The MEASURE DHS project assists countries worldwide in the collection and use of data to monitor 

and evaluate population, health, nutrition, and HIV/AIDS programs. Funded by the United States 

Agency for International Development (USAID) under Contract No. GPO-C-00-03-00002-00, 

MEASURE DHS is implemented by Macro International Inc. in Calverton, Maryland. 

The main objectives of the MEASURE DHS project are: 

• To provide decisionmakers in survey countries with information useful for informed policy 

choices;

• To expand the international population and health database; 

• To advance survey methodology; and 

• To develop in participating countries the skills and resources necessary to conduct highquality demographic and health surveys. 

Additional information about the MEASURE DHS project is available on the Internet at 

http://www.measuredhs.com or by contacting Macro International Inc., MEASURE DHS, 11785 

Beltsville Drive, Suite 300, Calverton, MD 20705 USA; Telephone: 301-572-0200, Fax: 301-572-

0999, E-mail: reports@orcmacro.com. 
DHS Comparative Reports No. 14 

New Estimates of Unmet Need and the 

Demand for Family Planning

Charles F. Westoff 

Office of Population Research 

Princeton University 

Macro International Inc. 

Calverton, Maryland USA 

December 2006 

The author’s views expressed in this publication do not necessarily reflect the views of the 

United States Agency for International Development or the United States Government. 
This publication was made possible through support provided by the United States Agency for 

International Development under Contract No. GPO-C-00-03-00002-00. 

Recommended citation: 

Westoff, Charles F. 2006. New Estimates of Unmet Need and the Demand for Family Planning. DHS 

Comparative Reports No. 14. Calverton, Maryland, USA. Macro International Inc. 

iii

Contents

Preface ................................................................................................................................ v 

Acknowledgments.............................................................................................................vii

Executive Summary ...........................................................................................................ix 

1 Introduction............................................................................................................ 1 

 1.1 The Concept and Measurement of Unmet Need....................................... 1 

2 Estimates of Unmet Need for Any Method and the Demand for 

Family Planning .................................................................................................... 3 

3 Urban-Rural and Wealth Differentials................................................................... 6 

4 Unmet Need and the Demand for Modern Methods............................................ 19 

5 Trends in Unmet Need......................................................................................... 20 

 5.1 Trends in Unmet Need by Level of Education ....................................... 25 

6 Past and Future Use among Women in Need ...................................................... 37 

 6.1 Trends among Never Users Who Do Not Intend to Use......................... 39 

7 Unmet Need among Unmarried Women ............................................................. 44 

8 Fertility Implications of Reducing Unmet Need.................................................. 48 

9 Conclusions.......................................................................................................... 51 

References......................................................................................................................... 53 

Appendix A....................................................................................................................... 55 

v

Preface

One of the most significant contributions of the MEASURE DHS program is the creation of an 

internationally comparable body of data on the demographic and health characteristics of populations in 

developing countries. The DHS Comparative Reports series examines these data across countries in a 

comparative framework. The DHS Analytical Studies series focuses on specific topics. The principal objectives of both series are to provide information for policy formulation at the international level and to 

examine individual country results in an international context. Whereas Comparative Reports are primarily descriptive, Analytical Studies have a more analytical approach. 

The Comparative Reports series covers a variable number of countries, depending on the availability of data sets. Where possible, data from previous DHS surveys are used to evaluate trends over 

time. Each report provides detailed tables and graphs organized by region. Survey-related issues such as 

questionnaire comparability, survey procedures, data quality, and methodological approaches are addressed as needed. 

The topics covered in Comparative Reports are selected by MEASURE DHS staff in conjunction with the U.S. Agency for International Development. Some reports are updates of previously 

published reports. 

It is anticipated that the availability of comparable information for a large number of developing 

countries will enhance the understanding of important issues in the fields of international population and 

health by analysts and policymakers. 

Martin Vaessen 

Project Director

vii

Acknowledgments 

The author would like to thank Judie Miller of the Office of Population Research, Princeton 

University, for secretarial help and for the graphic work, and Albert Themme and Shea Rutstein of Macro 

International Inc. for help in several tabulations and for ideas for further analyses. Special thanks are due 

to Luis Ochoa at Macro International Inc. for his invaluable, detailed review of the manuscript, and to 

Melissa McCormick for her careful editing and corrections. 

ix

Executive Summary 

This report is an update of estimates of unmet need for family planning that have been part of the 

ongoing DHS comparative analyses. The emphasis is on trends in unmet need and the demand for family 

planning in 58 developing countries. In addition to the standard measure, estimates of the unmet need for 

modern methods have also been included. 

The important finding is that the proportion of women with unmet need has declined in most 

countries except in sub-Saharan Africa where little change is apparent in 15 of the 23 countries with 

available trend data. Moreover, in the least developed countries, there are significant proportions of 

married women who are in need and have never used contraception, and who say that they do not intend 

to use any method. The proportion in this category has declined in many countries but remains a serious 

challenge in others. The proportion of the total demand for family planning that has been satisfied ranges 

from 11 percent in Chad to 94 percent in Vietnam. In sub-Saharan Africa, an average of 43 percent of 

demand for all methods is satisfied, while in the other regions the average is 77 percent. The total demand 

satisfied for modern methods ranges from 6 percent in Chad to 82 percent in Brazil. 

In this report unmet need among unmarried women has been inferred from the use of 

contraception by unmarried, sexually active women age 15-49. It is clear that, over time, more unmarried 

women are using a contraceptive method. 

The significance of reducing unmet need for the fertility rate was estimated in terms of the 

potential distance to replacement fertility that would be realized. This ranges from 28 percent in West 

Africa to 100 percent in the Latin America/Caribbean region. 

1

1 Introduction 

This is the fourth review of unmet need and the demand for family planning in the developing 

countries included in the Demographic and Health Surveys (DHS) program. In the first publication in 

1991 (Westoff and Ochoa, 1991), the concept and the measure were refined and applied to 25 countries 

surveyed between 1985 and 1989. In the subsequent reviews (Westoff and Bankole, 1995; Westoff, 

2001), additional countries were added and time trends for countries with repeat surveys were analyzed. 

The coverage in the present report now extends to 58 countries in which surveys have been conducted 

since 1995, with a significant increase in repeat surveys that has enabled trend analyses. 

1.1 The Concept and Measurement of Unmet Need 

The concept of unmet need was developed more than 25 years ago (Westoff, 1978) and has been 

refined several times over the years (Westoff and Pebley, 1981; Westoff, 1988; Westoff and Ochoa, 

1991). The basic objective is to estimate the proportion of women not using contraception who either 

want to cease further childbearing (unmet need for limiting) or who want to postpone the next birth at 

least two more years (unmet need for spacing). These estimates, along with the proportion currently using 

contraception, are intended to measure the total demand for family planning. Its usefulness lies in 

identifying groups of women who might be receptive to program efforts and in evaluating the 

effectiveness of these efforts. Another purpose is to assess the potential impact on the level of fertility, 

because there is a strong association between contraceptive prevalence and fertility. 

While there have been many suggestions over the years to refine or expand the measure of unmet 

need—for example, to include husbands or to include abortion—the measure used in this report is 

essentially the same as the one that has been used in all of the DHS reports. This measure is based on 

currently married women only, though a separate measure is used in this report to gauge the needs of 

unmarried women. The measure focuses on the use of all methods of contraception, but there is an 

additional measure in this report that estimates the unmet need for modern methods only, an addition that 

is particularly relevant for family planning program interests. 

Figure 1.1 shows the measurement procedure illustrated with data from the 2001-2002 survey in 

Zambia. Currently married Zambian women are first divided into those using (34 percent) and those not 

using a method (66 percent). The nonusers are then divided into currently pregnant or amenorrheic 

women (33 percent) and nonusers who are in neither category (also 33 percent). The pregnant or 

amenorrheic women are then classified by whether the pregnancy or birth is reported as having been 

intended at that time (18 percent), mistimed (10 percent), or not wanted at any time (5 percent). Those in 

the mistimed or unwanted category are regarded as one component of total unmet need. The other 

component consists of nonusers who are not pregnant or amenorrheic. These women are first divided into 

fecund (24 percent) or infecund women (9 percent), with the fecund women then subdivided by their 

reproductive preferences. Those who want another child soon (11 percent) are excluded from the unmet 

need estimate, while women who want to wait (6 percent) or who want no more children (6 percent) are 

classified in the unmet need category. These 12 percent are then combined with the 15 percent for the 

pregnant or amenorrheic women in need, for an estimate of 27 percent in the total unmet need category. 
2

Figure 1.1 Unmet need among currently married women, Zambia 2001-2002 

Currently Married Women 100% 

Using 

for

Limiting

15%

Using Not Using Any Method 66% 

for

Spacing 

19%

Intended

18%

Need for 

Spacing 

10%

Need for 

Limiting

5%

Need for 

Spacing

6%

Need for 

Limiting

6%

Total Unmet Need 27% 

Pregnant or Amenorrheic 33% Not Pregnant or Amenorrheic 33% 

Mistimed

10%

Unwanted

5%

Fecund

24%

Infecund 

9%

Want

Later

6%

Want

No More 

6%

Want

Soon

11%
3

2 Estimates of Unmet Need for Any Method and the Demand for Family 

Planning

Estimates of unmet need, contraceptive use, the demand for family planning, and the percentage 

of total demand satisfied are shown in Table 2.1 for the most recent completed surveys. Table 2.1 also 

shows unmet need and total demand satisfied by modern methods (described in Section 4). 

Table 2.1 Demand for family planning and its components for currently married women from the most recent surveys 

 

 

Unmet need Current use 

Country

Year

of

survey 

Total

(1) 

Spacing

(2) 

Limiting

(3) 

Total

(4) 

Spacing

(5) 

Limiting

(6) 

Total

demand1

(7) 

Percentage

of total 

demand

satisfied 

(8) 

Unmet 

need

modern

methods 

(9) 

Using 

modern

methods

(10) 

Percentage

of total 

demand

satisfied by 

modern

methods 

(11) 

ASIA 

Bangladesh 2004 11.3 5.1 6.3 58.1 16.2 41.8 71.4 84.1 22.1 47.3 66.3 

Cambodia 2000 29.7 14.4 15.2 23.8 9.4 14.4 56.4 44.5 34.7 18.8 35.1 

India 1998-99 15.8 8.3 7.5 48.2 3.5 44.7 64.0 75.3 21.2 42.8 66.9 

Indonesia 2002-03 8.6 4.0 4.6 60.3 24.2 36.2 69.7 87.6 12.2 56.7 81.4 

Kazakhstan 1999 8.7 3.6 5.1 66.1 23.0 43.0 75.2 88.5 22.1 52.7 70.7 

Kyrgyz Republic 1997 11.6 4.5 7.2 59.5 26.3 33.3 71.2 83.6 22.3 48.9 68.7 

Moldova 2005 6.7 2.5 4.2 67.8 19.3 48.5 75.2 91.1 30.6 43.8 58.2 

Nepal 2001 27.8 11.4 16.4 39.3 3.8 35.5 67.1 58.6 31.7 35.4 52.7 

Pakistan2 2003 32.7 11.2 21.5 32.1 na na 64.8 49.5 39.6 25.2 38.9 

Philippines 2003 17.3 7.9 9.4 48.9 13.7 35.2 68.5 74.7 32.8 33.4 48.8 

Turkmenistan 2000 10.1 5.2 4.9 61.8 22.0 39.8 72.2 86.0 18.9 53.1 73.6 

Uzbekistan 1996 13.7 6.6 7.0 55.6 20.2 35.4 69.3 80.3 17.9 51.3 74.1 

Vietnam 2002 4.8 2.0 2.8 78.5 13.9 64.6 84.3 94.3 26.7 56.7 67.3 

 

NEAR EAST/ 

 NORTH AFRICA 

Armenia 2000 11.3 2.1 9.3 60.5 11.8 48.7 73.6 84.5 50.1 22.3 30.3 

Egypt 2005 10.3 3.6 6.7 59.2 12.4 46.8 70.4 85.4 13.0 56.5 80.2 

Jordan 2002 11.0 5.6 5.5 55.8 25.5 30.3 69.7 84.2 25.6 41.2 59.1 

Morocco 2003-04 10.0 3.5 6.6 63.0 22.3 40.6 75.0 86.6 18.2 54.8 73.1 

Turkey 2003 6.0 2.3 3.7 71.0 15.8 55.2 77.0 90.6 34.5 42.5 54.2 

Yemen 1997 38.6 17.2 21.4 20.8 7.2 13.6 59.4 35.0 49.6 9.8 16.5 

 

LATIN AMERICA/ 

 CARIBBEAN 

Bolivia 2003 22.7 6.1 16.6 58.4 15.8 42.5 81.0 72.0 46.1 34.9 43.1 

Brazil 1996 7.3 2.6 4.7 76.7 14.0 62.8 85.8 91.5 13.8 70.3 81.9 

Colombia 2005 5.8 2.5 3.3 78.2 16.9 61.3 86.2 93.3 15.8 68.2 79.1 

Dominican 

 Republic 2002 10.9 6.7 4.2 69.8 14.8 54.9 82.0 86.8 14.8 65.8 80.2 

Guatemala 1998-99 23.1 11.8 11.3 38.2 8.5 29.7 62.2 62.9 30.4 30.9 49.7 

Haiti 2000 39.8 16.0 23.8 28.1 9.8 18.3 67.7 41.4 44.9 22.8 33.7 

Nicaragua 2001 14.6 5.9 8.7 68.6 20.5 48.1 83.2 82.5 17.1 66.1 79.5 

Peru 2004 8.8 3.0 5.8 70.5 21.7 48.8 82.4 89.4 30.8 46.7 56.7 

 Continued... 
4

Table 2.1—Continued

 

 

Unmet need Current use 

Country

Year

of

survey 

Total

(1) 

Spacing

(2) 

Limiting

(3) 

Total

(4) 

Spacing

(5) 

Limiting

(6) 

Total

demand1

(7) 

Percentage

of total 

demand

satisfied 

(8) 

Unmet 

need

modern

methods 

(9) 

Using 

modern

methods

(10) 

Percentage

of total 

demand

satisfied by 

modern

methods 

(11) 

