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  • Title: Unmet need and nonuse of family planning in Botswana.
    Author: Brophy G.
    Journal: Popul Today; 1990 Nov; 18(11):6-7. PubMed ID: 12316526.
    Abstract:
    This article examines the unmet need for family planning services and possible explanations for underutilization of these services in Botswana, a sub-Saharan African country with the highest contraceptive prevalence rates. In the 1988 Botswana Family Health Survey II, 33% of the 4368 union women between the ages of 15-49 reported using contraceptives. The common denominator among the women was their being in a union. The contraceptive status consisted of those women protected or whose needs were met and those women who were unprotected or whose needs were not met. The protected status included categories of contraceptive users, pregnant women, amenorrheic or abstaining women, infecund or menopausal women, women who desired a birth soon, and women who were undecided. The unprotected status was categorized by reproductive intention into birth spacing and limiting. Misreporting concerning status could have occurred and some women may have been in more than 1 status simultaneously. From the survey, the unmet need for women between 15-29 years in age is for birth spacing. After age 30, the unmet need is for birth limiting. 2 reasons may inflate the unmet need for women: underreporting of infecundity and separation from husband. Of those women currently pregnant or amenorrheic, between 15- 34 years of age, a greater proportion of pregnant women intended to use birth spacing after their current birth. After age 35, more women reported that they planned to limit the number of births. For amenorrheic women between 15-24 years, a greater proportion reported that they intended to space the births while those between 30-49 years intended to limit the births. Of amenorrheic women between 25-29 years, 42.4% plan to limit the births and 43.5% planned to space the births. For nonusers, the key factor for not using contraceptives was the women's attitude regarding family planning services; this attitude may have been her own opposition to contraceptive usage, influenced by others opposing family planning, or related to health concerns. Costs of family planning services and geographical distance did not influence the decision for nonusers. If current users experience contraceptive failure, these women should also be placed in the unmet need status. Areas needing further examination include determining the overriding influence of men on women's decision to limit births.
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