Estimating contraceptive needs in the postpartum period: A population-level comparison of five measures of unmet need and demand for contraception among women in Ethiopia

Celia Karp, Johns Hopkins Bloomberg School of Public Health
Sophia Magalona, Johns Hopkins Bloomberg School of Public Health
Solomon Shiferaw, Addis Ababa University
Assefa Seme, Addis Ababa University
Linnea Zimmerman, Johns Hopkins Bloomberg School of Public Health

This study aimed to estimate unmet need and demand for contraception among postpartum women in Ethiopia using nationally representative data collected from 2019-2021. We conduct analyses of women at 6-weeks, 6-months, and 1-year postpartum to explore variation across five approaches to account for women’s pregnancy preferences and postpartum circumstances. Results indicate significant variation in identification of women 6-weeks postpartum with unmet need, ranging from 0% using the current status definition, which considers all women less than two months postpartum to lack pregnancy risk to 87.9% via the prospective definition. Differences between estimates across indicators dropped by more than half among women later postpartum. At six months postpartum, differences ranged 29 percentage points from 28.1% using the classic definition to 57.1% sing the prospective definition. Estimates of unmet demand indicate that roughly half of women with unmet need 1-year postpartum want to use contraception; research and programs should consider examining this indicator, as it more accurately aligns with women’s preferences. Results show that estimates of unmet need among postpartum women vary significantly based on the indicator used and the timing postpartum women are surveyed. Such variability has important implications for family planning policies and programs.

Keywords: Family planning and contraception, Fertility and childbirth, Longitudinal studies, Comparative methods

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  Presented in Session 196. Postpartum Contraceptive Needs and Use