Context: Unmet need for family planning in the developing world, as measured through surveys, is high. But it is important to determine whether there is a significant level of dormant demand for actual contraceptive services waiting to be satisfied, especially in a country such as Pakistan, where efforts to promote family planning have been disappointing. Methods: Records from six household contraceptive distribution projects in Pakistan are used to determine contraceptive prevalence over 13-22-month periods. An independent professional team conducted an external evaluation, interviewing project supervisors, fieldworkers and clients. Results: Contraceptive use increased dramatically in all six projects, from an average of 12% to 39% in less than two years. The external evaluation team found the contraceptive prevalence measurements to be generally accurate, but identified additional improvements in access and quality that might further increase contraceptive use. Conclusions: Increased use of contraceptives that result from improvements in service delivery confirm that a substantial unmet need exists. The evidence suggests that even greater improvements in access to and quality of services will further increase contraceptive use.

No abstract