WEST AFRICA 

Benin 2001 27.2 17.5 9.7 18.6 12.0 6.6 45.8 40.6 38.6 7.2 15.7 

Burkina Faso 2003 28.8 21.8 7.0 13.8 9.9 3.9 42.6 32.3 33.9 8.8 20.6 

Cameroon 2004 20.2 14.2 6.0 26.0 17.7 8.3 46.2 56.2 33.1 13.0 28.3 

Central African 

 Republic 1994-95 16.2 11.6 4.6 14.8 11.9 2.9 31.0 47.7 27.7 3.2 10.3 

Chad 2004 23.3 19.2 4.1 2.8 2.2 0.6 26.1 10.6 24.3 1.6 6.1 

Congo 2005 16.2 13.0 3.2 44.3 35.2 9.1 60.4 73.3 47.8 12.7 21.0 

Côte d'Ivoire 1998-99 27.7 20.0 7.6 15.0 10.0 5.0 42.7 35.2 35.4 7.3 17.0 

Gabon 2000 28.0 19.9 8.0 32.7 24.0 8.7 60.7 53.9 47.3 13.4 22.1 

Ghana 2003 34.0 21.7 12.3 25.2 13.7 11.4 59.2 42.5 40.5 18.7 31.6 

Guinea 2005 21.2 13.1 8.1 9.1 5.9 3.2 30.3 30.0 24.6 5.7 18.8 

Mali 2001 28.5 20.9 7.6 8.1 5.1 3.0 36.6 22.1 29.6 7.0 19.1 

Mauritania 2000-01 31.6 22.9 8.6 8.0 5.1 2.9 39.5 20.2 34.4 5.1 13.0 

Niger 1998 16.6 14.0 2.7 8.2 6.9 1.3 24.9 33.0 20.3 4.6 18.5 

Nigeria 2003 16.9 11.8 5.1 12.6 7.8 4.8 29.5 42.7 21.2 8.2 27.8 

Senegal 2004-05 31.6 24.2 7.3 11.8 7.3 4.5 43.4 27.2 33.1 10.3 23.7 

Togo 1998 32.3 21.4 10.9 23.5 14.6 8.9 55.8 42.1 48.8 7.0 12.5 

EAST AND

SOUTHERN AFRICA 

Comoros 1996 34.6 21.8 12.9 21.0 11.8 9.2 55.6 37.7 44.2 11.4 20.5 

Eritrea 2002 27.0 21.0 6.0 8.0 5.0 3.0 35.1 22.9 27.8 7.3 20.7 

Ethiopia 2005 33.8 20.1 13.7 14.7 6.7 8.4 48.7 30.7 34.6 13.9 28.5 

Kenya 2003 24.5 14.4 10.1 39.3 14.3 25.0 65.8 62.8 32.3 31.5 47.9 

Lesotho 2004-05 30.9 10.9 20.0 37.3 13.8 23.5 68.2 54.7 33.0 35.2 51.6 

Madagascar 2003-04 23.6 11.3 12.3 27.1 12.3 14.9 50.8 53.4 32.4 18.3 36.0 

Malawi 2004 27.6 17.2 10.4 32.5 15.5 17.0 61.7 55.2 31.9 28.1 45.5 

Mozambique 2003 18.4 10.8 7.5 16.5 9.0 7.4 34.8 47.2 23.1 11.7 33.6 

Namibia 2000 22.1 9.3 12.8 43.7 13.1 30.7 65.9 66.4 23.3 42.6 64.7 

Rwanda 2005 37.9 24.5 13.4 17.4 7.4 9.9 55.3 31.4 45.0 10.3 18.6 

South Africa 1998 15.0 4.7 10.3 56.3 14.4 41.8 71.2 79.0 16.1 55.1 77.4 

Tanzania 2004-05 21.8 15.1 6.7 26.4 15.5 10.9 49.5 55.9 28.2 20.0 40.4 

Uganda 2000-01 34.6 20.7 13.9 22.8 11.2 11.6 57.3 39.7 39.1 18.2 31.7 

Zambia 2001-02 27.4 16.8 10.6 34.2 19.2 15.0 61.6 55.5 36.3 25.3 41.1 

Zimbabwe 1999 12.9 7.3 5.6 53.5 29.4 24.1 68.2 81.0 16.1 50.4 73.9 

1

 “Total demand” also includes pregnant or amenorrheic women who became pregnant while using a method. In most of the sub-Saharan countries, this information was 

not collected. 

2

 Based on estimates from the National Institute for Population Studies (2003). 

na = not available 
5

Asia

The highest estimates of unmet need in Asia are for Pakistan (33 percent), Cambodia (30 

percent), and Nepal (28 percent), while the lowest values are for Vietnam (5 percent) and Moldova (7 

percent). The spacing and limiting components of unmet need are fairly evenly divided except in Pakistan 

where the emphasis is on limiting. In contrast, the actual use of contraception is concentrated among 

limiters in these Asian countries. The percentage of total demand satisfied is highest in Vietnam (94 

percent) and now averages around 85 percent in half of these countries. 

Near East/North Africa 

In five of the six countries in the Near East/North Africa, the levels of unmet need and of 

contraceptive prevalence are very similar to those in the Asian countries with the exception of Yemen. 

Unmet need is 6 to 11 percent in the five countries, and contraceptive prevalence ranges from 56 to 71 

percent. Yemen, on the other hand, shows an unmet need of 39 percent and a prevalence of 21 percent 

(the survey was in 1997). As in the Asian countries, the use of contraception for limiting births is greater 

than for spacing purposes. Total demand for family planning ranges between 70 and 77 percent; Yemen is 

at the extreme with 59 percent. The percentage of total demand satisfied ranges from 84 to 91 percent, 

except in Yemen where it was estimated at 35 percent of women using for spacing births. 

Latin America/Caribbean 

There are essentially two sub-groups of countries in the Latin America/Caribbean region. Low 

levels of unmet need and high contraceptive prevalence are evident in Brazil, Colombia, the Dominican 

Republic, and Peru, with the demand satisfied over 80 percent. At the opposite extreme are Bolivia, 

Guatemala, and Haiti with the highest estimates of unmet need, reaching 40 percent in Haiti. Nicaragua 

shows levels in between the lowest and highest levels. The use of contraception to limit rather than to 

space childbearing is the mode in this region of the world. The overall demand for family planning 

averages 79 percent, the highest of any region. 

Sub-Saharan Africa 

There is about the same number of countries in West Africa (16) and in East and Southern Africa 

(15) represented in this report. In West Africa, unmet need ranges from 16 to 34 percent. A similar range 

is evident in East and Southern Africa (13 to 38 percent). Contraceptive prevalence is somewhat lower in 

West Africa, as is the overall demand for family planning and the percentage of demand satisfied. Total 

demand in West Africa averages 42 percent compared with 57 percent in East and Southern Africa. 

Unlike other regions of the world, the unmet need for spacing births, as well as the use of 

contraception for this purpose, is the main pattern in sub-Saharan Africa. The primary exceptions are 

South Africa, Namibia, Malawi, Lesotho, and Kenya, where smaller family norms are more developed. 

All of the countries in West Africa show a greater use as well as unmet need for spacing rather than for 

the limiting of births. As noted in the last DHS publication on the subject (Westoff, 2001), the main 

fertility regulation behavior in sub-Saharan Africa is birth spacing rather than limiting, in sharp contrast to 

other regions of the world. This is probably the result of the emphasis on health rationales for family 

planning in sub-Saharan Africa as well as the much earlier emergence of a small family norm in other 

regions. An extreme example is in the Congo, where the total demand satisfied is 73 percent as a 

consequence of the high proportion (35 percent) of women using spacing. 

In West Africa, the total demand satisfied exceeds 50 percent in only three of the 16 countries 

(Cameroon, Congo, and Gabon), compared with nine of the 15 countries in East and Southern Africa. 
6

3 Urban-Rural and Wealth Differentials 

Urban-Rural 

There is no instance in countries outside of sub-Saharan Africa in which unmet need for family 

planning in urban areas exceeds that in rural areas (Table 3.1) except for Moldova where the proportion is 

slightly higher in urban than in rural areas. Within sub-Saharan Africa, however, unmet need in the cities 

exceeds the estimates for rural areas in nine of the 31 countries. Most of these nine countries are the least 

developed, with the latest survey at least five years in the past. 

On the other hand, the higher proportion of (married) women in the cities currently using 

contraception is virtually universal (Armenia1

 and Moldova are the only exceptions among the 57 

countries). The proportion using a method is particularly high in Brazil, Colombia, and Vietnam (all at 79 

percent). At the opposite extreme is Chad at 10 percent in urban areas and 1 percent in rural areas. 

The implication of these comparisons, with few exceptions, is that the percentage of total demand 

for contraception that is satisfied is greater—or at least as high—in urban than in rural communities. The 

highest satisfied demand in cities is in Vietnam (96 percent); the lowest is in rural areas of Chad (5 

percent) and Mauritania (8 percent).

The explanation of these urban-rural differences no doubt includes the easier accessibility of 

family planning services in cities, the desire for more children in rural places, and the greater education in 

urban areas. The association of education with unmet need is covered in a later assessment of trends in 

unmet need by level of schooling. 

Wealth

The association of the wealth index with unmet need and the total demand for family planning is 

shown in Figure 3.1. The DHS wealth index typically includes such components as the type of flooring, 

water supply, sanitation facilities, electricity, radio, television, telephone, refrigerator, type of vehicle, 

persons per sleeping room, ownership of agricultural land, having a domestic servant, and various other 

country-specific items (Rutstein and Johnson, 2004). 

Unmet need is inversely related to wealth in most of the countries. The exceptions are in some of 

the least developed African (mostly West African) nations. Total demand for family planning, on the 

other hand, either increases with wealth or shows no association. The shape of that relationship is 

determined by the typically offsetting balance of unmet need and contraceptive prevalence. The strongest 

positive associations between total demand and wealth are in the less developed countries, e.g., Yemen, 

Guatemala, Benin, Cameroon, Madagascar, and Uganda. 

 

1

 The 2005 Preliminary Report for Armenia now shows a higher proportion of women currently using contraception 

in the cities. 
7

Table 3.1 Percentage of currently married women with unmet need, currently using any method, and extent that total 

demand is satisfied, by urban and rural residence 

Unmet need Use any method 

Percentage of 

demand satisfied 

Country

Year

of

survey Urban Rural Urban Rural Urban Rural 

ASIA 

Bangladesh 2004 9 12 63 57 87 83 

Cambodia 2000 25 31 33 22 57 42 

India 1998-99 13 17 58 45 81 73 

Indonesia 2002-03 9 9 61 60 88 88 

Kazakhstan 1999 8 10 67 65 90 87 

Kyrgyz Republic 1997 11 12 66 57 86 82 

Moldova 2005 7 6 67 68 91 92 

Nepal 2001 16 29 62 37 80 56 

Philippines 2003 15 20 50 47 77 72 

Turkmenistan 2000 9 11 62 61 87 85 

Uzbekistan 1996 13 14 56 55 81 80 

Vietnam 2002 4 5 79 78 96 94 

 

NEAR EAST/NORTH AFRICA 

Armenia 2003 12 12 59 63 84 84 

Egypt 2005 9 12 50 45 88 83 

Jordan 2002 10 15 57 51 86 78 

Morocco 2003-04 10 11 66 60 88 85 

Turkey 2003 5 9 72 61 94 88 

Yemen 1997 33 40 36 16 52 28 

 

LATIN AMERICA/CARIBBEAN 

Bolivia 2003 18 30 64 48 78 61 

Brazil 1996 6 13 79 69 93 85 

Colombia 2005 5 8 79 77 94 91 

Dominican Republic 2002 11 11 70 70 87 87 

Guatemala 1998-99 18 27 52 28 75 51 

Haiti 2000 38 40 30 27 44 40 

Nicaragua 2001 12 19 73 62 86 77 

Peru 2004 7 12 75 63 92 85 

 

WEST AFRICA 

Benin 2001 30 26 21 17 41 40 

Burkina Faso 2003 23 30 34 10 60 25 

Cameroon 2004 20 21 36 16 65 44 

Central African Republic 1994-95 22 13 19 12 47 49 

Chad 2004 27 23 10 1 27 5 

Congo 2005 15 17 47 41 75 71 

Côte d’Ivoire 1998-99 26 28 24 10 48 27 

Gabon 2000 27 30 37 21 57 41 

Ghana 2003 28 38 31 21 53 36 

Guinea 2005 22 21 15 7 40 25 

Mali 2001 31 28 18 5 36 15 

Mauritania 2000-01 35 29 16 3 31 8 

Niger 1998 21 16 23 6 52 26 

Nigeria 2003 17 17 20 9 54 36 

Senegal 2004-05 32 31 20 6 39 16 

Togo 1998 28 34 27 22 49 39 

 Continued... 
8

Table 3.1—Continued

Unmet need Use any method 

Percentage of 

demand satisfied 

Country

Year

of

survey Urban Rural Urban Rural Urban Rural 

EAST AND SOUTHERN AFRICA 

Comoros 1996 32 36 26 19 45 35 

Eritrea 2002 25 28 17 4 40 11 

Ethiopia 2005 17 36 47 11 74 24 

Kenya 2003 17 27 48 37 74 60 

Lesotho 2004 20 34 50 34 72 50 

Madagascar 2003-04 19 25 41 25 68 48 

Malawi 2004 23 29 37 32 63 54 

Mozambique 2003 20 18 28 12 59 40 

Namibia 2000 21 23 54 35 72 61 

Rwanda 2005 34 38 32 15 48 28 

South Africa 1998 11 21 64 45 85 68 

Tanzania 2004-05 17 24 42 22 72 49 

Uganda 2000-01 23 36 46 19 66 35 

Zambia 2001-02 26 29 46 28 64 50 

Zimbabwe 1999 8 16 63 48 89 76 
Figure 3.1 Unmet need and total demand for family planning by wealth quintile 

