Assessment of unmet need for family planning among women in Alexandria city

Despite the Family Planning Program's success, many married women in the reproductive age are defined as having an unmet need for family planning. The concept of unmet need points to the gap between women's reproductive intentions and their contraceptive behavior. This study was carried out to estimate the level of unmet need for family planning among currently married women in Alexandria. Moreover, it aimed at providing the profile of women with unmet need for family planning [FP] and to find out the various reasons why women who would prefer to avoid pregnancy do not use contraception. For achieving these aims, the cross sectional approach was used as a research methodology where the target population was the currently married fecund women in the reproductive period [15-49 years]. The cluster sampling technique was used and a sample size of 840 currently married women were selected from 30 clusters, i.e., 28 women within each cluster. Data were collected using a specially designed interview questionnaire during the period from beginning of February 2000 till the end of July 2001. Data were analyzed using SPSS version 9. The results of this study revealed that women with unmet need for family planning services constituted 24.3% of the studied women. About half of this unmet need [11.9%] represents a desire to space the next birth, and the remaining 12.4% represents an interest in limiting births. However, need for better contraception was encountered among 2.3% of the studied women; they experience pregnancy while using contraceptive method, i.e., method failure. On the other hand, women in need for FP services, however met, constituted 62.1% of all studied women [49.5% for limiting their family size and 12.6% for spacing]. Therefore, at the time of the study, the total demand for FP comprised 88.7% of the studied women and 70.0% of the total demand for FP services was satisfied. The highest percept of total unmet need for FP services [38.8%] was encountered among women aged 25-29 years that declined thereafter to reach 7.7% among the eldest studied women aged 45-49 years. The reverse holds true regarding the total met need. When the purpose of need for FP services was considered, the youngest women had the highest percent of need for spacing births whether met [43.3%] or unmet [26.9%]. Unmet need for limiting births was highly presented among women aged 30-34 years [18.9%]. An inverse relationship was observed between number of children the women had and the percent of unmet need whether for spacing births, limiting births, or altogether. Health concerns were the most commonly given reasons for unmet need [53.9%]. Little perceived risk of pregnancy ranked the second reason [29.9%]. Opposition to use of contraceptives due to either the woman's own attitude or that of her husband, was the reason cited by 16.2% of women with unmet need for family planning. From the present study, the followings are recommended: improvement of the family planning concept, improving the existing family planning services to minimize the negative attitude towards contraception and motivate women to put their fertility desire into action, and strengthening the Information Education Communication [IEC] activities. Mass media play an important role in combating circulating rumors in the community. Personal communication and counseling are important for changing attitude towards contraception that will have a substantial impact on both initial and continual acceptability of contraceptive methods