Dr. Onikepe Owolabi at Foreign Policy Magazine’s Her Power Forum

Transcript: I want to hone in on the concept of need, because need is one of the most critical factors for those of us who work in measuring family planning.  

And why need? Need helps us really think carefully about what we need to provide high-quality family planning services that align with the principles of voluntariness and that really listen to what women want, which I think is something we've heard all the former speakers say.  

Now, for a long time, the family planning field has traditionally defined need based on the number of women who say they want to avoid a pregnancy and are not using a modern contraceptive method. So, those women actually haven't been explicitly asked, "What do you want?" Because we know that wanting to avoid pregnancy doesn't directly translate into wanting to use a method. But because we all know that we need the voices of women in our programs, in these estimates and in collaboration with many of our colleagues, we've moved into defining a much more nuanced measure of need. One that takes account of the fact that women want to prevent pregnancies, but we're now starting to look at the number of women who have explicitly said, "Yes, I would like to use a method or I intend to use one in future."  

And why is this really critical? Understanding and segmenting out this smaller subgroup is very important for policymakers, because when you're trying to prioritize limited investments, this is the right first subgroup to go to with in your national budgets. They want to prevent pregnancies. They've expressed a clear need for it, which doesn't undermine their agency. And so, if you're thinking of the narrowest definition of, "Where should I put my funds as a policymaker?" those are the women you want to target. You're going to get a lot of bang for your buck. It's not going to be wasted.  

Now, having said so, it wouldn't serve us well, as people who respect all women and girls, to just focus on one subgroup, because we know that sometimes need is tied to the context you live in. Your culture, your environment, your stigma.  

And so drawing on our data, we see that adolescent women who express this new nuanced need, which we're calling 'unmet demand', have three times as much unmet demand as all other women of reproductive age. And so when you think of that definition of need, even though some people think that it's very uncomfortable to talk about adolescent access to contraception, this is a group that has expressed a great need for it. And so when governments are thinking of prioritizing investment, you want to find a way to get it into the hands of those people.  

But then I'm going to end by saying something. Sometimes it feels very challenging to reach the last mile. Sometimes we don't even have the services that capture need in the last mile. But when we think of women in humanitarian contexts in Gaza, in Ukraine, in sub-Saharan Africa, we know that they express a strong need for family planning methods. Regardless of what happens, people have sex, but they don't necessarily want to get pregnant. These women are exposed to a greater risk of gender-based violence and sexual violence. And so whilst we think of funneling resources and really getting need to low-hanging fruit, we need to remember that reaching the last mile is absolutely critical and we can't neglect it because it's too hard to do.