Unmet need for contraception in Kuwait: issues for health care providers

Based on a nationally representive household survey of Kuwaiti women held in 1999 (n=1502) unmet need for contraception was analyzed in Kuwait, an oil-rich Muslim country. It was found that 9.7% currently married women had an unmet need for contraception. Of those, 6.1% wanted to stop child bearing, while 3.6% wanted to space their children. A bivariate comparison of the women with unmet need and current contraceptors showed that the unmet need group comprised of relatively older women with a significantly higher level of parity and ones where husband or wife disapproved of contraception. Also, larger percentages of the unmet need group belonged to relatively lower socio-economic status and were Bedouins. Among the reasons for current non-use, two-third believed that they had a low risk of pregnancy due to infrequent sexual activity or sub-fecundity, and 22% were not using a method because of health concerns. A significantly larger percentage of the unmet need group disapproved of contraception, and believed that Islam forbids family planning, compared to current users (30% and 15%, respectively). The logistic regression analysis showed that the wife's perception of the husband's disapproval of contraceptive use had the strongest negative association with unmet need. We conclude that the contraceptive needs of about 90% of all non-pregnant currently married women who wanted to delay or limit children were being met adequately despite the absence of a formal family planning program, while about 10% women had an unmet need. Issues for health care providers are discussed and family planning counseling is recommended for higher risk older women with unmet need.