title: Determinants of unmet need for family planning among women in Urban Cameroon: a cross sectional survey in the Biyem-Assi Health District, Yaoundé.
abstract: BACKGROUND
  With the unacceptably high level of unmet need for family planning in Sub-Saharan Africa, reducing unmet need is paramount in the fight against the high levels of induced abortions, maternal and neonatal morbi-mortality. A clear understanding of the determinants of unmet need for family planning is indispensable in this light. The objective of this study was to determine the prevalence of unmet need for family planning in Urban Cameroon while identifying major determinants of unmet need among women in a union in Urban Cameroon.
  
  
  METHODS
  A community based cross sectional study was conducted from March 2015 to April 2015 during which 370 women in a union were recruited using cluster multistep sampling in the Biyem-Assi Health District, Yaounde. Data were collected using a pretested and validated questionnaire. Proportions and their 95% confidence intervals were calculated with the Westoff/DHS method used to estimate unmet need for family planning and the odds ratio used as measure of association with statistical significant threshold set at p-value ≤ 0.05.
  
  
  RESULTS
  Of the 370 eligible women included, the mean age was 29.9 ± 6.8 years, and 61.1% were married. The prevalence of unmet need for family planning was 20.4 (16.4-24.8)% with 14.2 (11.2-18.7)% having an unmet need for spacing and 6.2 (3.6-8.7)% an unmet need for limiting. Husband's approval of contraception had a statistically significant protective association with unmet need (AOR = 0.52 [0.30-0.92], p = 0.023), and discussion about family planning within the couple had a highly statistically significant protective association with unmet need (AOR = 0.39 [0.21-0.69], p = 0.001). The major reason for non-use of contraception among women with unmet need was the fear of side effects.
  
  
  CONCLUSIONS
  The prevalence of unmet need of family planning among women in the Biyem-Assi Health District remains high. Husband's approval of contraception and couples' discussion about family planning are two major factors to be considered when planning interventions to reduce unmet need for family planning. Family planning activities focused on couples or including men could be useful in reducing the rate of unmet need in Cameroon.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. christrah@yahoo.fr.
authors.forename: Atem Bethel
authors.initials: AB
authors.lastname: Ajong
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. njotangnanaphilip@yahoo.com.|Obstetrics and Gynaecology unit, Yaoundé Central Hospital, Higher Institute of Health Technologies, Yaoundé, Cameroon. njotangnanaphilip@yahoo.com.
authors.forename: Philip Nana
authors.initials: PN
authors.lastname: Njotang
authors.affiliation: Meilleur Accès aux soins de Santé, Yaoundé, Cameroon. martinyakum@yahoo.com.
authors.forename: Martin Ndinakie
authors.initials: MN
authors.lastname: Yakum
authors.affiliation: Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. essimj@yahoo.com.
authors.forename: Marie José
authors.initials: MJ
authors.lastname: Essi
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. essibenx@yahoo.com.
authors.forename: Felix
authors.initials: F
authors.lastname: Essiben
authors.affiliation: Obstetrics and Gynaecology unit, Yaoundé Central Hospital, Higher Institute of Health Technologies, Yaoundé, Cameroon. fileko@yahoo.com.
authors.forename: Filbert Eko
authors.initials: FE
authors.lastname: Eko
authors.affiliation: Department of Biomedical Sciences, Faculty of Science, University of Dschang, Dschang, Cameroon. brunokenfack@gmail.com.
authors.forename: Bruno
authors.initials: B
authors.lastname: Kenfack
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. rembu20012000@yahoo.com.|Directorate of Family Health, Ministry of Public Health, Yaoundé, Cameroon. rembu20012000@yahoo.com.
authors.forename: Enow Robinson
authors.initials: ER
authors.lastname: Mbu
mesh_terms: D000293:Adolescent; D000328:Adult; D002163:Cameroon; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003906:Developing Countries / Q000706:statistics & numerical data; D005193:Family Planning Services / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D011795:Surveys and Questionnaires