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“Supply‐Side Versus Demand‐Side Unmet Need: Implications for Family Planning Programs”: A Comment
Population and Development Review ( IF 4.6 ) Pub Date : 2024-12-06 , DOI: 10.1111/padr.12701
Mahesh Karra

I review a study by Senderowicz and Maloney (2022), which proposes an approach to classifying women's reasons for not using contraception as either being driven by supply‐side factors or by a lack of demand. Using Demographic and Health Survey (DHS) data from seven countries, the authors conclude that most unmet need can be attributed to demand‐side reasons for non‐use. I replicate the analysis and find errors in the authors’ calculations. When corrected, the relative differences between demand‐side and supply‐side reasons are smaller, and the proportion of women reporting supply‐side reasons is larger than demand‐side reasons in two countries. In addition, the approach does not account for endogeneity between supply and demand, which cannot be disentangled using cross‐sectional data like the DHS. Using longitudinal data, I find that more than four out of five women with “demand‐side unmet need” use contraception after receiving an intervention that reduced supply‐side barriers. I discuss the extent of inference gained by these indicators for informing programs, noting that women's true reasons for non‐use may be poorly proxied with cross‐sectional data, and prioritizing resources based on these reasons would fail to reach a nontrivial proportion of non‐users who would have preferred to contracept if access were improved.

中文翻译:


“供给侧与需求侧未满足的需求:对计划生育项目的影响”:评论



我回顾了 Senderowicz 和 Maloney (2022) 的一项研究,该研究提出了一种方法,将女性不使用避孕措施的原因分类为由供给侧因素驱动或需求不足。使用来自 7 个国家的人口与健康调查 (DHS) 数据,作者得出结论,大多数未满足的需求可归因于需求方未使用的原因。我复制了分析并在作者的计算中发现了错误。更正后,需求侧和供给侧原因之间的相对差异较小,并且在两个国家报告供给侧原因的女性比例大于需求侧原因。此外,该方法没有考虑供需之间的内生性,这无法使用 DHS 等横截面数据来解开。使用纵向数据,我发现超过五分之四的“需求未满足”女性在接受减少供给侧障碍的干预措施后采取了避孕措施。我讨论了这些指标为告知计划而获得的推断程度,指出女性不使用的真正原因可能无法用横断面数据来代理,并且根据这些原因确定资源的优先级将无法达到非使用者的非使用者比例,如果可及性得到改善,他们更愿意避孕。
更新日期:2024-12-06
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