title: Using measurements of unmet need to inform program investments for health service integration.
abstract: Demographic and Health Survey (DHS) data could potentially inform optimal strategies to reach women having unmet need with contraceptive services through integrated service delivery. Using 2010-11 DHS data from Nepal, Senegal, and Uganda, we estimate the proportion of married or cohabitating women of reproductive age (MWRA) having unmet need for family planning (FP) who have accessed selected health services and therefore could be offered FP services through integrated service delivery. We find substantial missed opportunities to reach MWRA having unmet need for family planning (FP) in the three countries examined. We also find considerable variation within and between countries in the potential for integrated services to reach women having unmet need. Between 4 percent and 57 percent of MWRA having unmet need in these countries could be reached through integration of FP into any single-service delivery platform we explored. This analysis has the potential to provide program managers with an evidence-based road map indicating which service-delivery platforms offer the greatest potential to reach the largest number of women having unmet need for contraception.
authors.affiliation: Senior Best Practices Utilization Advisor, Office of Population and Reproductive Health, United States Agency for International Development (USAID), 1300 Pennsylvania Avenue NW, Washington DC 20523.. smalarcher@usaid.gov.
authors.forename: Shawn
authors.initials: S
authors.lastname: Malarcher
authors.forename: Chelsea B
authors.initials: CB
authors.lastname: Polis
mesh_terms: D003267:Contraception / Q000706:statistics & numerical data*; D003268:Contraception Behavior; D003906:Developing Countries; D005193:Family Planning Services / Q000458:organization & administration*; D005260:Female; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D008427:Maternal Health Services / Q000458:organization & administration; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000628:therapy; D012959:Socioeconomic Factors; D018511:Systems Integration