title: Policy and programme implications of unmet need for family planning in Pakistan.
abstract: BACKGROUND
  With the contraceptive prevalence rate (CPR) at 30% in 2006-7, the rates of contraception use among married women of reproductive age (MWRA) in Pakistan are among the lowest in the region. This paper explores some options of unmet need as a means of addressing the low CPR.
  
  
  METHODS
  We conducted secondary data analysis of the Pakistan Demographic Health Survey (PDHS) 2006-7 to understand the context of unmet need in Pakistan. Univariate and multiple regression techniques were used to understand associations. The numbers of women with unmet need were calculated by multiplying PDHS proportions with actual population figures.
  
  
  RESULTS
  There are 5.7 million women with an unmet need; 2.4 million with a need to space and 3.3 million with a need to limit. Unmet need decreases with age, increases with the number of children and increasing education, and is higher among poor women. Structural factors such as rural residence and exposure to family planning (FP) programmes and messages are relevant for unmet need for spacing, but not for unmet need for limiting. There are twice as many women in Pakistan with an unmet need for FP than those who avail FP services. Additionally there is much more need to limit than the need to space. In fact the need to limit is nearly 10 fold higher than the services for long-term methods. Structural interventions, that increase service delivery, quality, and uptake may address unmet need in the short-term, must be complemented with demand creation and behaviour-change interventions. All of these issues must be addressed concomitantly with research to understand how best to harness the "market forces" that are responsible for over half of all FP services.
authors.affiliation: Research and Development Solutions, Islamabad.
authors.forename: Shirin
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Research and Development Solutions, Islamabad.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Khan
authors.affiliation: Research and Development Solutions, Islamabad.
authors.forename: Adnan Ahmad
authors.initials: AA
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000706:statistics & numerical data*; D003906:Developing Countries; D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D010154:Pakistan; D016730:Program Development / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult