Unmet need for family planning; global and national trends and challenges

Abstract

The unmet need for family planning refers to the percentage of all fecund women who are married or living in union and thus are presumed to be sexually active but not using any method of contraception, who either do not want to have any more children or want to postpone their next birth at least by two years or do not know when or if they want another child. Use of appropriate contraceptive method helps the user to avoid unplanned pregnancies, reducing the risk of induced abortion; the number one killer of women in the reproductive age in developing countries. Due to its clandestine nature, most abortions in the developing world are unsafe, resulting in a series of complications, the most disastrous being maternal death. Worldwide, approximately 42 million pregnancies are voluntarily terminated, 22 within the national legal system and 20 outside it. The World Health Organization (WHO) estimates that a woman dies every 8 minutes due to complications of unsafe abortions. Even though induced abortion is criminalized in Sri Lanka except to save the mother’s life, about 700 abortions are performed daily, accounting for the second leading cause of maternal deaths in 2006, 2008 and 2010. According to Demographic and Health Survey (DHS) 2006/7, 17.2% of births in previous 5 years were unplanned or unwanted. It has been revealed that, 73% among 365 abortion seekers had unmet need for family planning. The economic burden of induced abortion is unbearable to the state and the total cost for management of complications of an abortion has been estimated to be 462 US $, of which 79% is spent by government health expenditure.