“Supply‐Side Versus Demand‐Side Unmet Need: Implications for Family Planning Programs”: A Comment

IF 4.6 2区 社会学 Q1 DEMOGRAPHY
Mahesh Karra
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Abstract

I review a study by Senderowicz and Maloney (2022), which proposes an approach to classifying women's reasons for not using contraception as either being driven by supply‐side factors or by a lack of demand. Using Demographic and Health Survey (DHS) data from seven countries, the authors conclude that most unmet need can be attributed to demand‐side reasons for non‐use. I replicate the analysis and find errors in the authors’ calculations. When corrected, the relative differences between demand‐side and supply‐side reasons are smaller, and the proportion of women reporting supply‐side reasons is larger than demand‐side reasons in two countries. In addition, the approach does not account for endogeneity between supply and demand, which cannot be disentangled using cross‐sectional data like the DHS. Using longitudinal data, I find that more than four out of five women with “demand‐side unmet need” use contraception after receiving an intervention that reduced supply‐side barriers. I discuss the extent of inference gained by these indicators for informing programs, noting that women's true reasons for non‐use may be poorly proxied with cross‐sectional data, and prioritizing resources based on these reasons would fail to reach a nontrivial proportion of non‐users who would have preferred to contracept if access were improved.
“供给侧与需求侧未满足需求:计划生育项目的影响”:评论
我回顾了Senderowicz和Maloney(2022)的一项研究,该研究提出了一种方法,将女性不使用避孕措施的原因分类为供给侧因素驱动或缺乏需求驱动。利用来自7个国家的人口与健康调查(DHS)数据,作者得出结论,大多数未满足的需求可归因于不使用的需求方原因。我重复了分析,发现了作者计算中的错误。修正后,需求侧和供给侧原因之间的相对差异较小,在两个国家中,报告供给侧原因的妇女比例大于需求侧原因。此外,该方法没有考虑供给和需求之间的内生性,这不能使用像国土安全部这样的横截面数据来解开。使用纵向数据,我发现超过五分之四的“需求方未满足需求”的妇女在接受减少供给侧障碍的干预后使用避孕措施。我讨论了这些指标为告知项目所获得的推断程度,注意到妇女不使用的真实原因可能无法用横截面数据进行很好的描述,并且基于这些原因对资源进行优先排序将无法达到非用户的重要比例,如果获得改善,这些非用户将更倾向于避孕。
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来源期刊
CiteScore
5.80
自引率
4.00%
发文量
60
期刊介绍: Population and Development Review is essential reading to keep abreast of population studies, research on the interrelationships between population and socioeconomic change, and related thinking on public policy. Its interests span both developed and developing countries, theoretical advances as well as empirical analyses and case studies, a broad range of disciplinary approaches, and concern with historical as well as present-day problems.
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