Causes of Unmet Need for Contraception in the Developing World

Gilda Sedgh, Guttmacher Institute
Rubina Hussain, Guttmacher Institute

Unintended pregnancy is a reproductive health problem in the developing world. Using data from the Demographic and Health Surveys in 50 countries, we identify women with disproportionately high levels of unmet need for family planning and the reasons they are not using contraception. On average, 1 in 7 married women and 1 in 13 never-married women are at risk of unwanted pregnancy. The prevalence of unmet need is highest in sub-Saharan Africa. Among married women with unmet need, the most common reasons for non-use include concerns about health and side effects. Also, significant proportions of women believe they are not at risk of pregnancy because they are breastfeeding or not having sex frequently. Among never-married women, infrequent sexual activity was the most common reason for not contracepting. Opposition to contraception was relatively low. Variations in the distribution of levels and reasons for unmet need are discussed, along with program implications.