Nonuse of contraceptive methods by women in need of contraception may impact their sexual and reproductive health. The aim of this study was to describe the reasons for nonuse of contraception among women with demand for contraception not satisfied in low and middle-income countries (considering both overall countries and various subgroups of women). We used the latest Demographic and Health Survey data from 47 countries. A descriptive analysis of the reasons for nonuse of contraceptive methods was performed among sexually active women with demand for contraception not satisfied. The prevalence of each reported reason was also evaluated according to marital status, woman’s age and schooling, area of residence, wealth index, and parity. Wealth-related absolute inequality for each reason was also evaluated using the Slope Index of Inequality. A pro-rich inequality pattern means that the reason is more prevalent among the richest women while a pro-poor means the reason is more common among the poorest ones. On average, 40.9% of women in need of contraception were not using any contraceptive methods to avoid pregnancy. Overall, the most prevalent reasons for nonuse of contraceptives were “health concerns” and “infrequent sex,” but the prevalence of each reason varied substantially across countries. Nonuse due to “opposition from others” was higher among married than unmarried women; in turn, the prevalence of nonuse due to “lack of access” or “lack of knowledge” was about two times higher in rural areas than in urban areas. Women with less schooling more often reported nonuse due to “lack of access.” Pro-rich inequality was detected for reasons “health concerns,” “infrequent sex,” and “method-related”, while the reasons “other opposed,” “fatalistic,” “lack of access,” and “lack of knowledge” were linked to patterns of pro-poor inequality. Family planning promotion policies must take into account the different reasons for the nonuse of contraceptive methods identified in each country as well as the contextual differences regarding women of reproductive age (such as social norms and barriers that prevent women from accessing and using contraceptives).

中文翻译：

---

妇女对避孕要求不使用避孕方法的原因未得到满足：使用人口统计和健康调查对中低收入国家进行评估

需要避孕的妇女不使用避孕方法可能会影响她们的性健康和生殖健康。这项研究的目的是描述低收入和中等收入国家（同时考虑到整个国家和妇女的各个子群体）对避孕的需求没有得到满足的妇女不使用避孕的原因。我们使用了来自47个国家/地区的最新人口统计和健康调查数据。对未满足避孕要求的性活跃妇女进行了描述性分析，分析了不使用避孕方法的原因。还根据婚姻状况，妇女的年龄和受教育程度，居住面积，财富指数和均等来评估每个报告原因的患病率。还使用不平等斜率指数评估了每个原因造成的与财富相关的绝对不平等。富裕者的不平等模式意味着原因在最富有的女性中更为普遍，而贫富者则意味着原因在最贫穷的女性中更为普遍。平均而言，需要避孕的女性中有40.9％没有使用任何避孕方法来避免怀孕。总体而言，不使用避孕药具的最普遍原因是“健康问题”和“不频繁发生性行为”，但是在每个国家，每种原因的患病率差异很大。已婚妇女比未婚妇女由于“来自他人的反对”而导致的不使用率更高；反过来，由于“缺乏获取”或“缺乏知识”，农村地区的不使用率是农村地区的两倍。受教育程度较低的妇女更经常报告由于“缺乏访问权”而没有使用。由于“健康问题”，“不经常性行为，”和“与方法有关”，而“其他人反对”，“致命性”，“缺乏获取”和“缺乏知识”的原因则与扶贫不平等的模式有关。计划生育促进政策必须考虑到每个国家未使用避孕方法的不同原因以及育龄妇女的背景差异（例如社会规范和阻碍妇女获取和使用避孕药具的障碍）。