Unmet need for contraception is a widely used but frequently misunderstood indicator. Although calculated from measures of pregnancy intention and current contraceptive use, unmet need is commonly used as a proxy measure for (1) lack of access to contraception and (2) desire to use it. Using data from a survey in Burkina Faso, we examine the extent to which unmet need corresponds with and diverges from these two concepts, calculating sensitivity, specificity, and positive/negative predictive values. Among women assigned conventional unmet need, 67 percent report no desire to use contraception and 61 percent report access to a broad range of affordable contraceptives. Results show unmet need has low sensitivity and specificity in differentiating those who lack access and/or who desire to use a method from those who do not. These findings suggest that unmet need is of limited utility to inform family planning programs and may be leading stakeholders to overestimate the proportion of women in need of expanded family planning services. We conclude that more direct measures are feasible at the population level, rendering the proxy measure of unmet need unnecessary. Where access to and/or desire for contraception are the true outcomes of interest, more direct measures should be used.

中文翻译：

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评估未满足的需求是否适合作为获取避孕措施和使用避孕措施的愿望的指标


避孕需求未得到满足是一个广泛使用但经常被误解的指标。尽管根据怀孕意愿和当前避孕药具使用情况进行计算，但未满足的需求通常被用作以下指标的替代衡量标准：(1) 缺乏避孕措施；(2) 使用避孕药具的愿望。使用布基纳法索的一项调查数据，我们检查了未满足的需求与这两个概念的对应和偏离程度，计算敏感性、特异性和阳性/阴性预测值。在传统未满足需求的女性中，67% 的人表示无意使用避孕药具，61% 的人表示可以获得各种负担得起的避孕药具。结果表明，未满足的需求在区分那些无法使用某种方法和/或希望使用某种方法的人与那些不希望使用某种方法的人时，敏感性和特异性较低。这些发现表明，未满足的需求对于计划生育方案的作用有限，并且可能导致利益相关者高估需要扩大计划生育服务的妇女比例。我们的结论是，在人口层面上采取更直接的措施是可行的，因此没有必要对未满足的需求进行替代衡量。如果获得和/或渴望避孕是真正的利益结果，则应采取更直接的措施。