# Unmet needs for non-communicable diseases and sexual and reproductive health services among women of reproductive age in low-and-middle-income countries: evidence from the Demographic and Health Surveys

## TL;DR

This study finds that many women in low- and middle-income countries lack access to essential health services for non-communicable diseases and reproductive health.

## Contribution

The study provides new evidence on unmet health needs using recent demographic and health survey data from six countries.

## Key findings

- Unmet needs for cervical cancer screening were extremely high at 98.5%.
- India had the lowest unmet needs for reproductive health services compared to other countries.
- Socioeconomic factors significantly influence access to health services, with employed women showing mixed patterns of unmet needs.

## Abstract

Despite international efforts to address women’s long-term health and well-being, significant gaps in sexual and reproductive health (SRH) services and non-communicable diseases (NCDs) prevention remain, particularly in low-and-middle-income countries (LMICs).

We analysed data from 726 278 women aged 15–49 from six national surveys (2017–2021, Benin, Cameroon, Gabon, India, Madagascar and Mauritania) on unmet needs for NCD prevention (blood pressure, glucose, cervical cancer screening) and SRH services (contraception, antenatal, postnatal care). Unmet needs prevalence was calculated as the percentage of participants with specific unmet needs and estimated across demographics and socioeconomic groups using multivariable logistic regression models.

Unmet needs were strikingly high for NCD prevention: 36.6% for blood pressure, 70.0% for blood glucose and 98.5% for cervical cancer screening. In contrast, unmet needs for contraception, antenatal care and postnatal care were relatively lower: 7.5%, 14.5% and 14.5%, respectively. Significant variations were observed across countries. India had the lowest unmet needs for SRH services: 6.7% for contraception, 13.1% for antenatal care and 13.1% for postnatal care. Gabon had lower unmet needs for prenatal (16.8%) and postnatal care (14.8%) compared with other African countries and the lowest unmet need for cervical screening at 84.7% (95% confidential interval 83.1% to 86.2%), over 10 percentage points lower than others. Furthermore, socioeconomic factors like higher education, better economic status, healthcare access, insurance and internet use significantly lowered unmet needs, especially for antenatal and postnatal care. Employed women had higher unmet needs for antenatal (35.7%) and postnatal (37.3%) care than unemployed women (28.1%, 27.8%) but lower for NCDs prevention (98.9%, 71.8%) under two definitions than unemployed women (99.3%, 79.2%).

This study highlights the urgent need to address high unmet needs for NCD prevention among women in LMICs, particularly cervical cancer screening. Unmet SRH needs are also a major concern, given significant disparities across countries. Especially, governments should prioritise measures to focus on vulnerable groups.