The Question of Access

This essay was written in response to a critical review made by Ross of one the authors previous publications. The authors agree with Ross about the unproductive nature of the debate over whether increased distribution is more important than service improvements in increasing contraceptive prevalence and about the fact that satisfactory access to modern contraceptives remains problematic in developing countries. In fact the authors made these points in the work which Ross critiqued. Ross was inaccurate when he said that the authors believe that access is not a problem. Instead the authors agree with Ross that access must include a range of contraceptive choices but they also note that access involves the additional factors of adequate counseling about side effects and opportunities to switch methods. Another issue remaining to be resolved is the role that access has in explaining unmet need. Women with unmet need can be broadly defined as those for whom access is the dominant issue and those for whom other obstacles are more important. As access improves women in the second group constitute a larger percentage of remaining unmet need. Thus for most women with an unmet need access is not more important than survey data indicate. Unmet need will remain a problem unless programs improve the quality of information given to clients and deal with social concerns underlying contraceptive nonuse

Geography · Global Health Care Issues · Global Maternal and Child Health · Healthcare Policy and Management · Medicine

• The Causes of Unmet Need for Contraception and the Social Content of Services

  John Bongaarts, Judith Bruce•Studies in Family Planning•1995

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