Unmet need for contraception is a widely used but frequently misunderstood indicator. Although calculated from measures of pregnancy intention and current contraceptive use, unmet need is commonly used as a proxy measure for (1) lack of access to contraception and (2) desire to use it. Using data from a survey in Burkina Faso, we examine the extent to which unmet need corresponds with and diverges from these two concepts, calculating sensitivity, specificity, and positive/negative predictive values. Among women assigned conventional unmet need, 67 percent report no desire to use contraception and 61 percent report access to a broad range of affordable contraceptives. Results show unmet need has low sensitivity and specificity in differentiating those who lack access and/or who desire to use a method from those who do not. These findings suggest that unmet need is of limited utility to inform family planning programs and may be leading stakeholders to overestimate the proportion of women in need of expanded family planning services. We conclude that more direct measures are feasible at the population level, rendering the proxy measure of unmet need unnecessary. Where access to and/or desire for contraception are the true outcomes of interest, more direct measures should be used.

中文翻译：

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评估未满足的需求是否适合作为获得避孕药具和使用避孕药具的意愿的指标

未满足的避孕需求是一个广泛使用但经常被误解的指标。尽管根据怀孕意愿和当前避孕药具使用情况计算得出，但未满足的需求通常用作 (1) 无法获得避孕药具和 (2) 使用避孕药具的愿望的替代衡量标准。我们使用来自布基纳法索调查的数据，检查未满足的需求与这两个概念对应和偏离的程度，计算敏感性、特异性和阳性/阴性预测值。在分配给常规未满足需求的女性中，67% 的人表示不想使用避孕药具，61% 的人表示可以获得范围广泛的负担得起的避孕药具。结果表明，未满足的需求在区分那些无法访问和/或希望使用某种方法的人与那些不希望使用某种方法的人时的敏感性和特异性较低。这些研究结果表明，未满足的需求对于为计划生育计划提供信息的作用有限，并且可能导致利益相关者高估需要扩大计划生育服务的女性比例。我们的结论是，在人口层面更直接的措施是可行的，从而使未满足需求的代理措施变得不必要。如果获得和/或渴望避孕是真正感兴趣的结果，则应使用更直接的措施。