ASIA

9

Unmet need 

Use of any method 

Total demand 

Bangladesh 2004

13

1212

11

9 73

71

72

72

69

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Cambodia 2000

22

32

31

36

42 53

51

53

53

57

0 20 40 60 80

India 1998-99

12

15

14

20 54

18 57

64

69

75

0 20 40 60 80

Indonesia 2002-03

11

9

77

9 70

73

69

70

67

0 20 40 60 80

Highest

M iddleFourth

Lowest

Second

Kazakhstan 1999

88

6

12 76

11 74

73

78

75

0 20 40 60 80

Kyrgyz Republic 1997

11

12

10

12

14 69

66

68

74

78

0 20 40 60 80
Figure 3.1—Continued

ASIA—Continued

10 

Unmet need 

Use of any method 

Total demand 

Nepal 2001

17

26

3131

34

78

68

66

63

61

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Philippines 2003

13

12

15

20

27 67

71

7070

65

0 20 40 60 80

Turkmenistan 2000

11

10

1111

8 70

75

70

7373

0 20 40 60 80

Uzbekistan 1996

11

14

12

 17

15

68

72

70

65

71

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Vietnam 2002

4

3

6

5

8 83

84

88

86

81

0 20 40 60 80
Figure 3.1—Continued

NEAR EAST/NORTH AFRICA 

11

Unmet need 

Use of any method

Total demand 

Armenia 2000

1212

11

13

12 71

69

73

78

77

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Egypt 2005

8

1211

14

8

68

69

71

72

71

0 20 40 60 80

Jordan 2002

7

9

11

10

17 65

67

69

73

76

0 20 40 60 80

Morocco 2003-04

111111

108 79

75

75

74

72

0 20 40 60 80

Highest

M iddleFourth

Lowest

Second

Turkey 1998

6

5

10

13

20 69

74

7676

80

0 20 40 60 80

Yemen 1997

31

4040

41

40 48

54

60

65

70

0 20 40 60 80
Figure 3.1—Continued

LATIN AMERICA/CARIBBEAN 

12 

Unmet need 

Use of any method 

Total demand 

Bolivia 2003

23

18

25

24

38

81

82

83

80

79

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Colombia 2005

2

4

7

6

11 86

8787

87

84

0 20 40 60 80

Dominican Republic 2002

8

20

27

3232

83

81

83

82

80

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Guatemala 1998-99

8

20

27

3232

41

47

59

76

81

0 20 40 60 80

Haiti 2000

35

41

37

42

44 66

6767

71

68

0 20 40 60 80

Brazil 1996

5

44

8

18 83

84

85

87

89

0 20 40 60 80 100
Figure 3.1—Continued

LATIN AMERICA/CARIBBEAN—Continued

WEST AFRICA 

13 

Unmet need 

Use of any method 

Total demand 

Nicaragua 2001

12129

16

25

84

86

85

84

78

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Benin 2001

29

31

28

27

22

61

49

46

41

35

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Cameroon 2004

16

20

23

24

19 26

37

49

59

62

0 20 40 60 80

Peru 2004

8

66

11

15 80

8484

84

81

0 20 40 60 80

Burkina Faso 2003

22

31

32

29

30

39

42

41

40

54

0 20 40 60 80
Figure 3.1—Continued

WEST AFRICA—Continued

14

Unmet need 

Use of any method

Total demand 

Chad 2004

27

2222

24

22

37

24

26

23

22

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Guinea 2005

23

22

23

19

20

24

26

31

33

40

0 20 40 60 80

Ghana 2003

24

35

33

38

41

58

62

59

62

55

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Gabon 2000

22

26

28

33

31

52

58

64

63

64

0 20 40 60 80

Côte d’Ivoire 1998-99

24

2929

32

23 29

40

46

48

51

0 20 40 60 80

Congo 2005

11

16

15

20

19

67

67

74

77

80

0 20 40 60 80
Figure 3.1—Continued

WEST AFRICA—Continued

15

Unmet need 

Use of any method

Total demand 

Mali 2001

29

30

29

28

27

51

37

32

31

34

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Mauritania 2000-01

31

33

31

33

29 31

35

36

44

53

0 20 40 60 80

Niger 1998

20

18

15

14

17 21

20

20

25

43

0 20 40 60 80

Nigeria 2003

18

20

15

16

17

48

33

26

22

21

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Senegal 2004-05

29

3434

30 34

31 37

44

50

54

0 20 40 60 80

Togo 1998

28

32

34

33

35 55

53

58

56

57

0 20 40 60 80
Figure 3.1—Continued

EAST AND SOUTHERN AFRICA 

16

Unmet need 

Use of any method

Total demand 

Comoros 1996

22

32

34

38

47

53

52

53

59

61

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Eritrea 2002

22

27

31

27

28

29

30

36

41

41

0 20 40 60 80

Ethiopia 2005

24

38

37

36

33 37

45

49

52

61

0 20 40 60 80

Kenya 2003

1717

27

30

33

70

71

71

64

53

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Lesotho 2004-05

19

30

28

40

43 61

66

68

69

74

0 20 40 60 80

Madagascar 2003-04

17

24

2727

26

36

41

48

57

68

0 20 40 60 80
Figure 3.1—Continued

EAST AND SOUTHERN AFRICA—Continued

17

Unmet need 

Use of any method

Total demand 

Malawi 2004

22

28

27

30

32

64

66

61

59

58

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Mozambique 2003

1818

21

19

17 26

28

32

36

59

0 20 40 60 80

Namibia 2000

16

27

26

33

30

80

72

57

52

57

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Namibia 2000

16

27

26

33

30

80

72

57

52

57

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Rwanda 2005

34

40

38

40

38

51

53

55

53

66

0 20 40 60 80

South Africa 1998

11

6

15

22

25

78

74

71

68

61

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second
Figure 3.1—Continued

EAST AND SOUTHERN AFRICA—Continued 

18

Unmet need 

Use of any method

Total demand 

Tanzania 2004-05

15

23

26

24

22

40

42

49

54

62

0 20 40 60 80

Uganda 2000-01

26

3737

38

34 49

51

55

62

72

0 20 40 60 80

Zambia 2001-02

21

29292929

77

67

58

55

51

0 20 40 60 80

Highest

Middle

Fourth

Lowest

Second

Zimbabwe 1999

10

7

17

16

17

64

66

64

68

77

0 20 40 60 80
19

4 Unmet Need and the Demand for Modern Methods 

In response to family planning program interests, an additional measure of unmet need and the 

demand for family planning focusing on modern methods is introduced in this report. In effect, this 

measure—unmet need for modern methods—excludes primarily withdrawal and periodic abstinence; 

operationally, it treats these two methods, along with folk methods, as nonuse and adds their prevalence 

to total unmet need. In those countries with significant use of traditional methods, the effect can be 

considerable. For example, in the Philippines, where traditional methods comprise nearly one-third of all 

use, unmet need rises from 17 to 33 percent when confined to modern methods. Another example is 

Moldova where withdrawal is common; when confined to modern methods, unmet need increases from 7 

to 31 percent. 

These new calculations are shown in columns 9 to 11 of Table 2.1. Column 9 shows the new 

measure of unmet need for modern methods—the sum of total unmet need and the percentage using 

traditional methods. Column 10 displays the percentage using modern methods. The last column 

estimates the percentage of total demand satisfied by the use of modern methods (column 10 divided by 

column 7). The unmet need for modern methods is higher than the unmet need for any method. It 

averages 26 percent in the Asian countries, 32 percent in the Near East and North Africa, and 27 percent 

in Latin America and the Caribbean. In West Africa, the average unmet need for modern methods is 34 

percent, and in East and Southern Africa it is 31 percent. 

The percentage of total demand satisfied by modern methods is more variable. It is highest in 

Asia and in the Latin America/Caribbean region. The Near East/North Africa countries have lower levels, 

while the percentages satisfied in sub-Saharan Africa (where modern method use is very low) are lowest, 

especially in West Africa. Particular countries with the highest levels of satisfied demand for modern 

methods are Indonesia, Egypt, Brazil, and the Dominican Republic, all over 80 percent. The lowest is in 

Chad (6 percent).

Unmet need for modern methods and the extent to which this demand is being met is shown in 

association with education and wealth in Appendix Table A.1. There is a great amount of detail in the 

table that is perhaps best summarized by counting the countries that show negative or positive 

relationships or no association at all. 

In connection with education, the dominant picture is no association with unmet need for modern 

methods. In 56 countries, 31 are in this category while 16 show a negative association (less need with 

more education), and nine show unmet need increasing with education. 

There is not a strong association of wealth with unmet need for modern methods. Negative 

associations are more prevalent than positive relationships, but the absence of association is as frequent as 

the negative relationships. 

The association of the percentage of total demand satisfied by modern methods with education is 

mostly positive and extensive except for a few Asian countries. The relationship is much stronger than 

with unmet need, a reflection of the strong association between education and the prevalence of modern 

methods. Essentially the same picture emerges with the wealth index. 
20

Jordan

7 6

14

11

22

14

1990 1997 2002

5 Trends in Unmet Need 

A decline in unmet need (for any method) is apparent in most of the 44 countries that have 

conducted more than one survey (Figure 5.1). Only two countries in Asia and the Near East/North 

Africa—Indonesia and Egypt—show no recent decline and seem to have plateaued in the recent past. 

Pakistan shows an increase in unmet need. In contrast, Morocco and Kazakhstan show particularly sharp 

declines.

With the exception of Nicaragua, which shows no change, a general decline is also apparent in 

the Latin American and Caribbean countries, though the level remains very high in Haiti. 

Little change is evident in West Africa, and in several countries unmet need has increased. The 

same mixed picture appears in East and Southern Africa. Unmet need has also increased in Mozambique 

and in Uganda but shows plateaus in Eritrea, Ethiopia, Kenya, Madagascar, Namibia, Rwanda, and 

Zambia. A stall in the level of unmet need is the most common pattern in sub-Saharan Africa. 

Figure 5.1 Trends in unmet need for currently married women 

ASIA, NEAR EAST, AND NORTH AFRICA

 

Bangladesh

9 8 7 6

11

15

18

16

0

10

20

30

40

1993-

1994

1996-

1997

1999-

2000

2004

%

India

8

19

16

1992-1993 1998-1999

8

Egypt

15 13 11

8

20

25

16

11 10

1988-

1989

1992-

1993

1995-

1996

2005 2003

6

Kazakhstan

12

5

9

16

1995 1999

 Total unmet need Unmet need for spacing Unmet need for limiting 

Indonesia

6 6 6 5 5

9 9 11

16 14

0

10

20

30

40

1987 1991 1994 1997 2002-

2003

%
21

Figure 5.1—Continued

ASIA, NEAR EAST, AND NORTH AFRICA—Continued

LATIN AMERICA/CARIBBEAN 

Morocco

7

11 10 10

10

16

22

20

0

10

20

30

40

1987 1992 1995 2003-

2004

%

Pakistan

18

22

33

28

1991 2003

Nepal

16 17

31

28

1996 2001

Philippines

9

11 13

17

26

19

0

10

20

30

40

1993 1998 2003

% Turkey

4 6 8

6

11 10

1993 1998 2003

Vietnam

4 3

7

5

1997 2002

Bolivia

17

26

18 19

23 23

36

26

0

10

20

30

40

1989 1994 1998 2003

% Brazil

8

5

7

13

1986 1996

Colombia

8 7 5 4 3

11

13

8 6 6

1986 1990 1995 2000 2005

 Total unmet need Unmet need for spacing Unmet need for limiting 
22

Figure 5.1—Continued

LATIN AMERICA/CARIBBEAN—Continued 

 WEST AFRICA 

Dominican Republic

5 4

9 9

4

12 11

19 17

12

0

10

20

30

40

1986 1991 1996 1999 2002

%

Guatemala

13 12 11

24

29

23

1987 1995 1998-

1999

Nicaragua

8 9

15 15

0

10

20

30

40

1997-1998 2001

%

Peru

6 7

20

11 9

9 10

15

28

12

1986 1992 1996 2000 2004

Benin

9 10

26 27

0

10

20

30

40

1996 2001

% Burkina Faso

6 7 7

29

25 26

1992-

1993

1998-

1999

2003

Cameroon

5 6 6

20 20

22

1991 1998 2004

 Total unmet need Unmet need for spacing Unmet need for limiting 

Haiti

24 26

44

40

1994 2000
23

Figure 5.1—Continued

WEST AFRICA—Continued 

Côte d’Ivoire

7 8

27 28

1994 1998-1999

Chad

3 4

23

9

0

10

20

30

40

1996-1997 2004

% Ghana

6

12 12 12

37 35 34 34

1988 1993 1998 2003

Guinea

8

6 8

21

24 25

0

10

20

30

40

1992 1999 2005

%

Mali

8 6 6

29

23

26

1987 1995-

1996

2001

Niger

3 3

19

17

1992 1998

Nigeria

5 5 5

17 17

21

0

10

20

30

40

1990 1999 2003

%

Senegal

7

12

7

9

32

29

37 35

1986 1992-

1993

1997 2004-

2005

Togo

12 11

40

32

1988 1998

 Total unmet need Unmet need for spacing Unmet need for limiting 
24

 Figure 5.1—Continued

EAST AND SOUTHERN AFRICA 

Tanzania

7 9 8 8

22 22 24

28

1992 1996 1999 2004-

2005

Rwanda

12 13

18

39 36

38

1992 2000 2005

Namibia

7

13

22 22

0

10

20

30

40

1992 2000

%

Mozambique

2

8

18

7

1997 2003

Malawi

10

12 12

28 30

36

1992 2000 2004

Madagascar

11

16

12

32

26 24

0

10

20

30

40

1992 1997 2003-

2004

%

Kenya

10

15 14

10

25

38 35

24

1989 1993 1998 2003

Ethiopia

14 14

36 34

2000` 2005

Eritrea

6 6

28 27

0

10

20

30

40

1995 2002

%

 Total unmet need Unmet need for spacing Unmet need for limiting 
25

Figure 5.1—Continued

EAST AND SOUTHERN AFRICA—Continued 

5.1 Trends in Unmet Need by Level of Education 

It is important to see whether the trends in unmet need are uniform in the different educational 

strata or whether declines in unmet need are led by the more educated populations (Figure 5.2). 

In the countries of Asia (except in Pakistan) and North Africa, the decline in unmet need is 

evident in each of the three educational categories. With the exception of Nicaragua, where little change 

is observed, the same generalization applies to the Latin American and Caribbean countries. 

Sub-Saharan Africa presents a mixed picture. Unlike countries in the other regions, there are 

numerous examples of increases rather than decreases in unmet need. Typically, but with exceptions, 

these increases are concentrated in the “no education” category. It is plausible to expect initial increases 

in unmet need as a result of an increasing gulf between the desire to control fertility and the means to do 

so. Most of the decline in unmet need is among women with some education, particularly beyond the 

primary school level. 

