A recognized indicator for family planning—demand for family planning satisfied with modern methods (Demand Satisfied)—is key to the Sustainable Development Goals (SDGs). This indicator will improve monitoring of family planning because it measures use of modern methods of contraception (which are more effective than traditional methods at avoiding unintended pregnancies) and because it limits the population measured to women who have a demand for family planning.
Demand Satisfied will more effectively capture success and gaps in family planning programs and illustrates a strong commitment to the rights of individuals and couples to determine the number and timing of their children, endorsing the principles of voluntarism, informed choice, rights, and equity.
This infographic introduces users to the Demand Satisfied indicator—how it is measured and how it will be used moving forward.
Understanding the Population
To understand family planning indicators, let’s take a population
of 10 women and explore. In our population of 10 women:
Demand for family planning satisfied with modern methods is the share of women (or their partners) who are currently using at least one method of modern contraception, out of the group of women of reproductive age who do not want to become pregnant in the near future.
Demand Satisfied shifts attention to women with a demand for family planning. By focusing on modern methods, Demand Satisfied measures the most effective methods of contraception. Demand Satisfied is a dynamic measure that captures the constantly-changing nature of the demand for family planning. As women move through their reproductive years they have times of demand and times without demand, as they grow their families. Many programs see long-term increases in the demand for family planning as fertility preferences shift to smaller ideal family sizes. Programs need to increase the availability of modern contraceptive methods to maintain current levels of Demand Satisfied as desired family size changes.
Contraceptive Prevalence Rate
Contraceptive prevalence rate (CPR) is the share of women (or their partners) who are currently using at least one method of modern or traditional contraception, out of all women of reproductive age.
CPR is a simple method of measuring a population’s use of contraception. CPR includes modern and traditional methods (which are not as effective at delaying or avoiding a pregnancy). It is difficult for countries to set targets for CPR, because some women in the population wish to become pregnant in the near future. Encouraging contraceptive use to achieve CPR targets without taking into account a woman’s fertility intentions violates a woman or couple’s right to determine the timing and spacing of their children.
Modern Contraceptive Prevalence Rate
Modern contraceptive prevalence rate (mCPR) is the share of women (or their partners) who are currently using at least one method of modern contraception, out of all women of reproductive age.
MCPR measures a country’s ability to provide effective contraceptives to space or limit a birth. As with CPR, it is difficult for countries to set targets, because some women in the population wish to become pregnant in the near future. Encouraging modern contraceptive use to achieve mCPR targets without taking into account a woman’s fertility intentions violates a woman or couple’s right to determine the timing and spacing of their children.
Unmet need is the share of women who want to avoid a pregnancy but neither she nor her partner are using any contraceptive method (modern or traditional), out of all women of reproductive age.
Unmet need takes into account women and couples' fertility intentions. Women who wish to delay their next pregnancy can be calculated separately from women who wish to have no more children. Typically, it considers women using either traditional or modern contraceptive methods as having their needs met. Unmet need focuses on gaps in family planning provision, rather than whether/how a country’s family planning program is meeting demand. Programs may see increases in the demand for family planning as fertility preferences shift to smaller ideal family sizes, resulting in an increase in cases of unmet need.
- USING MODERN CONTRACEPTIVE
- USING TRADITIONAL CONTRACEPTIVE
- NOT USING CONTRACEPTIVE
- DOES NOT WANT A BIRTH IN THE NEXT TWO YEARS
- WANTS A BIRTH IN THE NEXT TWO YEARS
The Demand Satisfied Indicator Is Critical to Achieving the SDGs.
On Sept. 25, 2015, leaders from 193 countries adopted a new framework to end poverty, address inequality, and tackle environmental change by 2030.
Known as the SDGs, this framework builds on the success of the Millennium Development Goals (MDGs) and seeks to complete what they did not achieve.
It comprises 17 goals and 169 targets to improve people’s lives, achieve gender equality, and empower all women and girls.
