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

TLDR

Unmet need for family planning has long been a central concept in international population discourse, with key causes beyond service access including lack of contraceptive knowledge, social opposition, and health concerns about side effects. The article reviews the history and evolving measurement methods of unmet need, outlining key questions about its validity and policy relevance. The review relies on 1990s localized, in‑depth studies that blend quantitative and qualitative methods to refine unmet‑need measurement. The authors contend that unmet need, by linking contraceptive behavior with fertility preferences, supports integrating family‑planning programs with broader development policies and serves as a defensible rationale for population policy and program design.

Abstract

Unmet need for family planning has been a core concept in international population discourse for several decades. This article reviews the history of unmet need and the development of increasingly refined methods of its empirical measurement and delineates the main questions that have been raised about unmet need during the past decade, some of which concern the validity of the concept and others its role in policy debates. The discussion draws heavily on empirical research conducted during the 1990s, much of it localized, in‐depth studies combining quantitative and qualitative methodologies. Of the causes of unmet need other than those related to access to services, three emerge as especially salient: lack of necessary knowledge about contraceptive methods, social opposition to their use, and health concerns about possible side effects. The article argues that the concept of unmet need for family planning, by joining together contraceptive behavior and fertility preferences, encourages an integration of family planning programs and broader development approaches to population policy. By focusing on the fulfillment of individual aspirations, unmet need remains a defensible rationale for the formulation of population policy and a sensible guide to the design of family planning programs.