[Un]met Need and [Un]wanted Family Planning: A Cross‐Sectional Study Among Women in Argentina, Ghana, and India Examining Characteristics, Reasons, and Alignment With Fertility Desires

Unwanted family planning often refers to fertility desires as a proxy for contraceptive desire and lacks alignment with the tenets of person-centered care. We construct a person-centered measure of unwanted family planning by asking women whether they wanted to use a method, examine its alignment with the fertility-derived measure, and describe the characteristics of women with unwanted family planning and reasons women state for not wanting to use a method. We conducted a cross-sectional study of women aged 15-49 in Argentina, Ghana, and India. Data were collected on stated desire to use contraception and basic sociodemographic characteristics. Fertility desire was collected using the standard Demographic and Health Survey questionnaire. In total, 4794 women were included in our study. Among women using a method, 2.5 percent (n = 53) of women had unwanted family planning, with 4.2 percent in Ghana, 2.2 percent in Argentina, and 2.0 percent in India. Most unwanted family planning (85.2 percent, n = 23) occurred among women who did not want a child within the next nine months. Sexual infrequency was the most common reason behind a lack of desire to use a method. Our results highlight the substantial differences found between classifying women's contraceptive needs from a person-centered versus a fertility-derived approach.