{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:54:47Z","timestamp":1790362487957,"version":"4.1.0"},"reference-count":58,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,2,26]],"date-time":"2023-02-26T00:00:00Z","timestamp":1677369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Studies in Family Planning"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Unmet need for contraception is a widely used but frequently misunderstood indicator. Although calculated from measures of pregnancy intention and current contraceptive use, unmet need is commonly used as a proxy measure for (1) lack of access to contraception and (2) desire to use it. Using data from a survey in Burkina Faso, we examine the extent to which unmet need corresponds with and diverges from these two concepts, calculating sensitivity, specificity, and positive\/negative predictive values. Among women assigned conventional unmet need, 67 percent report no desire to use contraception and 61 percent report access to a broad range of affordable contraceptives. Results show unmet need has low sensitivity and specificity in differentiating those who lack access and\/or who desire to use a method from those who do not. These findings suggest that unmet need is of limited utility to inform family planning programs and may be leading stakeholders to overestimate the proportion of women in need of expanded family planning services. We conclude that more direct measures are feasible at the population level, rendering the proxy measure of unmet need unnecessary. Where access to and\/or desire for contraception are the true outcomes of interest, more direct measures should be used.<\/jats:p>","DOI":"10.1111\/sifp.12233","type":"journal-article","created":{"date-parts":[[2023,2,26]],"date-time":"2023-02-26T05:24:26Z","timestamp":1677389066000},"page":"231-250","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Assessing the Suitability of Unmet Need as a Proxy for Access to Contraception and Desire to Use It"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6713-1473","authenticated-orcid":false,"given":"Leigh","family":"Senderowicz","sequence":"first","affiliation":[{"name":"Department of Gender and Women's Studies University of Wisconsin\u2010Madison  Madison WI 53706 USA"},{"name":"Department of Obstetrics and Gynecology University of Wisconsin\u2010Madison  Madison WI 53706 USA"},{"name":"Department of Global Health and Population Harvard T. H. Chan School of Public Health  Boston MA 02115 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke W.","family":"Bullington","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Gillings School of Global Public Health University of North Carolina  Chapel Hill NC 27599 USA"},{"name":"Carolina Population Center University of North Carolina  Chapel Hill Chapel Hill NC 27516 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Sawadogo","sequence":"additional","affiliation":[{"name":"Institut Sup\u00e9rieur des Sciences de la Population Universit\u00e9 Joseph Ki\u2010ZERBO  03 BP 7021, Ouagadougou 03 Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8314-8219","authenticated-orcid":false,"given":"Katherine","family":"Tumlinson","sequence":"additional","affiliation":[{"name":"Carolina Population Center University of North Carolina  Chapel Hill Chapel Hill NC 27516 USA"},{"name":"Department of Maternal and Child Health, Gillings School of Global Public Health University of North Carolina  Chapel Hill NC 27599 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Langer","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population Harvard T. H. Chan School of Public Health  Boston MA 02115 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdramane","family":"Soura","sequence":"additional","affiliation":[{"name":"Institut Sup\u00e9rieur des Sciences de la Population Universit\u00e9 Joseph Ki\u2010ZERBO  03 BP 7021, Ouagadougou 03 Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Zabr\u00e9","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna  Nouna Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Si\u00e9","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Sant\u00e9 de Nouna  Nouna Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11113-005-5096-8"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1363\/48e10316"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/sifp.12012"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0968\u20108080(07)29284\u20105"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2307\/2133525"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.2307\/2137932"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728\u20104465.2014.00381.x"},{"key":"e_1_2_8_9_1","unstructured":"Bradley Sarah TrevorCroft JoyFishel andCharlesWestoff.2012. \u201cRevising Unmet Need For Family Planning.\u201d Accessed January 23 2023.https:\/\/dhsprogram.com\/publications\/publication\u2010as25\u2010analytical\u2010studies.cfm."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2006.00088.x"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4457.2000.00691.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728\u20104465.2016.00059.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728\u20104465.2014.00380.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.2307\/2135895"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2017.03.004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-22-00030"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.05.015"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1363\/psrh.12025"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1363\/43e3417"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728\u20104457.2002.00229.x"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2010.00223.x"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","unstructured":"Machiyama Kazuyo andJohnCleland.2013. \u201cInsights into Unmet Need in Kenya.\u201d STEP UP Research Report. London: London School of Hygiene & Tropical Medicine. Accessed January 23 2023.https:\/\/knowledgecommons.popcouncil.org\/departments_sbsr\u2010rh\/280\/.","DOI":"10.31899\/rh4.1063"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728\u20104465.2014.00385.x"},{"key":"e_1_2_8_24_1","unstructured":"\u201cMarie Stopes International Australia.\u201d2021. Accessed December 12 2021.https:\/\/www.mariestopesinternational.org.au\/."