Men's unmet need for family planning: implications for African fertility transitions.

Ngom P.

Demographic Surveillance System, Navrongo Health Research Centre, Ghana.

This article introduces the concept of men's unmet need for family planning and explains its programmatic relevance. Using data from Demographic and Health Surveys (DHS) of Ghana (1988, 1993) and Kenya (1989, 1993), married men are found to have high levels of unmet need for family planning that are comparable to, although slightly lower than, those for women. The importance of men's unmet need is demonstrated when the analysis is restricted to marital pairs in the DHS samples; trends in the joint unmet need of husbands and wives are shown to be closely associated with the nature of the fertility transitions occurring in Ghana and Kenya. Because of wide discrepancies found between husbands' and wives' unmet need statuses, family planning programs that foster spousal communication are likely to facilitate the transition to lower fertility.

PIP: This study examines men's unmet need for family planning in Kenya and Ghana. Data are obtained from the 1988 and 1993 Ghana Demographic and Health Surveys (DHS) and the 1989 and the 1993 Kenya DHS. An initial discussion centers on the methodological problems of measuring men's unmet need. The sample is restricted to samples of marital pairs. Unmet need in the DHS is defined as married men or women who desire no more children and are not using any modern method. Unmet need includes those who relied on traditional methods. In both Ghana and Kenya, a large proportion of men had unmet need for contraception. 24% of married men in Ghana and 24% in Kenya in 1993 did not want more children and were not using any modern method. Most couples agreed with their family planning demand status. Around 75% of couples in Ghana had unmet need, no demand, or modern method use. Around 65% of couples in Kenya agreed on their family planning status. 34% of couples in 1988 and 36% in 1993 in Ghana had disagreements between spouses on family planning. 23% in 1989 and 25% in 1993 in Kenya did not agree. The figures on unmet demand varied between husbands and wives. Large percentages of women with no demand were married to husbands with unmet need: 22-41% in Kenya and Ghana during 1988-89, and 25-27% in 1993. Unmet demand increased in Ghana during the 1980s and declined in Kenya. Contraceptive prevalence rose from 27% to 33% in Kenya and from only 5% to 10% in Kenya. It is expected that as fertility transition advances, unmet need will decline and contraceptive prevalence will increase. Findings suggest that programs that encourage couple communication may facilitate the satisfaction of both partners' unmet need.