Measurement of unmet need for contraception: a counterfactual approach
Date
2022-12
Authors
Karra, Mahesh
Version
Published version
OA Version
Citation
M. Karra. 2022. "Measurement of Unmet Need for Contraception: A Counterfactual Approach." Studies in Family Planning, Volume 53, Issue 4, pp.657-680. https://doi.org/10.1111/sifp.12216
Abstract
Unmet need plays a critical role in reproductive health research, evaluation, and advocacy. Although conceptually straightforward, its estimation suffers from a number of methodological limitations, most notably its reliance on biased measures of women's stated fertility preferences. We propose a counterfactual-based approach to measuring unmet need at the population level. Using data from 56 countries, we calculate unmet need in a population as the difference between: (1) the observed contraceptive prevalence in the population; and (2) the calculated contraceptive prevalence in a subsample of women who are identified to be from "ideal" family planning environments. Women from "ideal" environments are selected on characteristics that signal their contraceptive autonomy and decision-making over family planning. We find significant differences between our approach and existing methods to calculating unmet need, and we observe variation across countries when comparing indicators. We argue that our indicator of unmet need is preferable to existing population-level indicators due to its independence from biases that are generated from the use of reported preference measures, the simplicity with which it can be derived, and its relevance for cross-country comparisons as well as context-specific analyses.
Description
License
©2022 The Authors. Studies in Family Planning, published by Wiley Periodicals LLC on behalf of PopulationCouncil. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial Li-cense, which permits use, distribution and reproduction in any medium, provided the original work is prop-erly cited and is not used for commercial purposes.