Zambia

11

9 8

27

31

26

1992 1996-

1997

2001-

2002

Uganda

14 11

7

35

27 29

0

10

20

30

40

1988-

1989

1995 2000

%

Zimbabwe

6 6 12

13

22

15

1998-

1989

1994 1999

 

 Total unmet need Unmet need for spacing Unmet need for limiting 
26

Figure 5.2 Trends in unmet need for currently married women by education 

ASIA, NEAR EAST, AND NORTH AFRICA 

18 16 17

11

0

10

20

30

40

50

1993-

1994

1996-

1997

1999-

2000

2004

Bangladesh

No education

18 16 16 12

0

10

20

30

40

50

1993-

1994

1996-

1997

1999-

2000

2004

18

13 12 11

0

10

20

30

40

50

1993-

1994

1996-

1997

1999-

2000

2004

%

Primary Secondary+

17 16

0

10

20

30

40

50

1992-1993 1998-1999

India

14 15

0

10

20

30

40

50

1992-1993 1998-1999

16 15

0

10

20

30

40

50

1992-1993 1998-1999

28

35

0

10

20

30

40

50

1991 2003

Pakistan

30 30

0

10

20

30

40

50

1991 2003

26 27

0

10

20

30

40

50

1991 2003

16 16 12 9 11

0

10

20

30

40

50

1987 1991 1994 1997 2002

17 15 11 10 9

0

10

20

30

40

50

1987 1991 1994 1997 2002

13 11 9 8 8

0

10

20

30

40

50

1987 1991 1994 1997 2002

Indonesia
27

Figure 5.2—Continued

ASIA, NEAR EAST, AND NORTH AFRICA—Continued

Philippines

% No education Primary Secondary+

33

28 27

0

10

20

30

40

50

1993 1998 2003

29

22 20

0

10

20

30

40

50

1993 1998 2003

23

17 16

0

10

20

30

40

50

1993 1998 2003

29

24

19

14 13

0

10

20

30

40

50

1988-

1989

1992-

1993

1995-

1996

2000 2005

Egypt 24

18 16

11 10

0

10

20

30

40

50

1988-

1989

1992-

1993

1995-

1996

2000 2005

15 14 11 7 9

0

10

20

30

40

50

1988-

1989

1992-

1993

1995-

1996

2000 2005

26

20 16

0

10

20

30

40

50

1990 1997 2002

Jordan 23

18 15

0

10

20

30

40

50

1990 1997 2002

20

13 10

0

10

20

30

40

50

1990 1997 2002

24 23

18

11

0

10

20

30

40

50

1987 1992 1995 2003-2004

16

11 13 10

0

10

20

30

40

50

1987 1992 1995 2003-2004

11 9 8 8

0

10

20

30

40

50

1987 1992 1995 2003-2004

Morocco
28

Figure 5.2—Continued

ASIA, NEAR EAST, AND NORTH AFRICA—Continued

Nepal

No education %

Primary Secondary+

Turkey

Vietnam

31 28

0

10

20

30

40

50

1996 2001

36

29

0

10

20

30

40

50

1996 2001

28

23

0

10

20

30

40

50

1996 2001

20

16 13

0

10

20

30

40

50

1993 1998 2003

9 10 9

0

10

20

30

40

50

1993 1998 2003

5 6 4

0

10

20

30

40

50

1993 1998 2003

12 10

0

10

20

30

40

50

1997 2002

9 6

0

10

20

30

40

50

1997 2002

6 4

0

10

20

30

40

50

1997 2002
29

Figure 5.2—Continued

LATIN AMERICA/CARIBBEAN 

Bolivia

No education % Primary Secondary+

Brazil

Colombia

Dominican

Republic

35 41

31

45

0

10

20

30

40

50

60

1989 1994 1998 2003

27

33

26

41

0

10

20

30

40

50

1989 1994 1998 2003

14 17 16 15

0

10

20

30

40

50

1989 1994 1998 2003

30

15

0

10

20

30

40

50

1986 1996

12 9

0

10

20

30

40

50

1986 1996

5 5

0

10

20

30

40

50

1986 1996

22

17 13 10 12

0

10

20

30

40

50

1986 1990 1995 2000 2005

9 9 6 5 5

0

10

20

30

40

50

1986 1990 1995 2000 2005

30 30

20 16 13

0

10

20

30

40

50

1986 1991 1996 1999 2002

20 19

13 10 12

0

10

20

30

40

50

1986 1991 1996 1999 2002

15 12 10 13 10

0

10

20

30

40

50

1986 1991 1996 1999 2002

15 13 9 7 6

0

10

20

30

40

50

1986 1990 1995 2000 2005
30

Figure 5.2—Continued

LATIN AMERICA/CARIBBEAN—Continued

Guatemala

% No education Primary Secondary+

Haitil

Nicaragua

Peru

34 30 29

0

10

20

30

40

50

1987 1995 1998-

1999

24 26 24

0

10

20

30

40

50

1987 1995 1998-

1999

10 9 12

0

10

20

30

40

50

1987 1995 1998-

1999

44 42

0

10

20

30

40

50

60

1994 2000

4 7

4 1

0

1 0

2 0

3 0

4 0

5 0

6 0

1994 2000

4 0

3 3

0

1 0

2 0

3 0

4 0

5 0

1994 2000

22 23

0

10

20

30

40

50

1997 2001

16 14

0

10

20

30

40

50

1997 2001

10 11

0

10

20

30

40

50

1997 2001

49

28 23

16 16

0

10

20

30

40

50

60

1986 1991-

1992

1996 2000 2004

32

19 15 13 10

0

10

20

30

40

50

1986 1991-

1992

1996 2000 2004

15 11 8 7 7

0

10

20

30

40

50

1986 1991-

1992

1996 2000 2004
31

Figure 5.2—Continued

WEST AFRICA 

Benin

% No education Primary Secondary+

Burkina

Faso

Cameroon

Chad

25 27

0

10

20

30

40

50

1996 2001

30 31

0

10

20

30

40

50

1996 2001

21

26

0

10

20

30

40

50

1996 2001

24 26

30

0

10

20

30

40

50

1992-1993 1998-1999 2003

29 28 25

0

10

20

30

40

50

1992-1993 1998-1999 2003

24

16 15

0

10

20

30

40

50

1992-1993 1998-1999 2003

19 19 20

0

10

20

30

40

50

1991 1998 2004

27

22 23

0

10

20

30

40

50

1991 1998 2004

20

16 17

0

10

20

30

40

50

1991 1998 2004

9

22

0

10

20

30

40

50

1997 2004

13

30

0

10

20

30

40

50

1997 2004

17

26

0

10

20

30

40

50

1997 2004
32

Figure 5.2—Continued

WEST AFRICA—Continued 

Côte

d'Ivoire

% No education Primary Secondary+

Ghana

Guinea

Mali

26 29

0

10

20

30

40

50

1994 1998-1999

32

27

0

10

20

30

40

50

1994 1998-1999

23 21

0

10

20

30

40

50

1994 1998-1999

32

37 34 35

0

10

20

30

40

50

1988 1993 1998 2003

39 39 39 40

0

10

20

30

40

50

1988 1993 1998 2003

28

18

31 30

0

10

20

30

40

50

1988 1993 1998 2003

24 24 20

0

10

20

30

40

50

1992 1999 2005

26 28 25

0

10

20

30

40

50

1992 1999 2005

31

25 29

0

10

20

30

40

50

1992 1999 2005

22 26 28

0

10

20

30

40

50

1987 1995-1996 2001

30 27 31

0

10

20

30

40

50

1987 1995-1996 2001

28

21 25

0

10

20

30

40

50

1987 1995-1996 2001
33

Figure 5.2—Continued

WEST AFRICA—Continued

Niger

No education % Primary Secondary+

Nigeria

Senegal

Togo

18 16

0

10

20

30

40

50

1992 1998

28

21

0

10

20

30

40

50

1992 1998

2 3

1 6

0

1 0

2 0

3 0

4 0

5 0

1992 1998

19 16 14

0

10

20

30

40

50

1990 1999 2003

26 22 21

0

10

20

30

40

50

1990 1999 2003

20 18 20

0

10

20

30

40

50

1990 1999 2003

28

34 31

0

10

20

30

40

50

1991-1992 1997 2004

34

41

34

0

10

20

30

40

50

1991-1992 1997 2004

31 27 26

0

10

20

30

40

50

1991-1992 1997 2004

37

32

0

10

20

30

40

50

1988 1998

51

36

0

10

20

30

40

50

60

1988 1998

39

24

0

10

20

30

40

50

1988 1998
34

Figure 5.2—Continued

EAST AND SOUTHERN AFRICA

Eritrea

% No education Primary Secondary+

Kenya

Madagascar

27 26

0

10

20

30

40

50

1995 2002

32 30

0

10

20

30

40

50

1995 2002

27 24

0

10

20

30

40

50

1995 2002

36 35

25 21

0

10

20

30

40

50

1989 1993 1998 2003

41 39

28 30

0

10

20

30

40

50

1989 1993 1998 2003

32

26

15 13

0

10

20

30

40

50

1989 1993 1998 2003

27 24 25

0

10

20

30

40

50

1992 1997 2003

38

29 26

0

10

20

30

40

50

1992 1997 2003

24

19 19

0

10

20

30

40

50

1992 1997 2003

35 35

0

10

20

30

40

50

2000 2005

42

37

0

10

20

30

40

50

2000 2005

29

17

0

10

20

30

40

50

2000 2005

Ethiopia
35

Figure 5.2—Continued

EAST AND SOUTHERN AFRICA—Continued 

Mozambique

No education

%

Primary Secondary+

20 17

0

10

20

30

40

50

1997 2003

25

20

0

10

20

30

40

50

1997 2003

23

15

0

10

20

30

40

50

1997 2003

24 23

0

10

20

30

40

50

1992 2000

23 27

0

10

20

30

40

50

1992 2000

23 27

0

10

20

30

40

50

1992 2000

37 43 40

0

10

20

30

40

50

1992 2000 2005

36 38

36

0

10

20

30

40

50

1992 2000 2005

27 29

27

0

10

20

30

40

50

1992 2000 2005

Namibia

Rwanda

36

31 30

0

10

20

30

40

50

1992 2000 2004

Malawi

37

30 27

0

10

20

30

40

50

1992 2000 2004

25 24 24

0

10

20

30

40

50

1992 2000 2004
36

Figure 5.2—Continued

EAST AND SOUTHERN AFRICA—Continued

Uganda

No education

%

Primary Secondary+

Zambia

Zimbabwe

24 26

35

0

10

20

30

40

50

1988-1989 1995 2000-2001

29 31

37

0

10

20

30

40

50

1988-1989 1995 2000-2001

35

30

22

0

10

20

30

40

50

1988-1989 1995 2000-2001

29

24 27

0

10

20

30

40

50

1992 1996-1997 2001-2002

32 28 29

0

10

20

30

40

50

1992 1996-1997 2001-2002

27 24 23

0

10

20

30

40

50

1992 1996-1997 2001-2002

19 16

0

10

20

30

40

50

1994 1999

17 16

0

10

20

30

40

50

1994 1999

10 9

0

10

20

30

40

50

1994 1999

26 22 23 22

0

10

20

30

40

50

1992 1996 1999 2004-

2005

29 25 22 23

0

10

20

30

40

50

1992 1996 1999 2004-

2005

21 23

13 10

0

10

20

30

40

50

1992 1996 1999 2004-

2005

Tanzania
37

6 Past and Future Use among Women in Need 

In order to meet the family planning needs of women classified with an unmet need, it is useful to 

consider four subgroups: women who have used any method in the past who either intend to use again in 

the future or who do not intend to use; and women who have never used a method, also subdivided by 

whether they intend to use in the future. 

Women who have never used contraception tend, in general, to be younger, less educated, and 

less wealthy. Women who have used in the past and who intend to resume use are more likely to be at the 

higher ends of education and wealth. The subset who have used but who do not intend future use are 

concentrated among women over 40 years of age. 

The distribution of women in these four categories is shown in Table 6.1 for the most recent 

surveys. There is a great variety in the different regions as well as within regions. In Asia, there is a 

mixed picture. Women in need who have used a method in the past comprise about half of the Asian 

countries, while in all of the Asian countries included here, those past users who intend to resume use are 

the larger category. Among Asian women who have never used any method, those who intend to use 

predominate. 

In the Near East and North African countries, with the exception of Yemen, the pattern is very 

similar to that in Asia and is dominated by past users, especially those who intend to use in the future. 

The Latin American/Caribbean pattern is also dominated by past users who intend to use. Guatemala is a clear exception to this, with those in need concentrated in the category of never users who do 

not intend to use. 

Sub-Saharan Africa is difficult to summarize. Women in need who have never used and who do 

not intend to use predominate in Chad, Eritrea, Mauritania, Niger, and Senegal, while never users who 

intend future use are high in Burkina Faso, Congo, Ethiopia, Guinea, and Uganda. Among women who 

have used in the past, virtually every country shows a predominance of those who plan to resume use. 
38

Table 6.1 Percent distribution of currently married women with an unmet need for family planning by 

past use and intention to use a contraceptive method in the future 

Never used Used in the past 

Country

Year

of

survey 

Does not 

intend 

to use 

Intends 

to use 

Does not 

intend 

to use 

Intends 

to use Total 

ASIA 

Bangladesh 2004 5.8 28.0 7.5 58.8 100.0 

Cambodia 2000 33.2 40.4 11.0 15.4 100.0 

India 1999 21.4 57.1 5.9 15.7 100.0 

Indonesia 2002-03 23.2 12.8 26.1 37.9 100.0 

Kazakhstan 1999 8.5 12.4 26.8 52.3 100.0 

Kyrgyz Republic 1997 2.3 21.5 29.2 47.0 100.0 

Nepal 2001 12.4 52.2 6.7 28.7 100.0 

Philippines 2003 32.8 22.6 15.0 29.6 100.0 

Turkmenistan 2000 4.5 6.1 35.4 54.0 100.0 

Uzbekistan 1996 34.9 22.8 20.9 21.4 100.0 

Vietnam 2002 10.1 27.2 19.0 43.6 100.0 

 

NEAR EAST/NORTH AFRICA 

Armenia 2000 14.9 11.0 31.8 42.3 100.0 

Egypt 2003 9.3 18.1 19.7 53.0 100.0 

Jordan 2002 14.0 21.0 15.6 49.4 100.0 

Morocco 2003-04 4.2 7.9 34.4 53.5 100.0 

Yemen 1997 53.3 16.0 14.9 15.7 100.0 

 

LATIN AMERICA/ 

 CARIBBEAN 

Bolivia 2003 24.3 27.0 12.2 36.5 100.0 

Brazil 1996 8.1 16.6 15.8 59.6 100.0 

Colombia 2000 4.0 19.4 10.8 65.8 100.0 

Dominican Republic 2002 10.8 23.2 12.6 53.4 100.0 

Guatemala 1999 52.2 32.6 4.6 10.7 100.0 

Haiti 2000 17.5 35.7 15.0 31.8 100.0 

Nicaragua 2001 12.7 19.0 14.1 54.2 100.0 

Peru 2000 15.5 23.8 13.3 47.5 100.0 

 

WEST AFRICA 

Benin 2001 19.1 32.3 15.5 33.1 100.0 

Burkina Faso 2003 22.6 54.9 5.1 17.4 100.0 

Cameroon 2004 30.2 16.7 16.4 36.8 100.0 

Central African Republic 1995 14.9 41.9 8.2 35.0 100.0 

Chad 1997 62.1 29.4 4.3 4.2 100.0 

Côte d'Ivoire 1998-99 24.9 37.3 7.1 30.8 100.0 

Gabon 2000 16.7 11.0 29.1 43.2 100.0 

Ghana 2003 19.9 33.7 14.0 32.4 100.0 

Guinea 1999 35.4 50.9 2.7 11.0 100.0 

Mali 2001 38.6 38.1 7.9 15.4 100.0 

Mauritania 2000-01 69.4 10.5 9.3 10.7 100.0 

Niger 1998 47.8 29.0 7.9 15.4 100.0 

Nigeria 2003 38.7 26.3 14.0 21.1 100.0 

Senegal 1997 40.4 38.6 4.7 16.2 100.0 

Togo 1998 13.7 23.1 17.7 45.5 100.0 

 Continued... 
39

Table 6.1—Continued

Never used Used in the past 

Country

Year

of

survey 

Does not 

intend 

to use 

Intends 

to use 

Does not 

intend 

to use 

Intends 

to use Total 

EAST AND SOUTHERN AFRICA 

Comoros 1996 30.4 30.0 11.3 28.3 100.0 

Eritrea 2002 50.6 29.6 7.1 12.8 100.0 

Ethiopia 2005 29.7 57.5 1.8 16.9 100.0 

Kenya 2003 18.1 38.2 7.4 36.3 100.0 

Madagascar 2003-04 36.3 27.8 19.8 16.1 100.0 

Malawi 2000 11.9 46.9 5.1 36.0 100.0 

Mozambique 2003 20.8 24.0 19.6 35.7 100.0 

Namibia 2000 11.8 23.2 18.3 46.7 100.0 

Rwanda 2000 26.7 38.4 12.3 22.7 100.0 

South Africa 1998 13.1 10.5 32.0 44.4 100.0 

Tanzania 1999 27.7 34.1 11.1 27.1 100.0 

Uganda 2000-01 16.7 49.6 6.9 26.8 100.0 

Zambia 2001-02 7.9 26.1 10.6 55.3 100.0 

Zimbabwe 1999 11.5 14.0 14.1 60.4 100.0 

Note: Totals may not add to 100.0 because of rounding. 

