Factors Affecting Unmet Need for Family Planning in Bhutan: Evidence from the 2010 Bhutan Multiple Indicator Survey

by Yeshey Wangmo, Master of Arts in Demography (June 2013)

This study aims to determine the effect of selected variables on the unmet need for family planning (FP) of currently married women of reproductive age in Bhutan. Unmet need for FP refers to the proportion of women who do not want to become pregnant but are not using contraception. Women who want to postpone their next birth but are not using contraception are regarded as having an unmet need for spacing while women who did not want additional children but are not using contraception are considered to have an unmet need for limiting. This study describes the level of unmet need for family planning, the differentials in the need for FP, and the degree to which these factors predict unmet need for FP. The study used data from the Bhutan Multiple Indicator Survey conducted in 2010 by the National Statistics Bureau (NSB). Information from a total of 10,029 currently married women were used for the analysis.

The study adopted the new standard definition of unmet need for FP, which enables more consistent estimates and comparable results across countries and over time. The study provides a more recent estimate of unmet need for FP in Bhutan. Women’s demographic and socio-economic characteristics and their contact with a family planning provider were used as explanatory variables in this study.

Frequency distribution and cross-tabulations were used to determine the pattern of association between the selected background variables and unmet need for FP. Binary logistic regression analysis was used to determine the net effect of the explanatory variables on the unmet need for FP. Five logistic regression models were developed to examine how much of the variation in unmet need for family planning is predicted by each group of explanatory variables.

The total unmet need for FP in Bhutan was estimated at 10.0 percent. The unmet need for limiting was 6.4 percent, while the unmet need for spacing was 3.6 percent. The bivariate analysis revealed a statistically significant association between the dependent and explanatory variables. Compared with their counterparts, unmet need for FP was higher among younger women aged 15–24, women who got married at age 20 or over, those with no living child, rural residents, those from Eastern Bhutan, those with a secondary or higher level of education, the poor or those from the middle socio-economic status, and those who did not visit a health facility.

The multivariate analyses revealed that age, age at marriage, number of living children, region of residence, rich socio-economic status, and contact with a family planning provider are significant predictors of women’s unmet need. Women’s age is inversely related to unmet need for FP. In contrast, women’s age at first marriage and their number of living children is positively related with unmet need. Women residing in Eastern Bhutan are less likely to have unmet need compared to those residing in Western and Central Bhutan. Finally, women who did not visit a health facility are more likely to have unmet need for FP compared to those who visited a health facility and discussed FP and those who visited a health facility but did not discuss FP.