Casterline J B, Perez A E, Biddlecom A E
University of the Philippines.
Stud Fam Plann. 1997 Sep;28(3):173-91.
The prevalence of unmet need for family planning is a primary justification for family planning programs, but the causes of unmet need have not been much explored. This article investigates four explanations for unmet need: (1) as an artifact of inaccurate measurement of fertility preferences and contraceptive practice; (2) as a reflection of weakly held fertility preferences; (3) as a result of women's perceiving themselves to be at low risk of conceiving; (4) as due to excessive costs of contraception. The explanations are examined using quantitative and qualitative data collected in 1993 from currently married women and their husbands in two provinces in the Philippines. The results indicate that the preference-behavior discrepancy commonly termed "unmet need" is not an artifact of survey measurement. The most important factors accounting for this discrepancy are the strength of women's reproductive preferences, husbands' fertility preferences, and the perceived detrimental side effects of contraception. Inaccessible family planning services appear to carry little weight in this setting. Modification of services to make them more attentive to other obstacles to contraceptive use would improve their effectiveness in reducing unmet need.
计划生育需求未满足的普遍情况是计划生育项目的主要依据,但需求未满足的原因尚未得到充分探讨。本文研究了需求未满足的四种解释:(1)作为生育偏好和避孕行为测量不准确的人为产物;(2)作为生育偏好较弱的反映;(3)由于女性认为自己怀孕风险较低;(4)由于避孕成本过高。使用1993年从菲律宾两个省份的已婚妇女及其丈夫那里收集的定量和定性数据对这些解释进行了检验。结果表明,通常称为“需求未满足”的偏好与行为差异并非调查测量的人为产物。造成这种差异的最重要因素是女性生殖偏好的强度、丈夫的生育偏好以及对避孕副作用的感知。在这种情况下,难以获得计划生育服务似乎影响不大。改进服务使其更关注避孕使用的其他障碍将提高其在减少需求未满足方面的有效性。