6.1 Trends among Never Users Who Do Not Intend to Use 

The important statistic is the proportion of women with an unmet need, but a critical subset is 

women in need who have never used a method and who report that they have no intention of using in the 

future. This is a particularly challenging population for family planning program efforts. While women 

currently in need who intend to use may need further encouragement and greater availability of different 

methods, their motivation is ostensibly established. Those who have used in the past but who do not 

intend to use tend to be older and at less risk of unintentional pregnancy. This leaves women in need who 

have never used contraception and who do not intend to use, a category requiring both motivation as well 

as supplies. As evident in Table 6.1 for women with an unmet need, the proportion of women in this 

category is particularly high in the least developed countries, e.g., Yemen, Guatemala, and numerous subSaharan African countries. 

The statistic highlighted here, however, is the proportion of all currently married women who 

collectively have an unmet need and who have never used contraception and who say that they do not 

intend to use a method in the future. These estimates are shown in Figure 6.1 for the most recent surveys 

and for earlier surveys in order to assess trends. In the Philippines in 2003, for example, 5.7 percent of all 

married women are in this category (unmet need and never used a method and do not intend to use one). 

This is unchanged from 1998. The highest values of this statistic are seen in Guatemala (1999), 

12 percent; Eritrea (2002), 14 percent (unchanged since 1995); Senegal (1997), 14 percent; and Mali 

(2001), 11 percent. 

The trend in this proportion, however, is clearly downward in all but a few of these countries, and 

in some countries it has fallen to a level of around or below 1 percent. Only a few countries show an 

increase: Kenya, Mali, and Uganda. In Kenya, a stall in the increase of contraceptive prevalence has been 

observed and analyzed (Westoff and Cross, 2006). The estimates for Mali and Uganda are now five to six 

years old and may have changed. In Senegal, the level was high (14 percent) but unchanged over the five 

years after 1992-1993. 
40

There are several other countries not included in Figure 6.1 because only one survey is available 

to date. High values of the statistic are evident in Comoros (1996), 11 percent; Ethiopia (2000), 11 

percent; and Cambodia (2000), 10 percent. Yemen (1997) has the highest value at 21 percent. 

As reported in the last review of unmet need (Westoff, 2001), the main reasons offered by never 

users for not intending to use a method in the future are various kinds of opposition to contraception, 

including religious considerations, husband’s objections, and personal reasons. Other major reasons 

include lack of knowledge of methods and where to find them, especially in sub-Saharan Africa. 

Figure 6.1 Trends in the percentage of currently married women 

who have an unmet need for family planning and who have never used 

a contraceptive method and who do not intend to use a method in the future 

ASIA, NEAR EAST, AND NORTH AFRICA 

2.4

1.7

1.4

0.6

4.9

1.9

1.3

0.9

2.6

2.4

2.0

6.9

1.6

1.5

1.1

0.7

6.2

3.4

5.8

5.7

2.1

1.7

1.2

0.5

1993-1994

1996-1997

2000

2004

1992-1993

1995-1996

2000

2003

1994

1997

2002-2003

1990

1997

2002

1995

1999

1996

2001

1998

2003

1993

1998

1997

2000

0.0 5.0 10.0 15.0

Percentage

Bangladesh

Egypt

Indonesia

Jordan

Kazakhstan

Nepal

Philippines

Turkey

Vietnam
41

Figure 6.1—Continued

LATIN AMERICA/CARIBBEAN 

7.5

8.6

6.6

5.7

0.6

1.3

0.5

0.2

2.8

1.2

0.9

12.7

12.1

13.2

6.9

2.5

1.8

2.8

2.4

1.4

1994

1998

2003

1991-1992

1996

1990

1995

2000

1991

1996

2002

1995

1998-1999

1994

2000

1998

2001

1991-1992

1996

2000

0.0 5.0 10.0 15.0

Percentage

Bolivia

Brazil

Colombia

Dominican Republic

Guatemala

Haiti

Nicaragua

Peru
42

Figure 6.1—Continued

WEST AFRICA 

6.5

5.2

8.2

6.5

6.1

8.7

6.9

7.0

8.7

6.8

9.1

11.0

10.4

8.0

11.3

9.1

6.5

13.8

14.1

1996

2001

1991

1998

2004

1994

1998-1999

1992

1998

2003

1996

2001

1992

1998

1990

1999

2003

1992-1993

1997

0.0 5.0 10.0 15.0

Percentage

Benin

Cameroon

Côte d'Ivoire

Ghana

Mali

Niger

Nigeria

Senegal
43

Figure 6.1—Continued

EAST AND SOUTHERN AFRICA 

13.7

13.7

6.2

3.5

4.4

10.4

7.4

8.6

11.1

3.8

12.6

6.0

5.4

5.8

6.4

2.5

2.2

2.0

1.5

1995

2002

1993

1998

2003

1992

1997

2003-2004

1997

2003

1992

1999

1995

2000-2001

1992

1996-1997

2001

1994

1999

0.0 5.0 10.0 15.0

Percentage

Eritrea

Kenya

Madagascar

Mozambique

Tanzania

Uganda

Zambia

Zimbabwe

Note: The Kenya 2003 survey was confined to the same

areas of the country that were surveyed in 1993 and 1998.
44

7 Unmet Need among Unmarried Women 

There are several problems in measuring the unmet need for family planning of unmarried 

women. One is the uncertain quality of the reports on sexual activity and on its timing, especially among 

unmarried teenagers. Another problem is the assumption that unmarried women who report sexual 

activity but no contraceptive use are necessarily averse to the idea of becoming pregnant, an assumption 

that seems reasonable for most but certainly not for all such women. In the 18 sub-Saharan countries 

surveyed in the late 1990s, an average of 25 percent of unmarried women did not report that they would 

be unhappy if they became pregnant in the “next few weeks” (Westoff, 2001). 

In the present report, the approach has been simplified and is based only on a tabulation of 

unmarried women who are sexually active (reporting sex in the past four weeks) who are not using any 

method. On the one hand, this may overestimate unmet need because these women are not all trying to 

avoid pregnancy, but, on the other hand, there is probably some underreporting of sexual activity. As 

before, for reasons of reliability and coverage, the estimates are confined to sexually active women in 

sub-Saharan Africa and are presented in the context of trends both for all unmarried women ages 15-49 

(Figure 7.1) and for those 15-19 (Figure 7.2). The estimates are shown both for nonuse of any method and 

nonuse of modern methods. 

Unmet need by this measure of nonuse of contraception appears to have declined in most of these 

countries for both age groups. The main exceptions are Rwanda and Senegal. There have been large 

declines in unmet need among unmarried sexually active women in Burkina Faso, Kenya, Mozambique, 

Namibia, and Uganda. In the remaining countries, unmet need has also declined but more moderately. 

Figure 7.1 Trends in the percentage of unmarried sexually active women 

age 15-49 in sub-Saharan Africa who are not using a contraceptive method 

Not using modern method Not using any method 

Benin

62

50

86 83

0

20

40

60

80

100

1996 2001

Burkina Faso

42 48

65 45

56

84

0

20

40

60

80

100

1992-1993 1998-1999 2003

Cameroon

37

46

78

90

0

20

40

60

80

100

1991 1998

Côte d’Ivoire

44 51

73

82

0

20

40

60

80

100

1994 1998-1999

Ghana

72

61 63

 57

93

81 80

68

0

20

40

60

80

100

1988 1993 1998 2003

Ethiopia

45

59

57 64

0

20

40

60

80

100

2000 2005
45

Figure 7.1—Continued

Not using modern method Not using any method 

Kenya

45

53

60 64

64

55

70 76

0

20

40

60

80

100

1989 1993 1998 2003

M ali

58 68

80

78 73

92

0

20

40

60

80

100

1987 1995-1996 2001

M ozambique

55

82

58

85

0

20

40

60

80

100

1997 2003

Nigeria

50

41

57

61 65

85

0

20

40

60

80

100

1990 1999 2003

Namibia

42

65

42

66

0

20

40

60

80

100

1992 2000

Rwanda

88

78

71

94

85

75

0

20

40

60

80

100

1992 2000 2005

Senegal

57

48

59

55 57

69

0

20

40

60

80

100

1992-1993 1997 2004-2005

Tanzania

41

67

74

82

54

74 79

88

0

20

40

60

80

100

1992 1996 1999 2004-

2005

Uganda

52

64

85

56

73

93

0

20

40

60

80

100

1988 1995 2000-2001

Zambia

67

76

86 70

82

91

0

20

40

60

80

100

1992 1996 2001-2002

Togo

47 41

77

87

0

20

40

60

80

100

1988 1998

Madagascar

62

74 79

78

90 97

0

20

40

60

80

100

1992 1997 2003-04
46

Figure 7.1—Continued

Figure 7.2 Trends in the percentage of unmarried sexually active teenage women 

(age 15-19) in sub-Saharan Africa who are not using a contraceptive method 

 

 

Not using modern method Not using any method 

Benin

67

53

87 84

0

20

40

60

80

100

1996 2001

Burkina Faso

50

57

69 53

63

86

0

20

40

60

80

100

1992-1993 1998-1999 2003

Cameroon

27

35

80

96

0

20

40

60

80

100

1991 1998

Côte d’Ivoire

46

53

75

84

0

20

40

60

80

100

1994 1998-1999

Ghana

54 55 67

74

66

77

85

99

0

20

40

60

80

100

1988 1993 1998 2003

Kenya

50

70

80

88

80

62

92 96

0

20

40

60

80

100

1989 1993 1998 2003

Zimbabwe

44 45

56 47 46

59

0

20

40

60

80

100

1988 1994 1999
47

Figure 7.2—Continued

 

Not using modern method Not using any method 

Madagascar

69

83 82

82

94 98

0

20

40

60

80

100

1992 1997 2003-2004

M ali

76

71

88

84 83 88

0

20

40

60

80

100

1987 1995-1996 2001

Mozambique

57

93

59

95

0

20

40

60

80

100

1997 2003

Namibia

49

71 49

73

0

20

40

60

80

100

1992 2000

Nigeria

55 53

59

71 77

87

0

20

40

60

80

100

1990 1999 2003

Rwanda

72

49

75

60

0

20

40

60

80

100

1992 2000

Senegal

70

65

85

67 70

85

0

20

40

60

80

100

1992-1993 1997 2004-2005

Tanzania

68

72

86 90 70

78

88 96

0

20

40

60

80

100

1992 1996 1999 2004-2005

Togo

44

49

75

89

0

20

40

60

80

100

1988 1998
48

Figure 7.2—Continued

8 Fertility Implications of Reducing Unmet Need 

As noted in the introduction, potential reductions of unmet need have implications for the future 

decline of fertility. One way of estimating this potential, used in earlier work on unmet need (Westoff and 

Bankole, 1995), is to exploit the high correlation between contraceptive prevalence and fertility across 

countries. The correlation ranges from 0.84 to 0.94, depending on the sample of countries. The regression 

equations are very similar regardless of whether the sample is confined to the 60 DHS countries2

 or the 

120 developing countries in the Population Reference Bureau’s data sheet. Confining the analysis to the 

prevalence of modern methods rather than to all methods (as used here) significantly reduces the 

association.

The basic idea is to estimate the contraceptive prevalence (all methods) that would hypothetically 

result from the reduction of unmet need and substitute the estimated total demand for family planning in 

the regression equation calculated for the survey data on the most recent total fertility rate (TFR) and 

current contraceptive prevalence. One assumption is the total elimination of unmet need, but this is 

obviously an extreme and unrealistic outer limit, though some countries are moving toward low levels 

(e.g., Vietnam with an unmet need of 4.8 percent). The predicted TFRs are shown in Table 8.1, in the 

next-to-last column for the maximum estimate and in the last column for the most likely estimates. The 

maximum estimate is based on the total demand for family planning (the sum of the contraceptive 

prevalence rate [CPR] and unmet need) while the most likely values lower this demand with two 

adjustments. The first adjustment is to reduce by 30 percent the birthspacing component of unmet need 

(Bongaarts, 1991). The rationale for this is that these spacers will sooner or later discontinue contraceptive practice in order to have a child. This means that the estimated demand for family planning would 

exaggerate the steady-state effect of satisfying the unmet need for spacing. The second adjustment is to 

reduce total unmet need (and therefore the total demand for family planning) by the percentage of women 

in need who have never used a method and who say that they do not intend to use a method in the future. 

Of course, many of these women may change their mind and eventually begin to use a method, but others 

who currently intend to use may also change their minds. The magnitude of this second adjustment can be 

seen in Figure 6.1. The point of these adjustments is to make the fertility impact estimate more plausible. 

 

2

 Five countries from the Centers for Disease Control and Prevention (CDC) program of surveys are also included. 

