Prevalence and determinants of unmet family planning needs among women of childbearing age in The Gambia: analysis of nationally representative data

Abstract

Background: Family planning is imperative in the control of population growth by preventing unintended pregnancies and reducing other pregnancy-related risks. However, the effectiveness of family planning is constrained by unmet needs. This study determined the proportion and identify factors associated with unmet family planning needs among women of childbearing age in The Gambia. Methods: We utilized cross-sectional population-based Demographic and Health Survey (DHS) data from Gambian women aged 15-49 years in 2013. The outcome measured was the total unmet/met need for FP.  The sample comprised 10,233 women aged 15-49 years old. Chi-square and multivariable logistic regression analysis were used. Results: Of the 10,233 eligible women recruited in the study, the mean age was 27.4±9.1 years while 67.5% were married. Overall, 17.6% of women reported unmet FP need, of whom 14.0% and 3.6% reported unmet birth spacing and birth limitation needs, respectively. The women's age, region, ethnicity, number of live children, number of household/family members, the optimal number of children, and husband/partners’ desire for the children were found as significant determinants of unmet FP needs. Furthermore, breastfeeding has been identified as the key reason for the non-use of FP in mothers. Conclusions: The study findings suggest a need to expand FP programs and related strategic communications especially for younger women in order to improve their contraceptive prevalence. Improving women empowerment and accessibility to FP will help to lessen the current trend towards rising unmet needs in The Gambia.