https://imcjms.com/public Ibrahim Medical College Journal of Medical Science https://imcjms.com/public/registration/journal_full_text/134 Sun, 06 Nov 2016 13:56:35 +0000 Ibrahim Med. Coll. J. 2009; 3(1): 24-28 Key words: Unmet need, contraceptive, reasons of unmet need Introduction The term unmet contraceptive need is defined as the percentage of currently married women in their reproductive ages who do not want additional children or wanting to postpone child bearing by at least two years and yet are not practicing any contraceptive method.1 This gap between some women’s reproductive intention and their contraceptive behaviour clearly poses a challenge to the ongoing family planning program.Unmet need has generated much interest, both among academics and policy makers over the years. At the international level, the policy makers are unanimous about the usefulness of this concept which has been amply reflected in the following statement of the International Conference on Population and Development “governmental goals for family planning should be defined in terms of unmet needs for information and services.”2, 3 Over the past three decades, Bangladesh has made impressive gains in indicators related to population and family planning.Ever use of any contraceptive method increased five-fold during the past two decades, from 13.6% in 1975 to 69.2% in 1997. The contraceptive prevalence rate (CPR) has increased six-fold, from 8% in the mid-1970s to 58% in 2004.4 Total fertility rate (TFR) dropped by half, from about 6 children per women to about 3 children per woman. However, there is a discrepancy between rural and urban areas, as well as between rich and poor population.5 Around 148 million people live in Bangladesh with majority below the level of poverty.6 Increasing landlessness, underemployment in the rural areas are the main factors to cause constant migration of the rural poor to the urban sector and the percentage of urban population has increased from 8.8 percent in 1974 to 18 percent in 1991.7, 8 With the expansion of the urban centers and increase in the urban population, the number of slums and slum dwellers are rapidly increasing. The slum dwellers are largely the distressed migrants from the rural areas and, more importantly, most of them live below the poverty line. The slum dwellers do not have sufficient access to education, employment and health facilities of the formal sector: The health and nutritional status and contraceptive use of the urban poor are even worse than that of the rural poor. In recent years much attention has been devoted to the replacement of demographic targets by a focus upon unmet needs to raise the contraceptive prevalence above the level inherent in the demographic target.9 Thus, this group of deprived urban slum dwellers become an area of research to find out the unmet contraceptive needs among the eligible couples. Materials and Methods This cross-sectional study was conducted on married women residing in urban slums of Kamrangirchar in Dhaka. Kamrangirchar is adjacent to Dhaka city and has 42 areas (paras/mohollas). Of those four paras: Matborbazar, Munshihati, Parshim Rasulpur, Nobinogor, were purposively selected for the study. Sample size was calculated by using formula n = Z2pq/d2,taking the prevalence rate of unmet need (p=11%),4 the calculated sample size coming to 150. Cluster sampling technique was used to select the sample. Data were collected by face-to-face interview with a pre-tested structured questionnaire, visiting every house in the selected slum areas. As per inclusion criteria a total of 265 eligible couples were found in the cluster. As all were included in the study, the number of sample was more than the calculated sample size. Results     Characteristics %   15 – 19 14.3 74 25 – 29 20.8 98 Respondents age at marriage (yrs)   99 15 – 19 55.8 18 Respondents’ education   84 Sign only 30.6 63 Secondary 11.3 07 Husbands’ education   84 Sign only 31.7 48 Secondary 12.5 16 Respondent’s occupation   197 Labour & garments’ workers 14.4 30 Husbands’ occupation   108 Business 27.5 79 Unemployed 1.9   < 5000 30.9 180 > 10000 1.1   Never pregnant 8.3 61 Twice 18.1 134 Outcome of last pregnancy   223 Still-birth 1.1 10 MR/Abortion 2.6 22   Fig-1. Subgroups of Married Women Reproductive Age (MWRA) Constituting Unmet Need Reasons of unmet need for contraceptiveAbout 35% of the respondents with unmet contraceptive need mentioned not menstruating after last child birth as reason of non-use of any method though they are all beyond the post partum period, about 24% did not specify any reason of unmet need, side effect of past use were 19%, discouraged by husband or other family members were 11%, did not know about any method or did not know where to get contraceptives from were also 11% (Figure 2).       1.   Adam Sonfield. Working to eliminate the world’s unmet need for contraception. Guttmacher Policy Recview 2006; 9: Number-1. 3.   De Graff, D.S. and V. De Silva (1991). Unmet need for contraception in Sri Lanka. International Family Planning Perspectives 17(4): 123-130. 5.   Islam, M.N. and M.M. Islam. Biological and behavioural determinants of fertility in Bangladesh: 1975-1989. Asia-Pacific Pnpulation Journal 1993; 8(1): 3­18. 7.   Stalker P. A Fork in the Path: Human Development choice for Bangladesh, FAO, ILO, UNDP, UNFPA, WHO, The World Bank Dhaka, 1995. 9.   Mahmud M. Adolescent reproductive behaviour in Bangladesh M.Sc. thesis (unpublished), Department of Statistics, Dhaka University, 1994. 11.Bangladesh Demographic and Health Survey. NIPORT, Mitra and Associates, 1996-1997. 13.Chaudhury, R.H. The influence of female education, labor force participation, and age at marriage on fertility behavior in Bangladesh. Social Biology 1984; 31(1-2): 57-9. 2026 Ibrahim Medical College. All rights reserved.