Not using modern methods Not using any method 

Uganda

48

71

94

52

78

98

0

20

40

60

80

100

1988 1995 2000-2001

Zambia

77

84

94 80

87

96

0

20

40

60

80

100

1992 1996 2001-2002

Zimbabwe

65 63 65

66 65

76

0

20

40

60

80

100

1988 1994 1999
49

Table 8.1 Potential impact on fertility of reducing unmet need 

 TFR

Country 

Year 

of

survey 

Percentage

using 

a method 

Recent

TFR

Total 

demand

Adjusted 

demand

Predicted 

from total 

demand

Predicted 

from

adjusted 

demand

ASIA 

Bangladesh 2004 58 3.0 71 67 2.2 2.5 

Cambodia 2000 24 4.0 56 41 3.2 4.0 

India 1998 48 2.9 64 58 2.7 2.8 

Indonesia 2002-03 60 2.6 70 66 2.3 2.5 

Kazakhstan 1999 66 2.1 75 73 2.0 2.1 

Nepal 2001 39 4.1 67 60 2.5 2.9 

Philippines 2003 49 3.5 69 58 2.4 2.8 

Turkmenistan 2000 62 2.9 72 69 2.2 2.4 

Uzbekistan 1996 56 3.8 69 63 2.4 2.7 

Vietnam 2002 79 1.9 84 82 1.4 1.6 

NEAR EAST/NORTH 

 AFRICA/EUROPE 

 

Armenia 2000 61 1.7 74 69 2.1 2.4 

Egypt 2003 60 3.2 71 67 2.2 2.5 

Jordan 2002 56 3.7 70 63 2.3 2.7 

Moldova 2005 68 1.7 75 67 2.0 2.5 

Morocco 2003-04 63 2.5 75 71 2.0 2.2 

Turkey 2003 71 2.2 78 73 1.9 2.1 

Yemen 1997 21 6.5 59 33 3.0 4.6 

LATIN AMERICA/ 

 CARIBBEAN 

 

Bolivia 2003 58 3.8 81 73 1.6 2.1 

Brazil 1996 77 2.5 86 82 1.3 1.6 

Colombia 2005 78 2.4 86 83 1.3 1.6 

Dominican Republic 2002 70 3.0 82 78 1.6 1.8 

Guatemala 1999 38 5.0 63 47 2.8 3.7 

Haiti 2000 28 4.7 68 56 2.4 3.2 

Nicaragua 2001 69 3.2 83 79 1.5 1.7 

Peru 2004 71 2.4 82 77 1.6 1.9 

WEST AFRICA 

Benin 2001 19 5.6 46 36 3.8 4.4 

Burkina Faso 2003 14 6.2 43 29 4.0 4.9 

Cameroon 2004 26 5.0 46 36 3.8 4.4 

Central African 

Republic 

1995 15 5.1 31 26 4.7 5.1 

Chad 2004 3 6.3 26 22 5.1 5.3 

Congo (Brazzaville) 2005 44 4.8 60 50 2.9 3.5 

Côte d’Ivoire 1998-99 15 5.2 43 30 4.0 4.8 

Gabon 2000 33 4.3 61 50 2.9 3.5 

Ghana 2003 25 4.4 59 46 3.0 3.8 

Guinea 1999 6 5.5 30 17 4.8 5.6 

Mali 2001 8 6.8 37 19 4.4 5.5 

Niger 1998 8 7.5 25 13 5.1 5.9 

Nigeria 2003 13 5.7 30 19 4.8 5.5 

Senegal 2003-04 12 5.3 43 23 4.0 5.2 

Togo 1998 24 5.2 56 45 3.2 3.9 

 Continued...
50

Table 8.1—Continued

 TFR

Country 

Year 

of

survey 

Percentage

using 

a method 

Recent

TFR

Total 

demand

Adjusted 

demand

Predicted 

from total 

demand

Predicted 

from

adjusted 

demand

EAST AND SOUTHERN 

 AFRICA 

 

Comoros 1996 21 5.1 56 38 3.2 4.3 

Eritrea 2002 8 4.8 35 15 4.5 5.7 

Ethiopia 2000 8 5.9 43 26 4.0 5.1 

Kenya 2003 39 4.9 66 55 2.6 3.2 

Lesotho 2004-05 37 3.5 68 55 2.9 3.2 

Madagascar 2003-04 27 5.2 51 38 3.5 4.3 

Malawi 2000 31 6.3 60 51 2.9 3.5 

Mozambique 2003 17 5.5 35 28 4.5 4.9 

Namibia 2000 44 4.2 66 60 2.6 2.9 

Rwanda 2000 13 5.8 49 32 3.6 4.7 

South Africa 1998 56 2.9 71 68 2.2 2.4 

Tanzania 1999 25 5.6 47 37 3.7 4.4 

Uganda 2000-01 23 6.9 57 45 3.1 3.9 

Zambia 2001-02 34 5.9 62 55 2.8 3.2 

Zimbabwe 1999 54 4.0 68 62 2.4 2.8 

The TFRs predicted for the unadjusted and adjusted estimates of total demand are shown in the 

last two columns of Table 8.1.3

 The unadjusted maximum fertility impact exceeds the adjusted estimates 

by varying amounts, ranging from 0.1 to 1.6 births per woman, in the TFR. The percentage declines in the 

TFR for both estimates, aggregated for regions of the world, are summarized in Table 8.2. The greatest 

“most likely” effect is a 35 percent decline in the Latin America/Caribbean region while the least effect is 

in West Africa (14 percent) and in Asia (16 percent). One of the reasons for the minimal effect in West 

Africa is the high proportion of unmet need estimates concentrated in the spacing component. 

Table 8.2 Decline in the TFR implied by reduction of unmet need by region 

Most likely 

prediction 

Region 

Recent

TFR

Maximum 

percent

decline 

Percent

decline 

Implied 

TFR

Replacement 

fertility 

Asia 3.1 26 16 2.6 2.3 

 

Near East/North Africa 3.1 39 13 2.7 2.3 

Latin America/Caribbean 3.4 48 35 2.2 2.2 

West Africa 5.5 27 14 4.8 2.7 

East and Southern Africa 5.1 37 24 3.9 2.6 

The last column in Table 8.2 shows the level of fertility needed for replacement. Because of 

higher mortality in the developing world, these levels are higher than the familiar TFR of 2.1 (Espenshade 

et al., 2003). A comparison of these levels with the predicted TFRs shows that the distance needed to 

acheive replacement-level fertility in Africa remains substantial. 

 

3

 There are several anomalies in the predicted estimates. In Armenia, Eritrea, and Moldova, the predicted rates are 

higher than the current TFR. This is a result of the TFR being lower than normally expected for the reported levels 

of the CPR. 
51

9 Conclusions 

Although declining in many developing countries, unmet need for family planning remains 

significant, especially in the least developed countries where it reaches levels above 20 percent of married 

women in 31 of the 58 countries examined. Moreover, even in those countries experiencing declines in 

unmet need, numerical increases in population growth can more than overcome the gains (Ross and 

Winfrey, 2002). Regionally, the greatest need remains in sub-Saharan Africa with an average of 26 

percent of married women classified in the unmet need category. In other regions, this average is 16 

percent, ranging from a low of 5 percent in Vietnam to 40 percent in Haiti. Focusing on the unmet need 

for modern methods, the average is 32 percent in sub-Saharan Africa and 27 percent in other regions. 

With the exception of Pakistan, there is consistent evidence of a decline in total unmet need in the 

19 Asian, Near Eastern, and North African countries reviewed here. In the eight Latin American/ 

Caribbean countries, similar declines are evident except in Haiti and Nicaragua, which show no change. 

In West Africa, there is hardly any decline apparent in contrast to East and Southern Africa where 

declines are evident in about half of the countries. Trends in unmet need are fairly uniform across 

educational categories, but in some sub-Saharan African countries, unmet need shows an increase over 

time that is concentrated in the least educated populations. 

A crucial component of unmet need is the existence of significant proportions of women with 

unmet need who have never used contraception and who do not intend to use any method in the future. 

This percentage is declining in most countries but remains above 10 percent of married women in a 

significant number of sub-Saharan African countries. This presents a particular challenge to family 

planning service providers. 

Unmet need among unmarried women has been approached here by studying trends in nonuse of 

contraception by unmarried sexually active women in sub-Saharan Africa. The picture is fairly clear and 

indicates that over time more women in this category are using a method. 

In addition to the relevance of unmet need for family planning administrators, the subject is 

particularly relevant for future fertility levels and rates of population growth. The upshot of this analysis 

is that the satisfaction of unmet need, even with conservative assumptions, could reduce fertility 

significantly. 

In summary, unmet need remains an important issue in family planning (Casterline and Sinding, 

2000; Casterline et al., 2003). Although the percentage of total demand satisfied exceeds 80 percent in 

most of the countries outside of sub-Saharan Africa, it has reached only 45 percent, on average, in subSaharan Africa. 

53

References 

Bongaarts, J. 1991. The KAP-gap and the unmet need for contraception. Population and Development 

Review 17(2): 293-313. 

Casterline, J.B. and S.W. Sinding. 2000. Unmet need for family planning and implications for population 

policy. Population and Development Review 26(4): 691-723. 

Casterline, J.B., F. El-Zanatay, and L.O. El-Zeini. 2003. Unmet need and unintended fertility: 

Longitudinal evidence from Upper Egypt. International Family Planning Perspectives 29: 158-166. 

Espenshade, T.J., J.C. Guzman, and C.F. Westoff. 2003. The surprising global variation in replacement 

fertility. Population Research and Policy Review 22(5-6): 575-583. 

National Institute for Population Studies (NIPS). 2003. Status of women, reproductive health and family 

planning survey. 

Ross, J.A. and W.L. Winfrey. 2002. Unmet need for contraception in the developing world and the former 

Soviet Union: An updated estimate. International Family Planning Perspectives 28: 138-143. 

Rutstein, S.O. and K. Johnson. 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. 

Calverton, Maryland: ORC Macro.

Westoff, C.F. 1978. The unmet need for birth control in five Asian countries. Family Planning 

Perspectives 10: 173-181. 

Westoff, C.F. 1988. The potential demand for family planning: A new measure of unmet need and 

estimates for five Latin American countries. International Family Planning Perspectives 14(2): 45-53. 

Westoff, C.F. 2001. Unmet need at the end of the century. DHS Comparative Reports No. 1. Calverton, 

Maryland: ORC Macro. 

Westoff, C.F. and A. Bankole. 1995. Unmet need: 1990-1994. DHS Comparative Studies No. 16. 

Calverton, Maryland: Macro International Inc. 

Westoff, C.F. and A.R. Cross. 2006. The stall in the fertility transition in Kenya. DHS Analytical Studies 

No. 9. Calverton, Maryland: ORC Macro. 

Westoff, C.F. and L.H. Ochoa. 1991. Unmet need and the demand for family planning. DHS Comparative 

Studies No. 5. Columbia, Maryland: Institute for Resource Development. 

Westoff, C.F. and A.R. Pebley. 1981. Alternative measures of unmet need for family planning in 

developing countries. International Family Planning Perspectives 7(4): 126-136. 

55

Appendix A 

Table A.1 Unmet need and the demand for modern methods of family planning, by level 

of education and wealth quintile 

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

ASIA 

Bangladesh 2005 22.1 47.3 71.4 66.3 

Education 

None 21.6 48.3 71.4 67.7 

Primary incomplete 23.6 45.4 71.3 63.7 

Primary complete 23.5 47.4 72.9 65.0 

Secondary incomplete 21.4 46.7 70.2 66.5 

Higher 30.8 49.1 73.2 67.1 

Wealth quintile 

Lowest 22.0 44.7 68.7 65.1 

Second 21.7 47.7 71.3 66.9 

Middle 22.9 46.6 71.5 65.2 

Fourth 22.4 47.4 71.8 66.0 

Highest 21.1 50.1 73.0 68.5 

 

Cambodia 2000 34.7 18.8 53.5 35.1 

Education 

None 34.7 16.2 50.9 31.9 

Primary 34.7 19.0 53.8 35.4 

Secondary 35.0 23.2 58.1 39.9 

Higher 21.1 22.6 43.7 51.7 

Wealth quintile 

Lowest 40.5 12.5 53.0 23.6 

Second 35.7 15.4 51.2 30.1 

Middle 32.8 20.1 52.9 38.1 

Fourth 32.7 19.9 52.7 37.8 

Highest 32.0 25.4 57.4 44.2 

 

India 1998-1999 21.2 42.8 64.0 66.9 

Education 

None 20.2 38.4 58.6 65.6 

Primary 19.6 49.1 68.7 71.4 

Secondary 22.7 47.4 70.1 67.6 

Higher 26.8 46.5 73.3 63.5 

Wealth quintile 

Lowest 24.4 29.3 53.7 54.6 

Second 22.1 34.9 57.0 61.2 

Middle 19.5 44.9 64.4 69.7 

Fourth 19.6 49.7 69.2 71.7 

Highest 20.6 54.6 75.1 72.6 

 

Indonesia 2002-2003 12.2 56.7 69.7 81.3 

Education 

None 13.3 44.8 58.7 76.3 

Primary 11.2 57.5 69.4 82.9 

Secondary 13.0 58.5 72.4 80.8 

Higher 16.9 54.4 72.1 75.5 

Wealth quintile 

Lowest 14.2 52.2 66.9 78.0 

Second 11.6 57.1 68.6 83.2 

Middle 10.9 57.9 69.9 82.8 

Fourth 11.2 61.0 72.6 84.0 

Highest 13.3 55.3 69.5 79.6 

Continued... 
56

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Kazakhstan 1999 22.1 52.7 75.2 70.1 

Education 

Secondary 22.6 51.5 74.6 69.0 

Higher 19.5 57.6 77.1 74.7 

Wealth quintile 

Lowest 26.8 48.9 76.0 64.3 

Second 23.1 50.6 74.3 68.1 

Middle 19.3 50.9 72.8 69.9 

Fourth 23.2 54.5 77.9 70.0 

Highest 19.2 55.1 74.5 74.0 

 

Kyrgyz Republic 1997 22.3 48.9 71.2 68.7 

Education 

Secondary 22.3 48.6 70.9 68.6 

Higher 22.0 51.2 73.2 69.9 

Wealth quintile 

Lowest 24.2 44.4 68.6 64.8 

Second 21.2 44.9 66.1 67.9 

Middle 19.5 48.4 67.9 71.3 

Fourth 22.6 50.9 73.6 69.3 

Highest 23.8 54.4 78.1 69.6 

 

