I don’t agree that the conclusions regarding low unmet need for contraception in developing countries, and this being due to access, is correct based on the sources that you have linked (although thanks for providing sources).
I just had a very quick (<5 minute) look at some of the sources regarding the low unmet needs for contraception in developing countries, largely because it goes against what I would expect (lower resource settings having proportionally higher resources in this area than high resource settings). Because I looked very quickly I’ve so far only looked at the abstract/highlights, however I expect that nothing in the main text would contradict this.
The source you gave for ‘low unmet need for contraception in developing countries’: https://pubmed.ncbi.nlm.nih.gov/23489750/
It does say that generally contraceptive prevalence has gone up and unmet needs have gone down (this is a good thing, i.e. progress), unless this was already high or low respectively (not surprising, a low unmet need can only decrease by a lesser degree than a high unmet need).
However: “The absolute number of married women who either use contraception or who have an unmet need for family planning is projected to grow from 900 million (876-922 million) in 2010 to 962 million (927-992 million) in 2015, and will increase in most developing countries.”
This suggests that the unmet need is projected to increase more in developing countries compared to others.
The sources on access: https://www.guttmacher.org/sites/default/files/pdfs/pubs/Contraceptive-Technologies.pdf
It does suggest that 7 in 10 cases access may not be main the issue: “Seven in 10 women with unmet need in the three regions cite reasons for nonuse that could be rectified with appropriate methods: Twenty-three percent are concerned about health risks or method side effects; 21% have sex infrequently; 17% are postpartum or breast-feeding; and 10% face opposition from their partners or others.” But: “In the short term, women and couples need more information about pregnancy risk and contraceptive methods, as well as better access to high-quality contraceptive services and supplies.”
It also says that a quarter of women in developing countries have an unmet need: “In developing countries, one in four sexually active women who want to avoid becoming pregnant have an unmet need for modern contraception.” I would not call that low, and I think this is one of those cases of it being important to put number on it otherwise people may have different definitions of what is/isn’t low.
(A very quick estimate using the first links that come up on Google: 152 developing countries, population approx 6.69 billion total, say therefore around 3.35 billion who are female.
Turns out a quick Google does not bring up the proportion of women who are of childbearing age (15-49), but an interesting 2019 UN source on the need for family planning does come up which breaks down the unmet needs by region and is consistent with saying around 1⁄4 of women in developing countries have unmet needs: https://www.un.org/en/development/desa/population/publications/pdf/popfacts/PopFacts_2019-3.pdf That UN source has a quote: “In 2019, 42 countries, including 23 in sub-Saharan Africa, still had levels of demand satisfied by modern methods below 50 per cent, including three countries of sub-Saharan Africa with levels below 25 per cent ”
Back to that raw numbers estimate I was attempting: 1⁄4 of 3.35 billion is around 840 million for the unmet needs part. Maybe classing 1⁄3 of those women being of childbearing age/benefiting from contraceptives. That’s around 280 million people.)
The second source of access: https://pubmed.ncbi.nlm.nih.gov/24931073/
This has less information than the others as I can by default only see the abstract
“Our findings suggest that access to services that provide a range of methods from which to choose, and information and counseling to help women select and effectively use an appropriate method, can be critical in helping women having unmet need overcome obstacles to contraceptive use. ” Suggesting that access is critical, and might imply that this is at least in part a reason for the unmet needs.
Edit: me reading the sources took about 5 minutes, the above writeup including me looking some stuff up (perhaps unsurprisingly) took a bit longer than that. I see having posted that Matt Sharp has also made a reply which says something very similar to what I am, would recommend reading that as well.
Thank you Lin for your thoughtful comment. I gave some further thoughts to Matt above, and it felt rude to copy and paste that comment again here. But if you have a particular hesitation which I haven’t addressed to Matt above please do let me know and I’ll do my best to come back to you on it.
I don’t agree that the conclusions regarding low unmet need for contraception in developing countries, and this being due to access, is correct based on the sources that you have linked (although thanks for providing sources).
I just had a very quick (<5 minute) look at some of the sources regarding the low unmet needs for contraception in developing countries, largely because it goes against what I would expect (lower resource settings having proportionally higher resources in this area than high resource settings). Because I looked very quickly I’ve so far only looked at the abstract/highlights, however I expect that nothing in the main text would contradict this.
The source you gave for ‘low unmet need for contraception in developing countries’: https://pubmed.ncbi.nlm.nih.gov/23489750/ It does say that generally contraceptive prevalence has gone up and unmet needs have gone down (this is a good thing, i.e. progress), unless this was already high or low respectively (not surprising, a low unmet need can only decrease by a lesser degree than a high unmet need).
However: “The absolute number of married women who either use contraception or who have an unmet need for family planning is projected to grow from 900 million (876-922 million) in 2010 to 962 million (927-992 million) in 2015, and will increase in most developing countries.” This suggests that the unmet need is projected to increase more in developing countries compared to others.
The sources on access: https://www.guttmacher.org/sites/default/files/pdfs/pubs/Contraceptive-Technologies.pdf It does suggest that 7 in 10 cases access may not be main the issue: “Seven in 10 women with unmet need in the three regions cite reasons for nonuse that could be rectified with appropriate methods: Twenty-three percent are concerned about health risks or method side effects; 21% have sex infrequently; 17% are postpartum or breast-feeding; and 10% face opposition from their partners or others.” But: “In the short term, women and couples need more information about pregnancy risk and contraceptive methods, as well as better access to high-quality contraceptive services and supplies.” It also says that a quarter of women in developing countries have an unmet need: “In developing countries, one in four sexually active women who want to avoid becoming pregnant have an unmet need for modern contraception.” I would not call that low, and I think this is one of those cases of it being important to put number on it otherwise people may have different definitions of what is/isn’t low.
(A very quick estimate using the first links that come up on Google: 152 developing countries, population approx 6.69 billion total, say therefore around 3.35 billion who are female.
Turns out a quick Google does not bring up the proportion of women who are of childbearing age (15-49), but an interesting 2019 UN source on the need for family planning does come up which breaks down the unmet needs by region and is consistent with saying around 1⁄4 of women in developing countries have unmet needs: https://www.un.org/en/development/desa/population/publications/pdf/popfacts/PopFacts_2019-3.pdf That UN source has a quote: “In 2019, 42 countries, including 23 in sub-Saharan Africa, still had levels of demand satisfied by modern methods below 50 per cent, including three countries of sub-Saharan Africa with levels below 25 per cent ”
Back to that raw numbers estimate I was attempting: 1⁄4 of 3.35 billion is around 840 million for the unmet needs part. Maybe classing 1⁄3 of those women being of childbearing age/benefiting from contraceptives. That’s around 280 million people.)
The second source of access: https://pubmed.ncbi.nlm.nih.gov/24931073/ This has less information than the others as I can by default only see the abstract “Our findings suggest that access to services that provide a range of methods from which to choose, and information and counseling to help women select and effectively use an appropriate method, can be critical in helping women having unmet need overcome obstacles to contraceptive use. ” Suggesting that access is critical, and might imply that this is at least in part a reason for the unmet needs.
Edit: me reading the sources took about 5 minutes, the above writeup including me looking some stuff up (perhaps unsurprisingly) took a bit longer than that. I see having posted that Matt Sharp has also made a reply which says something very similar to what I am, would recommend reading that as well.
Thank you Lin for your thoughtful comment. I gave some further thoughts to Matt above, and it felt rude to copy and paste that comment again here. But if you have a particular hesitation which I haven’t addressed to Matt above please do let me know and I’ll do my best to come back to you on it.