.•Studies in Family Planning•2014

  • The Buzz Outside the Clinics

    Naomi Rutenberg, Susan Watkins et al.•Studies in Family Planning•1997

  • Measuring Access to Family Planning

    Open Access•Yoonjoung Choi, Madeleine Short Fabic et al.•Studies in Family Planning•2016

  • Reasons for Contraceptive Nonuse among Women Having Unmet Need for Contraception in Developing Countries

    Open Access•Gilda Sedgh, Rubina Hussain•Studies in Family Planning•2014

  • Developing the “120 by 20” Goal for the Global FP2020 Initiative

    Open Access•Joseph Brown, Win Brown et al.•Studies in Family Planning•2014

  • Do Natural Methods Count? Underreporting of Natural Contraception in Urban Burkina Faso

    Open Access•Clémentine Rossier, Leigh Senderowicz et al.•Studies in Family Planning•2014

  • Unmet Need for Family Planning in Ghana

    Open Access•Kazuyo Machiyama, John G F Cleland et al.•Studies in Family Planning•2014

  • Psychometric Evaluation of an Instrument to Measure Prospective Pregnancy Preferences

    Open Access•Corinne H Rocca, Lauren Ralph et al.•Medical Care•2019

  • The Concept of Access

    Roy Penchansky, J W Thomas•Medical Care•1981

  • Understanding the Complexity of Ambivalence Toward Pregnancy

    Sam Hyun Yoo, K B Guzzo et al.•Biodemography and Social Biology•2014

  • On the Modernity of Traditional Contraception

    Open Access•Jennifer Johnson‐hank, Jennifer Johnson‐Hanks•Population and Development Review•2002

  • I was obligated to accept

    Open Access•Leigh Senderowicz•Social Science & Medicine•2019

  • Behind the measures of maternal and reproductive health

    Open Access•Jan Brunson, Siri Suh•Social Science & Medicine•2020

  • Tool of economic development, metric of global health

    Open Access•Jan Brunson•Social Science & Medicine•2020

  • I am the master key that opens and locks

    Open Access•Cary Karp, Celia Karp et al.•Social Science & Medicine•2020

  • Measuring the Unmet Need for Contraception

    Charles F Westoff•Population and Development Review•1992

  • Feminists and Neo-Malthusians

    Dennis Hodgson, Susan Watkins et al.•Population and Development Review•1997

  • Desired Fertility and the Impact of Population Policies

    Lant Pritchett, Lant H Pritchett•Population and Development Review•1994

  • Unmet Need for Family Planning in Developing Countries and Implications for Population Policy

    Open Access•John B Casterline, Steven W Sinding•Population and Development Review•2000

  • The KAP-Gap and the Unmet Need for Contraception

    John Bongaarts•Population and Development Review•1991

  • Targeting Access to Reproductive Health

    Stan Bernstein, Lindsay Edouard•Reproductive Health Matters•2007

  • Women's health decline following (some) unintended births

    Open Access•Sara Yeatman, Emily Smith-Greenaway•Demographic Research•2021

  • It's those Pills that are Ruining Me

    Open Access•Krystale E Littlejohn•Gender & Society•2013

  • Measuring the World

    Open Access•Sally Engle Merry•Current Anthropology•2011

  • Metrics of Survival

    Siri Suh•Medical Anthropology•2019

Unique citing works41
Citations per year10,25
Citation span2022 - 2026 (5)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 40
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