Moldova 2005 30.6 43.8 75.2 58.2 

Education 

Secondary 32.4 40.2 73.5 54.7 

Secondary Special 28.2 47.7 76.1 62.7 

Higher 27.7 50.9 79.4 64.1 

Wealth quintile 

Lowest 35.4 36.6 73.4 49.9 

Second 35.2 38.6 74.8 51.6 

Middle 33.3 43.0 76.6 56.1 

Fourth 27.2 46.4 74.2 62.5 

Highest 24.7 51.3 76.5 67.1 

 

Nepal 2001 31.7 35.4 67.1 52.7 

Education 

None 31.4 33.5 65.0 51.6 

Primary 33.0 37.7 70.7 53.3 

Secondary 31.6 42.7 74.3 57.5 

Higher 33.8 42.1 75.9 55.4 

Wealth quintile 

Lowest 37.0 23.8 60.8 39.1 

Second 34.4 28.7 63.2 45.5 

Middle 34.5 31.7 66.1 47.9 

Fourth 29.0 38.9 67.9 57.3 

Highest 23.1 55.2 78.3 70.5 

Continued... 
57

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Philippines 2003 32.8 33.4 68.5 48.8 

Education 

None 33.0 11.7 46.0 25.4 

Elementary 34.0 30.3 65.8 46.1 

High School 32.7 35.9 71.3 50.4 

College or higher 32.0 34.2 68.5 49.9 

Wealth quintile 

Lowest 40.3 23.8 66.5 35.8 

Second 34.6 33.8 71.1 47.5 

Middle 32.0 35.7 70.0 51.0 

Fourth 29.9 37.9 69.9 54.2 

Highest 27.6 35.2 64.7 54.4 

 

Turkmenistan 2000 18.9 53.1 72.2 73.5 

Education 

No education 14.3 46.7 61.1 76.5 

Primary 19.7 52.8 72.5 72.8 

Secondary 18.5 53.2 71.9 74.0 

Higher 23.5 53.1 76.7 69.3 

Wealth quintile 

Lowest 21.5 50.9 72.8 69.9 

Second 16.4 56.7 73.2 77.5 

Middle 17.0 53.1 70.1 75.8 

Fourth 19.1 55.4 75.1 73.8 

Highest 20.2 49.9 70.3 71.0 

 

Uzbekistan 1996 17.9 51.3 69.3 74.1 

Education 

Secondary 17.8 51.6 69.5 74.3 

Higher 19.1 50.0 69.1 72.3 

Wealth quintile 

Lowest 21.6 46.0 67.7 68.0 

Second 17.0 55.1 72.1 76.4 

Middle 14.7 55.5 70.2 79.1 

Fourth 17.4 47.7 65.1 73.3 

Highest 19.0 52.2 71.2 73.3 

 

Vietnam 2002 26.7 56.7 84.3 67.3 

Education 

No education 21.9 53.9 76.9 70.1 

Primary 25.2 56.8 82.5 68.8 

Secondary 27.7 57.3 86.1 66.6 

Higher 28.6 50.9 80.3 63.4 

Wealth quintile 

Lowest 24.5 57.9 83.1 69.7 

Second 24.7 57.9 83.8 69.1 

Middle 28.1 58.1 87.5 66.4 

Fourth 27.1 58.0 86.1 67.4 

Highest 28.7 51.6 81.0 63.7 

Continued... 
58

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

NEAR EAST/NORTH AFRICA 

Armenia 2000 50.1 22.3 73.6 30.3 

Education 

Secondary 52.7 19.6 73.6 26.6 

Higher 37.7 35.3 73.8 47.8 

Wealth quintile 

Lowest 58.0 15.5 76.6 20.2 

Second 55.8 20.9 78.3 26.7 

Middle 49.8 22.4 73.2 30.6 

Fourth 46.5 22.3 69.3 32.2 

Highest 41.5 29.2 70.9 41.2 

 

Egypt 2005 13.0 56.5 70.4 80.3 

Education 

None 15.4 52.2 68.5 76.2 

Primary 12.2 60.5 73.9 81.9 

Secondary 12.3 57.9 70.8 81.3 

Higher 11.3 58.4 70.9 82.4 

Wealth quintile 

Lowest 17.5 50.0 68.3 73.2 

Second 13.7 54.4 69.3 78.5 

Middle 12.9 57.2 70.8 80.8 

Fourth 10.9 60.0 71.9 83.4 

Highest 10.8 59.6 71.4 83.5 

 

Jordan 2002 25.6 41.2 69.7 59.1 

Education 

None 23.7 33.0 58.4 56.5 

Primary 26.6 34.9 62.8 55.6 

Secondary 24.7 43.3 71.2 60.8 

Higher 27.5 41.0 72.1 56.9 

Wealth quintile 

Lowest 30.2 31.7 65.3 48.5 

Second 24.1 39.1 66.6 58.7 

Middle 25.4 40.9 69.3 59.0 

Fourth 24.5 46.0 73.1 62.9 

Highest 23.6 50.2 75.8 66.2 

 

Morocco 2003-2004 18.2 54.8 75.0 73.1 

Education 

None 18.3 53.7 74.0 72.6 

Primary 15.9 56.8 74.4 76.3 

Secondary 18.3 59.0 79.4 74.3 

Higher 27.5 46.2 76.5 60.4 

Wealth quintile 

Lowest 18.0 51.4 71.5 71.9 

Second 16.3 55.2 73.9 74.7 

Middle 17.5 55.4 74.9 74.0 

Fourth 18.7 54.8 75.4 72.7 

Highest 20.6 56.8 79.2 71.7 

Continued... 
59

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Turkey 2003 34.5 42.5 78.4 54.2 

Education 

None 39.6 29.9 68.7 43.5 

Primary 36.2 43.4 77.4 56.1 

Secondary 30.8 50.8 79.4 64.0 

High school and higher 25.9 52.2 71.6 72.9 

 

Yemen 1997 49.6 9.8 59.4 16.5 

Education 

None 49.7 8.0 57.7 13.9 

Primary 50.2 14.9 65.1 22.9 

Secondary 47.4 20.9 68.3 30.6 

Higher 42.1 34.3 76.4 44.9 

Wealth quintile 

Lowest 46.6 1.4 48.0 2.9 

Second 50.9 3.5 54.4 6.5 

Middle 52.9 6.8 59.7 11.4 

Fourth 51.5 13.8 65.3 21.1 

Highest 46.1 24.1 70.2 34.3 

 

LATIN AMERICA/CARIBBEAN 

Bolivia 2003 46.1 34.9 81.0 43.1 

Education 

Primary 51.2 30.2 81.4 37.1 

Secondary 40.4 44.7 85.1 52.5 

Higher 31.9 50.4 82.3 61.2 

Wealth quintile 

Lowest 57.0 22.5 79.5 28.3 

Second 51.3 27.7 79.0 35.1 

Middle 50.6 31.5 82.1 38.4 

Fourth 40.8 41.8 82.7 50.5 

Highest 32.0 49.3 81.4 60.6 

 

Brazil 1996 13.8 70.3 85.8 81.9 

Education 

No education 22.9 56.6 79.9 70.8 

Primary 15.1 66.1 83.4 79.3 

Secondary 11.7 74.8 88.2 84.8 

Higher 12.0 76.3 89.1 85.6 

Wealth quintile 

Lowest 24.4 55.8 82.9 67.3 

Second 13.6 68.9 84.2 81.8 

Middle 10.0 73.6 85.4 86.2 

Fourth 11.9 73.8 87.4 84.4 

Highest 10.6 76.8 88.6 86.7 

Continued... 
60

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Colombia 2005 15.8 68.2 86.2 79.1 

Education 

None 21.9 57.4 81.5 70.4 

Primary 17.4 67.5 86.9 77.7 

Secondary 15.1 69.6 87.0 80.0 

Higher 12.9 67.6 82.9 81.5 

Wealth quintile 

Lowest 23.1 60.4 86.0 70.2 

Second 17.5 66.7 86.9 76.7 

Middle 14.8 69.3 86.9 79.8 

Fourth 13.1 71.7 86.7 82.7 

Highest 11.1 71.8 84.4 85.1 

 

Dominican Republic 2002 14.8 65.8 82.0 80.2 

Education 

None 15.1 62.0 77.5 80.0 

Primary 14.8 66.4 82.5 80.5 

Secondary 13.7 66.5 82.1 81.0 

Higher 17.0 63.6 81.7 77.8 

Wealth quintile 

Lowest 19.7 58.8 80.4 73.1 

Second 16.2 64.6 82.6 78.2 

Middle 12.9 68.0 82.1 82.8 

Fourth 13.5 66.9 81.4 82.2 

Highest 12.7 69.6 83.4 83.5 

 

Guatemala 1998-1999 30.4 30.9 62.2 49.7 

Education 

None 32.2 16.0 48.4 33.1 

Primary 31.0 31.3 63.4 49.4 

Secondary 26.7 52.1 79.9 65.4 

Higher 20.8 66.5 94.0 70.7 

Wealth quintile 

Lowest 35.4 5.4 41.2 13.1 

Second 35.0 11.9 47.4 25.1 

Middle 32.8 24.5 59.0 41.5 

Fourth 30.1 45.0 76.3 59.0 

Highest 20.7 59.7 81.1 73.6 

 

Haiti 2000 44.9 22.8 67.7 33.7 

Education 

None 43.1 19.4 62.5 31.1 

Primary 47.5 23.1 70.6 32.7 

Secondary 43.1 29.9 73.0 41.0 

Higher 37.9 26.9 64.8 41.6 

Wealth quintile 

Lowest 48.2 17.4 65.5 26.5 

Second 44.7 22.2 66.9 33.2 

Middle 40.8 25.7 66.5 38.7 

Fourth 46.6 24.2 70.8 34.2 

Highest 44.2 24.2 68.4 35.4 

 Continued... 
61

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Nicaragua 2001 17.1 66.1 83.2 79.5 

Education 

None 25.0 50.4 75.3 66.8 

Primary 15.6 69.8 85.4 81.7 

Secondary 15.0 69.7 84.7 82.3 

Higher 14.6 68.3 82.9 82.4 

Wealth quintile 

Lowest 27.3 50.2 77.6 64.8 

Second 18.2 65.8 84.0 78.3 

Middle 13.5 71.2 84.7 84.1 

Fourth 14.4 71.1 85.5 83.1 

Highest 12.8 71.0 83.7 84.7 

 

Peru 2004 30.8 46.7 82.4 56.7 

Education 

None 40.4 24.0 70.5 34.0 

Primary 36.2 37.7 81.2 46.4 

Secondary 28.9 51.6 85.2 60.6 

Higher 23.6 57.2 82.5 69.3 

Wealth quintile (based on 2000 survey) 

Lowest 38.1 36.8 79.9 46.1 

Second 33.4 45.8 83.7 54.7 

Middle 26.2 54.4 83.6 65.1 

Fourth 24.8 56.3 83.8 67.2 

Highest 21.3 58.0 81.0 71.6 

 

WEST AFRICA 

Benin 2001 38.6 7.2 45.8 15.7 

Education 

None 37.1 5.3 42.4 12.4 

Primary 41.7 8.9 50.6 17.6 

Secondary 45.7 19.2 64.9 29.6 

Higher 31.2 26.5 57.7 46.0 

Wealth quintile 

Lowest 30.6 4.0 34.6 11.5 

Second 37.7 3.2 40.9 7.8 

Middle 39.6 6.7 46.3 14.4 

Fourth 40.5 8.3 48.8 17.0 

Highest 45.8 14.7 60.5 24.3 

 

Burkina Faso 2003 33.9 8.8 42.6 20.6 

Education 

No education 34.6 5.7 40.6 14.0 

Primary 34.5 13.2 51.6 25.6 

Secondary 23.7 43.2 68.1 63.4 

Wealth quintile 

Lowest 35.0 1.7 39.0 4.4 

Second 38.7 4.4 41.5 10.6 

Middle 34.5 6.1 41.2 14.8 

Fourth 31.4 6.9 39.6 17.4 

Highest 29.9 26.5 53.5 49.5 

Continued... 
62

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Cameroon 2004 31.2 12.5 46.2 27.1 

Education 

None 22.2 1.3 23.5 5.5 

Primary 36.9 11.0 47.9 23.0 

Secondary 40.2 24.7 65.0 38.0 

Wealth quintile 

Lowest 24.0 2.3 26.3 8.8 

Second 32.5 4.7 37.1 12.7 

Middle 38.1 10.6 48.8 21.7 

Fourth 39.6 19.3 59.0 32.7 

Highest 35.7 26.4 62.1 42.5 

 

Chad 2004 24.4 1.6 26.1 6.1 

Education 

None 22.3 0.5 22.8 2.2 

Primary 32.1 2.6 34.7 7.5 

Secondary 33.1 18.1 51.2 35.4 

Wealth quintile 

Lowest 21.8 0.0 21.8 0.5 

Second 22.6 0.2 22.7 0.9 

Middle 25.0 1.0 26.0 3.9 

Fourth 23.4 0.4 23.8 1.7 

Highest 30.0 7.3 37.3 19.6 

 

Congo 2005 47.8 12.7 60.4 21.0 

Education 

None 40.0 5.9 67.7 8.7 

Primary 52.2 8.9 69.1 12.9 

Secondary I 48.4 14.5 74.7 19.4 

Secondary II 40.9 19.1 80.5 23.7 

Wealth quintile 

Lowest 51.3 9.1 60.4 15.1 

Second 50.0 6.9 56.9 12.1 

Middle 50.8 12.2 63.0 19.4 

Fourth 48.2 16.4 64.7 25.3 

Highest 39.3 17.9 57.2 31.3 

 

Côte d'Ivoire 1998-1999 35.4 7.3 42.7 17.0 

Education 

None 32.1 4.4 36.5 12.0 

Primary 41.9 10.4 52.3 19.9 

Secondary 41.5 19.8 61.3 32.3 

Wealth quintile 

Lowest 27.5 1.9 29.4 6.3 

Second 34.2 5.3 39.5 13.5 

Middle 37.5 8.5 46.0 18.5 

Fourth 39.3 8.8 48.1 18.2 

Highest 38.6 12.6 51.2 24.7 

 Continued... 
63

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Gabon 2000 47.3 13.4 60.7 22.1 

Education 

None 35.8 5.7 41.5 13.8 

Primary 46.2 9.2 55.5 16.6 

Secondary 51.2 16.3 67.5 24.1 

Higher 33.0 33.3 66.3 50.2 

Wealth quintile 

Lowest 44.3 7.7 52.1 14.8 

Second 48.8 9.7 58.5 16.6 

Middle 49.7 14.6 64.3 22.7 

Fourth 47.9 14.8 62.7 23.6 

Highest 45.2 18.8 64.0 29.3 

 