},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.7208\/chicago\/9780226261317.001.0001"},{"issue":"4","key":"e_1_2_8_26_1","article-title":"Birth\u2010Preparedness for Maternal Health: Findings from Koup\u00e9la District, Burkina Faso","volume":"24","author":"Moran Allisyn C","year":"2006","journal-title":"Journal of Health, Population, and Nutrition"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102019\u2010001581"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650\u2010198102000\u201000001"},{"key":"e_1_2_8_29_1","unstructured":"PMA2020.2018. \u201cBurkina Faso Round 6 Indicators.\u201d Accessed January 23 2023.https:\/\/www.pmadata.org\/sites\/default\/files\/data_product_results\/PMA2020\u2010Burkina\u2010R6\u2010FP\u2010Brief\u2010EN.pdf."},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/scientificamerican0100-88"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11111-007-0042-9"},{"key":"e_1_2_8_32_1","unstructured":"Pritchett Lant.1996. \u201cNo Need for Unmet Need.\u201d Accessed January 23 2023.https:\/\/lantpritchett.org\/wp\u2010content\/uploads\/2019\/01\/noneedforunmetneed_hopkins.pdf."},{"key":"e_1_2_8_33_1","volume-title":"Reproductive Health and Human Rights: The Way Forward","author":"Reichenbach Laura","year":"2011"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001048"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/sifp.12084"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.3917\/pope.1301.0089"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728\u20104465.2014.00383.x"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys090"},{"key":"e_1_2_8_39_1","unstructured":"Sawadogo Nathalie.2016. \u201cDe l'initiation Sexuelle Au Mariage Chez Les Jeunes Urbains Burkinab\u00e8: Relations V\u00e9cu et Risques.\u201d Louvain\u2010La\u2010Neuve Belgium: Presses Universitaires de Louvain."},{"key":"e_1_2_8_40_1","unstructured":"Sedgh Gilda Lori SAshford andRubinaHussain.2016. \u201cUnmet Need for Contraception in Developing Countries: Examining Women's Reasons for Not Using a Method.\u201d Accessed January 23 2023.https:\/\/www.guttmacher.org\/report\/unmet\u2010need\u2010for\u2010contraception\u2010in\u2010developing\u2010countries."},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728\u20104465.2014.00382.x"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/sifp.12114"},{"key":"e_1_2_8_43_1","first-page":"40976626","volume-title":"Conceptions and Measurement of Contraceptive Autonomy","author":"Senderowicz, Leigh Gabrielle","year":"2019"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/padr.12478"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v3i0.5284"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-21-00450"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(18)30293\u20109"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182076"},{"key":"e_1_2_8_49_1","doi-asserted-by":"crossref","unstructured":"Sully Elizabeth AnnBiddlecom JacquelineDarroch TaylorRiley LoriAshford NaomiLince\u2010Deroche LaurenFirestein andRachelMurro.2020. \u201cAdding It Up: Investing in Sexual and Reproductive Health 2019.\u201d New York: Guttmacher Institute. Accessed January 23 2023.https:\/\/www.guttmacher.org\/report\/adding\u2010it\u2010up\u2010investing\u2010in\u2010sexual\u2010reproductive\u2010health\u20102019.","DOI":"10.1363\/2020.31593"},{"key":"e_1_2_8_50_1","unstructured":"The DHS Program.2022. \u201cUnmet Need for Family Planning.\u201d 2022. Accessed January 23 2023.https:\/\/dhsprogram.com\/topics\/unmet\u2010need.cfm."},{"key":"e_1_2_8_51_1","unstructured":"UNFPA.2010. \u201cFifty Years after the Pill More than 200 Million Women Still Lack Access to Contraception | UNFPA \u2010 United Nations Population Fund.\u201d 2010. Accessed January 23 2023.https:\/\/www.unfpa.org\/news\/fifty\u2010years\u2010after\u2010pill\u2010more\u2010200\u2010million\u2010women\u2010still\u2010lack\u2010access\u2010contraception."},{"key":"e_1_2_8_52_1","unstructured":"UNFPA.2019. \u201cOne Vision Three Zeros.\u201d UNFPA Annual Report. 2019. Accessed January 23 2023.https:\/\/esaro.unfpa.org\/en\/publications\/one\u2010vision\u2010three\u2010zeros."},{"key":"e_1_2_8_53_1","unstructured":"United Nations. n.d. \u201cMillenium Development Goals: Goal 5.\u201d Accessed January 23 2023.https:\/\/www.un.org\/millenniumgoals\/maternal.shtml."},{"key":"e_1_2_8_54_1","unstructured":"United Nations Committee on Economic Social and Cultural Rights.2000. \u201cThe Right to the Highest Attainable Standard of Health (Article 12 of the International Covenant on Economic Social and Cultural Rights).\u201d Geneva: UNCESCR.https:\/\/digitallibrary.un.org\/record\/425041?ln=en."},{"key":"e_1_2_8_55_1","unstructured":"United Nations Population Division.2022. \u201cSDG Indicator 3.7.1 on Contraceptive Use.\u201d 2022. Accessed January 23 2023.https:\/\/www.un.org\/development\/desa\/pd\/data\/sdg\u2010indicator\u2010371\u2010contraceptive\u2010use."},{"issue":"1","key":"e_1_2_8_56_1","first-page":"5","article-title":"The Concept of Unmet Need","author":"Westoff C F","year":"1994","journal-title":"Planned Parenthood Challenges"},{"key":"e_1_2_8_57_1","volume-title":"WHO Guideline on Health Workforce Development, Attraction, Recruitment and Retention in Rural and Remote Areas","author":"World Health Organization","year":"2021"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.4054\/DemRes.2021.45.17"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/sifp.12153"}],"container-title":["Studies in Family Planning"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sifp.12233","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/sifp.12233","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sifp.12233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T06:42:02Z","timestamp":1694760122000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sifp.12233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,26]]},"references-count":58,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1111\/sifp.12233"],"URL":"https:\/\/doi.org\/10.1111\/sifp.12233","archive":["Portico"],"relation":{},"ISSN":["0039-3665","1728-4465"],"issn-type":[{"value":"0039-3665","type":"print"},{"value":"1728-4465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,26]]},"assertion":[{"value":"2023-02-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}