Demand and unmet need for means of family limitation in Rwanda.

CONTEXT: Rwanda is the most densely populated country in Africa, with substantial annual population growth. The current government seeks new policies for family limitation as a way to facilitate more sustainable development. METHODS: Data from the 2005 Rwanda Demographic and Health Survey were used for a two-step analysis; binary logistic regression was used to identify factors associated with desiring to stop childbearing and having unmet need. RESULTS: Eighty-seven percent of women aged 15-49 approve of family planning, but only 64% believe that their partner approves of it. There is a high level of unmet need for family limitation; 58% of women who want to stop childbearing do not use modern contraceptives. Demand was lower among women who did not approve of family planning, those who did not know their partner's attitude toward family planning and those who had discussed family planning with their partner fewer than three times. Unmet need was higher among women who did not approve of family planning, those who believed their partner did not approve of family planning or who did not know his attitude, and those who had never discussed family planning with their partner or had done so only once or twice. CONCLUSIONS: Negative attitudes toward family planning and failing structures of provision are the dominant constraints on the use of modern contraceptives in Rwanda. Community-based family planning services could greatly expand access, especially in underserved provinces.