Unmet need for family planning and fertility in Nepal: Levels, trends and determinants.

Research Report.

ABSTRACT: This study examined the levels, trends, socioeconomic determinants of and changes in the unmet need, demand for family planning, and demand satisfied for family planning using the pooled NDHS 2006 and 2016 data as a part of the further analysis of the follow-up to the 2016 NDHS. This study also explores changes in the total fertility rate through the proximate determinants of fertility, with the addition of a spousal separation index to take into account Nepal's high level of migration. The analysis reveals that unmet need in Nepal has declined from 24.7% in 2006 to 23.7% in 2016. During that time, demand for modern family planning satisfied decreased from 61% to 56%, a scenario the reverse of the one expected. This may be attributable to the poor commodity supply and limited method choices across the country. Differences in unmet need and demand for family planning satisfaction were clearly evident among subgroups of population classified by age, education, wealth quintile, and child loss experience among women. Spousal separation was found to be the most important proximate determinants to explain the decline in fertility observed between 2006 and 2016. This was followed by changing marriage pattern, abortion, and contraception. Increased family planning commodity supply and services, intended to increase access to family planning methods and user choices, may improve the unmet need situation in Nepal, which ultimately may contribute to further decline in fertility in the country. KEY WORDS: Proximate determinants, unmet need, demand for family planning, demand for family planning satisfied, contraceptives, fertility