Sexual and reproductive health is essential to achieve SDG 3, “Ensure healthy lives and promote well-being for all at all ages,” which has a specific target for family planning:
Target 3.7: By 2030, ensure universal access to sexual and reproductive healthcare services, including for family planning, information and education, and the integration of reproductive health into national strategies and programs.
Family planning has the ability to impact all 17 SDGs. Experts recommended the Demand Satisfied indicator to measure countries’ progress toward achieving Target 3.7, universal access to family planning. The precise indicator is:
3.7.1: Percentage of women of reproductive age who have their need for family planning satisfied with modern methods.
Demand Satisfied builds on the indicators used to measure MDG 5: Improve Maternal Health, Target 5B: Achieve, by 2015, universal access to reproductive health, which are contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), and unmet need.
The Demand Satisfied Indicator Captures the Dynamic Changes in Women's Reproductive Lives.
The aim is to increase Demand Satisfied by modern methods to at least 75 percent in all countries by 2030. The proposed 75-percent benchmark was established because many member countries of the Organisation for Economic Co-operation and Development (OECD) have surpassed this level in recent years. The proposed 75-percent benchmark is also:
- Ambitious and achievable, if progress towards meeting demand for modern contraceptive methods is accelerated, especially in low-income countries. Achieving global goals, such as those of FP2020, are important milestones on the path to meeting the SDG target by 2030.
- In line with high-performing countries and presents an opportunity for both developed and developing countries to achieve the same level of progress.
- Easily disaggregated because it can be analyzed by geographic region, age, wealth, and educational attainment, enabling efforts to understand equity among different groups within a country.
Demand Satisfied Can Increase If:
- Women who are not using family planning (but wish to delay or avoid pregnancy) begin using a modern method.
- Women using traditional methods switch to more effective modern methods.
Demand Satisfied can decrease if the population of women who want to use modern methods increases but family planning programs cannot meet the increased demand.
Demand for Family Planning Is Constantly Changing.
Women and their partners often shift their fertility intentions. Desired family size can decrease as a result of societal changes, such as increases in women’s educational attainment and declines in infant mortality. Such shifts can mean that women spend more of their reproductive years with a family planning need.
In most developing countries, the number of women of reproductive age will continue to increase in the near future from large youth populations. To continue meeting demand, family planning programs will also have to expand to keep pace. If a country wants to increase its level of Demand Satisfied, family planning programs must grow at a faster rate than the population of women with demand.
Advocacy and the SDGs
Understanding the current status of family planning in every country is critical to advocacy efforts for increased investment to meet the SDG 2030 target. Advocates are using data from performance and monitoring efforts to measure progress and hold governments accountable. A renewed sense of urgency can accelerate existing efforts, such as family planning, that provide a pathway to achieve all of the SDGs.
Progress Toward Meeting the Demand for Modern Contraceptives Varies Across Countries.
Good Data Are Key to Monitoring Progress.
Data used to measure Demand Satisfied come from household surveys that interview women about their (and their partners') contraceptive use and fertility intentions. These data are the same data used to measure contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), and unmet need.
Data Sources Include
- Demographic and Health Surveys
- Multiple Indicator Cluster Surveys
- Performance, Monitoring, and Accountability 2020 Surveys
- Reproductive Health Surveys
- National surveys with similar methodologies
Using these data sources, organizations such as the Track20 program, provide country estimates and projections for Demand Satisfied.
In some surveys or countries, only married or cohabiting women are asked about their contraceptive use and fertility intentions. In these cases, data are not collected from women who may be sexually active and unmarried. As a result, international comparisons of family planning data often limit the population to women who are married or cohabiting, obscuring the demand that may be generated by sexually active unmarried women. To make measures inclusive of all women of reproductive age regardless of marital status, data for Demand Satisfied for all women will be available in the future.
EngenderHealth/RESPOND Project, “A Fine Balance: Contraceptive Choice in the 21st Century—An Action Agenda,” report presented at the September 2012 Bellagio Consultation, Bellagio, Italy, Sept. 4-7, 2012, accessed at www.respond-project.org/pages/bellagio/Bellagio-Report-February2013-FINAL.pdf, on April 5, 2016.