Ghana 2003 40.5 18.7 59.2 31.6 

Education 

None 39.3 11.0 50.4 21.8 

Primary 44.9 20.7 65.6 31.6 

Secondary 40.4 23.9 64.2 37.2 

Higher 35.8 28.1 63.9 44.0 

Wealth quintile 

Lowest 46.2 8.6 54.8 15.7 

Second 42.5 19.1 61.7 31.0 

Middle 40.8 18.6 59.4 31.3 

Fourth 40.7 21.3 62.0 34.4 

Highest 32.2 26.3 58.4 45.0 

 

Guinea 2005 24.6 5.7 30.3 18.8 

Education 

None 23.3 4.3 27.6 15.6 

Primary 29.3 9.3 37.9 24.5 

Secondary+ 35.9 18.4 54.2 34.0 

Wealth quintile 

Lowest 21.4 2.7 24.1 11.2 

Second 23.3 3.0 26.3 11.4 

Middle 26.4 4.3 30.6 14.1 

Fourth 26.2 7.0 33.2 21.1 

Highest 27.0 12.7 39.7 32.0 

 

Mali 2001 29.6 7.0 36.6 19.1 

Education 

None 29.1 5.2 34.3 15.2 

Primary 32.6 11.7 44.2 26.3 

Secondary 33.3 24.8 58.1 42.7 

Higher 23.1 38.4 61.5 62.4 

Wealth quintile 

Lowest 29.4 4.2 33.7 12.5 

Second 28.2 3.6 31.8 11.2 

Middle 27.9 3.4 31.3 11.0 

Fourth 29.6 7.3 36.9 19.7 

Highest 33.5 17.9 51.4 34.8 

 Continued... 
64

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Mauritania 2000-2001 34.4 5.1 39.5 13.0 

Education 

None 31.7 2.4 34.1 7.0 

Primary 40.4 8.2 48.6 16.9 

Secondary 39.2 17.9 57.1 31.4 

Higher 50.2 13.9 64.1 21.7 

Wealth quintile 

Lowest 30.7 0.1 30.8 0.4 

Second 34.6 0.5 35.2 1.5 

Middle 33.6 2.6 36.1 7.1 

Fourth 36.8 6.8 43.5 15.6 

Highest 36.4 16.5 52.9 31.1 

 

Niger 1998 20.3 4.6 24.9 18.5 

Education 

None 19.7 3.0 22.7 13.3 

Primary 25.2 13.0 38.2 34.0 

Secondary 22.7 32.0 54.7 58.5 

Wealth quintile 

Lowest 20.0 0.8 20.8 3.7 

Second 18.4 1.6 19.9 8.0 

Middle 17.4 2.2 19.6 11.3 

Fourth 22.3 2.9 25.2 11.7 

Highest 24.7 18.1 42.8 42.3 

 

Nigeria 2003 21.2 8.2 29.5 27.8 

Education 

None 15.7 2.3 18.0 12.7 

Primary 26.5 11.2 37.7 29.7 

Secondary 28.5 18.3 46.8 39.1 

Higher 30.0 21.7 51.7 42.0 

Wealth quintile 

Lowest 18.2 3.6 21.8 16.5 

Second 18.4 2.9 21.2 13.6 

Middle 19.1 6.7 25.8 26.0 

Fourth 24.2 9.2 33.4 27.5 

Highest 27.4 20.5 48.0 42.7 

 

Senegal 1997 33.1 10.3 43.4 23.7 

Education 

None 31.9 5.5 37.4 14.7 

Primary 35.5 12.6 48.1 26.2 

Secondary 30.5 29.7 60.2 49.3 

Wealth quintile 

Lowest 30.4 2.9 34.1 8.5 

Second 31.1 4.8 37.4 12.8 

Middle 33.7 9.1 44.0 20.7 

Fourth 33.6 14.4 49.6 29.0 

Highest 28.9 22.0 53.5 41.1 

 Continued... 
65

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Togo 1998 48.8 7.0 55.8 12.5 

Education 

None 48.2 4.3 52.5 8.3 

Primary 52.3 9.0 61.3 14.7 

Secondary 42.7 15.6 58.3 26.7 

Higher 37.2 9.3 46.5 20.0 

Wealth quintile 

Lowest 52.0 3.3 55.3 5.9 

Second 48.1 4.9 53.0 9.3 

Middle 50.9 7.0 57.9 12.0 

Fourth 48.1 7.5 55.6 13.5 

Highest 44.7 12.5 57.2 21.9 

 

EAST AND SOUTHERN 

 AFRICA 

 

Comoros 1996 44.2 11.4 55.6 20.5 

Education 

None 44.0 10.7 54.7 19.6 

Primary 49.2 11.0 60.1 18.2 

Secondary 39.3 14.2 53.6 26.5 

Wealth quintile 

Lowest 54.4 6.6 60.9 10.8 

Second 46.9 11.6 58.5 19.8 

Middle 42.5 10.2 52.7 19.3 

Fourth 42.4 10.0 52.4 19.1 

Highest 34.7 18.6 53.3 34.9 

 

Eritrea 2002 27.8 7.3 35.1 20.7 

Education 

None 26.6 3.2 29.8 10.8 

Primary 31.4 11.3 42.7 26.4 

Secondary 25.9 18.9 44.8 42.3 

Higher 32.7 21.3 54.0 39.4 

Wealth quintile 

Lowest 27.3 1.4 28.8 5.0 

Second 28.1 2.2 30.3 7.3 

Middle 31.9 3.7 35.6 10.5 

Fourth 28.1 12.8 40.9 31.3 

Highest 23.0 17.9 41.0 43.8 

 

Ethiopia 2005 34.6 13.9 48.7 28.5 

Education 

None 34.7 9.8 44.7 21.9 

Primary 38.5 21.9 60.5 36.2 

Secondary+ 23.6 45.9 70.8 64.8 

Wealth quintile 

Lowest 33.2 4.0 37.3 10.7 

Second 38.0 6.5 44.6 14.6 

Middle 37.2 11.6 49.1 23.6 

Fourth 36.5 15.2 52.0 29.2 

Highest 27.3 33.7 61.3 55.0 

 Continued... 
66

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Kenya 2003 32.3 31.5 65.8 47.9 

Education 

None 25.4 8.0 35.0 22.9 

Primary 42.2 23.1 69.1 33.4 

Secondary+ 23.3 51.7 76.9 67.2 

Wealth quintile 

Lowest 38.7 11.8 52.6 22.4 

Second 38.1 24.2 64.0 37.8 

Middle 35.3 33.4 71.2 46.9 

Fourth 27.1 41.0 70.6 58.1 

Highest 24.0 44.5 70.1 63.5 

 

Lesotho 2004-2005 33.0 35.2 68.2 51.6 

Education 

No education 50.0 6.6 56.6 11.7 

Primary incomplete 39.4 23.5 63.0 37.3 

Primary complete 33.0 34.8 67.8 51.3 

Secondary+ 26.5 47.5 74.0 64.2 

Wealth quintile 

Lowest 45.6 15.4 61.0 25.2 

Second 42.0 23.7 65.7 36.1 

Middle 33.4 34.5 68.0 50.7 

Fourth 30.1 39.1 69.2 56.5 

Highest 20.7 53.2 73.9 72.0 

 

Madagascar 2003-2004 32.4 18.3 50.8 36.0 

Education 

None 26.8 5.2 32.0 16.3 

Primary 31.8 18.6 50.3 37.0 

Secondary 38.2 28.4 66.7 42.6 

Wealth quintile 

Lowest 29.0 7.3 36.3 20.1 

Second 29.7 10.9 40.6 26.8 

Middle 30.6 17.8 48.4 36.8 

Fourth 33.9 23.4 57.2 40.9 

Highest 38.2 30.1 68.3 44.1 

 

Malawi 2004 31.9 28.1 61.7 45.5 

Education 

None 33.6 23.1 58.1 39.8 

Primary 32.1 28.0 62.0 45.2 

Secondary 27.0 41.0 69.1 59.3 

Wealth quintile 

Lowest 35.4 21.8 58.3 37.4 

Second 33.5 24.2 59.0 41.0 

Middle 33.6 25.2 60.7 41.5 

Fourth 33.0 31.1 65.8 47.3 

Highest 24.8 37.6 64.2 58.6 

 Continued... 
67

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Mozambique 2003 23.1 11.7 34.8 33.6 

Education 

None 21.9 4.7 26.6 17.7 

Primary 24.4 15.6 40.1 38.9 

Secondary 20.4 47.4 67.8 69.9 

Wealth quintile 

Lowest 21.6 3.9 25.6 15.2 

Second 23.0 5.1 28.1 18.2 

Middle 23.3 8.3 31.8 26.1 

Fourth 24.4 11.8 36.1 32.7 

Highest 24.1 34.8 58.9 59.1 

 

Namibia 2000 23.3 42.6 65.9 64.7 

Education 

No education 23.7 27.4 51.1 53.7 

Primary 28.7 31.9 60.6 52.6 

Secondary 20.4 54.2 74.6 72.7 

Higher 5.9 65.4 71.4 91.7 

Wealth quintile 

Lowest 27.6 28.8 56.5 51.1 

Second 28.2 24.1 52.4 46.1 

Middle 26.3 30.3 56.7 53.4 

Fourth 23.9 48.5 72.4 67.0 

Highest 15.2 64.2 79.5 80.8 

 

Rwanda 2005 45.0 7.1 55.3 12.8 

Education 

No education 45.0 5.0 50.1 10.0 

Primary 45.9 7.6 55.4 13.7 

Secondary 39.8 11.2 68.9 16.3 

Wealth quintile 

Lowest 45.0 5.0 51.1 9.8 

Second 46.3 7.8 52.7 14.8 

Middle 46.8 7.3 55.2 13.2 

Fourth 44.5 6.4 52.9 12.1 

Highest 43.3 9.4 65.8 14.3 

 

South Africa 1998 16.1 55.1 71.2 77.4 

Education 

No education 28.1 30.4 58.5 52.0 

Primary 19.9 46.3 66.2 69.9 

Secondary 13.2 61.8 75.0 82.4 

Higher 6.0 74.7 80.7 92.6 

Wealth quintile 

Lowest 27.0 34.0 61.0 55.7 

Second 22.8 45.1 67.9 66.4 

Middle 16.4 54.5 70.9 76.9 

Fourth 12.2 62.1 74.4 83.6 

Highest 7.3 70.3 77.7 90.6 

 Continued... 
68

Table A.1—Continued

Country

Unmet need 

for a modern 

method 

Using a 

modern

method 

Total 

demand 

for family 

planning

Percentage 

of demand 

satisfied by 

modern

methods 

Tanzania 2004-2005 28.2 20.0 49.5 40.4 

Education 

No education 27.1 8.3 36.1 23.0 

Primary 29.2 23.6 54.4 43.4 

Secondary 22.8 28.2 61.4 45.9 

Wealth quintile 

Lowest 28.8 10.7 40.4 26.5 

Second 28.1 12.8 41.9 30.6 

Middle 31.6 15.6 48.5 32.2 

Fourth 28.3 24.1 54.0 44.6 

Highest 24.6 36.0 62.3 57.8 

 

Uganda 2000-2001 39.1 18.2 57.3 31.7 

Education 

No education 38.3 9.4 47.7 19.6 

Primary 41.7 16.8 58.5 28.7 

Secondary 31.2 40.1 71.2 56.2 

Higher 18.9 51.1 70.0 73.0 

Wealth quintile 

Lowest 38.2 11.3 49.4 22.8 

Second 41.4 9.3 50.7 18.4 

Middle 42.5 11.9 54.5 21.9 

Fourth 42.7 19.5 62.2 31.4 

Highest 30.9 40.6 71.6 56.8 

 

Zambia 2001-2002 36.3 25.3 61.6 41.1 

Education 

No education 39.4 11.0 50.4 21.8 

Primary 38.3 21.8 60.1 36.3 

Secondary 30.1 41.2 71.4 57.8 

Higher 23.0 56.3 79.2 71.0 

Wealth quintile 

Lowest 39.8 10.8 50.6 21.3 

Second 41.7 12.9 54.6 23.6 

Middle 38.8 19.5 58.3 33.5 

Fourth 35.2 31.8 67.0 47.4 

Highest 25.1 52.3 77.4 67.5 

 

Zimbabwe 1999 16.1 50.4 68.2 73.9 

Education 

No education 21.7 35.2 59.1 59.6 

Primary 20.5 44.4 66.4 66.9 

Secondary 10.8 58.9 71.6 82.3 

Higher 7.2 65.6 73.6 89.1 

Wealth quintile 

Lowest 22.0 41.1 64.2 64.0 

Second 21.4 42.1 65.9 63.9 

Middle 20.2 42.8 63.8 67.1 

Fourth 12.1 53.7 68.0 79.0 

Highest 7.9 67.4 77.3 87.2 

DHS Comparative Reports Series 

1. Westoff, Charles F. 2001. Unmet Need at the End of the Century.

2. Westoff, Charles F. and Akinrinola Bankole. 2002. Reproductive Preferences in Developing 

Countries at the Turn of the Century.

3. Rutstein, Shea O. 2002. Fertility Levels, Trends, and Differentials 1995-1999.

4. Mahy, Mary. 2003. Childhood Mortality in the Developing World: A Review of Evidence from 

the Demographic and Health Surveys.

5. Westoff, Charles F. 2003. Trends in Marriage and Early Childbearing in Developing Countries.

6. Rutstein, Shea O. and Kiersten Johnson. 2004. The DHS Wealth Index.

7. Yoder, P. Stanley, Noureddine Abderrahim, and Arlinda Zhuzhuni. 2004. Female Genital Cutting 

in the Demographic and Health Surveys: A Critical and Comparative Analysis.

8. Stallings, Rebecca. 2004. Child Morbidity and Treatment Patterns.

9. Rutstein, Shea O. and Iqbal H. Shah. 2004. Infecundity, Infertility, and Childlessness in 

Developing Countries.

10. Mukuria, Altrena, Jeanne Cushing, and Jasbir Sangha. 2005. Nutritional Status of Children: Results 

from the Demographic and Health Surveys, 1994–2001. 

11. Mukuria, Altrena, Casey Aboulafia, and Albert Themme. 2005. The Context of Women’s Health: 

Results from the Demographic and Health Surveys, 1994-2001. 

12. Yoder, P. Stanley, Noureddine Abderrahim, and Arlinda Zhuzhini. 2005. L’excision dans les 

Enquêtes Démographiques et de Santé : Une Analyse Comparative. 

13. Garenne, Michel, and Julien Zwang. 2006. Premarital Fertility and Ethnicity in Africa.

14. Westoff, Charles F. 2006. New Estimates of Unmet Need and the Demand for Family Planning.