Seeking Common Ground: Unmet Need and Demographic Goals

Abstract

Population growth has been a world issue since the 1950s. The debates of the 1960s and 1970s focused on how best to achieve fertility decline: through family planning service provision or development. The Bucharest World Population Conference of 1974 established that socioeconomic development was a necessary precondition to fertility decline. Family planning funding stagnated until evidence was provided from the World Fertility Surveys and the Demographic and Health Surveys (DHS) that there were high levels of unwanted fertility. By 1992 environmentalists had joined family planners in addressing population growth as a serious concern. Environmentalists saw growth as an impediment to environmental sustainability. An estimated 56% contraceptive prevalence level is needed in order to achieve the UN medium variant of population projection by the year 2000. Contraceptive use worldwide has increased but the numbers of women not practicing any form of contraception has declined very little. Surveys have indicated that sub-Saharan Africa was the most behind in meeting unmet demand. Studies of the relationship between stated fertility desired and actual fertility by different development levels showed that both actual and desired fertility declined with increased socioeconomic development. Regardless of level of development unwanted fertility remains constant. Meeting unmet family planning need was considered more effective in achieving replacement level fertility than by increasing contraceptive prevalence. Satisfaction of the about 17% of women with unmet need would reduce the fertility rate by 1.13 points without including China. If China were included fertility would decline to 3.11. The fertility decrease of 44% would meet the UN medium variant of desired fertility of 3.34 by the year 2000. Contraceptive prevalence could be increased from 42% to 59% by meeting unmet need in 10 years but not 7 years. Programs should emphasize health and not targets in satisfying individual and societal goals.