Institute for Reproductive Health, “Standard Days Method: A Modern Family Planning Method,” FAM Project Expanding Family Planning Options Georgetown University (2012), accessed at http://irh.org/wp-content/uploads/2013/04/FAM_Project_SDM_Modern_Method_Brief_0.pdf, on June 28, 2016.
Karen Hardee et al., “Voluntary Family Planning Programs That Respect, Protect, and Fulfill Human Rights: A Conceptual Framework” (2013), accessed at www.engenderhealth.org/files/pubs/family-planning/Voluntary_Family_Planning_Programs_A_Conceptual_Framework, on April 2, 2016.
Leadership Council of the Sustainable Development Solutions Network, “Indicators and Monitoring Framework for the Sustainable Development Goals Launching a Data Revolution,” (June 2015), accessed at http://unsdsn.org/wp-content/uploads/2015/05/FINAL-SDSN-Indicator-Report-WEB.pdf, on March 31, 2016.
Madeleine S. Fabic et al., “Meeting Demand for Family Planning Within a Generation: The Post-2015 Agenda,” Lancet 385, no. 9981 (2014): 1928-31.
Sarah E.K. Bradley et al., “Revising Unmet Need for Family Planning,” DHS Analytical Studies, no. 25 (2012), accessed at https://dhsprogram.com/pubs/pdf/AS25/AS25%5B12June2012%5D.pdf, on June 3, 2016.
Shea Rutstein and Guillermo Rojas, “Demographic and Health Surveys Methodology” Guide to DHS Statistics (2006), accessed at www.dhsprogram.com/pubs/pdf/DHSG1/Guide_to_DHS_Statistics_29Oct2012_DHSG1.pdf, on June 3, 2016.
United Nations, “Estimates and Projections of Family Planning Indicators 2015” (2015), accessed at www.un.org/en/development/desa/population/theme/family-planning/cp_model.shtml, on July 26, 2016.
United Nations, “Millennium Development Goals Indicators” (2015), accessed at http://mdgs.un.org/unsd/mdg/Metadata.aspx, on March 31, 2016.
United Nations, “Transforming Our World: The 2030 Agenda for Sustainable Development” (September 2015), accessed at https://sustainabledevelopment.un.org/post2015/transformingourworld, on March 22, 2016.
United Nations Inter-Agency and Expert Group, “Report of the Inter-Agency and Expert Group on Sustainable Development Goal Indicators,” report presented at the 47th session of the Statistical Commission at the UN Economic and Social Council, New York, March 8-11, 2016, accessed at http://unstats.un.org/unsd/statcom/47th-session/documents/2016-2-IAEG-SDGs-E.pdf, on March 22, 2016.
United Nations Population Fund, “Programme of Action,” adopted at the International Conference on Population and Development, Cairo, Egypt, Sept. 5-13, 1994, accessed at www.unfpa.org/sites/default/files/event-pdf/PoA_en.pdf, on March 19, 2016.
United States Agency for International Development, “USAID's Family Planning Guiding Principles and U.S. Legislative and Policy Requirements” (2015), accessed at www.usaid.gov/what-we-do/global-health/family-planning/voluntarism-and-informed-choice, on April 3, 2016.
World Health Organization, “Ensuring Human Rights in the Provision of Contraceptive Information and Services: Guidance and Recommendations” (2014), accessed at http://apps.who.int/iris/bitstream/10665/102539/1/9789241506748_eng.pdf, on April 2, 2016.
World Health Organization, “Health in 2015: From MDGs to SDGs” (2015), accessed at www.who.int/gho/publications/mdgs-sdgs/en/, on March 23, 2016.
Yoonjoung Choi et al., “Meeting Demand for Family Planning Within a Generation: Prospects and Implications at Country Level,” Global Health Action 8 no. 29734 (2015), accessed at http://dx.doi.org/10.3402/gha.v8.29734, on March 18, 2016.
This graphic is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the PACE Project (No. AID-OAA-A-16-00002). The contents are the responsibility of the Population Reference Bureau and do not necessarily reflect the views of USAID or the United States Government.
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