Access or use?
Research by the Guttmacher Institute, Adding It Up (2020) shows that 218 million women of reproductive age in developing regions want to avoid pregnancy but aren't using modern contraception. They are not seeing the many benefits of contraception for their health and wellbeing as well as for their families and societies.
The language we use to describe unmet need is vital. Here, unmet need isn't framed as the number of women who want to avoid pregnancy but 'cannot access' contraception, or are 'denied access' to contraception. Instead, it’s simply the number of women who aren't using contraception. And that's for a range of reasons.
Understanding the reasons for unmet demand
Why does it matter how we talk about unmet need? To satisfy unmet demand, we need to understand why women aren't using contraception even though they don’t want to become pregnant.
The reality is complex. When asked, women rarely cite limited access to family planning as the reason why. The top reasons women give are:
Capturing this complexity isn't easy in a short, punchy message.
Meeting women's and girls’ needs
Access to rights-based contraception is essential. This means ensuring the availability of contraceptives; strengthening supply chains to avoid stock-outs; and delivering affordable services to marginalised, hard-to-reach groups, including adolescents, and in humanitarian settings.
But programmes must also ensure acceptability and quality of care. Dissatisfaction among family planning users – leading to discontinuation – is a major challenge. A study in 34 countries found that more than a third of women (38%) who were using a family planning method discontinued within 12 months.
To ensure family planning programmes are effective, evidence-informed, and meet women's and girls’ needs, we must listen to what women are saying. This means that programmes must:
To accelerate progress in meeting unmet demand for contraception and helping women and girls to exercise control over their own bodies, we need to make sure that our messaging is accurate and programmes are evidence-informed.