**5. Conclusion**

need for family planning in the studied countries particularly Guinea and the Gambia may require more urgent attention to accelerate pace of reduction in the countries. Bearing in mind that most women of advanced reproductive age in West Africa are high parous women [48, 50], it is important to devise specific programmes to target women in advanced age group by providing expanded counselling and services that addresses their peculiar contraceptive concerns. Such programmes should extensively use the mass media, particularly newspapers, to provide needed information. Two, the study found that gender norms affected the level of unmet need for family planning in all the countries. In virtually all West African countries, men still play dominant roles in women's reproductive health despite increasing attention on gender equity and the implementation of several women-focused social programmes across the region. The key challenge, however, has remained how to effectively alter the balance of power between men and women within households and communities. In this regard, behaviour change communication (BCC) programmes have been developed in all the studied countries [59]. While it is important to sustain the BCC programmes, it is also necessary to scale up the promotion of men's method in West Africa since research has provided sufficient evidence that many men will use modern methods of contraception if they have appropriate information and counselling [65, 66]. This may likely reduce the extent of unmet contraceptive need

112 Family Planning

by reducing the risk of unintended pregnancy and fertility among women.

grammes for urban women of advanced reproductive age.

Three, men's desire for fewer children reduces likelihood of unmet contraceptive need in urban West Africa. In many parts of the world, surveys have shown that men often desire more children than women [65, 66]. This further buttress continued need for male involvement in women's reproductive health particularly in the use of contraceptive. It is not likely that unmet contraceptive need among women in West Africa will substantially reduce without change in men's desire for more children. Governments and family planning providers in West Africa have onerous responsibility of helping more men not only to support or approve partners use of modern contraceptives, but also for men to take the lead in use of modern contraceptives. This may be achieved by developing family planning programmes that presents use of contraceptives as one of men's key responsibility to their partners. In addition, such programmes could provide information detailing how traditional gender roles can adversely affect women's sexual and reproductive health. Four, child death experience impact unmet contraceptive need among urban women of advanced reproductive age in West Africa. In virtually every part of West Africa, children have strong cultural relevance. Births are highly celebrated, and childlessness is not accepted in most communities. Hence, the event of death of a child is viewed as a serious tragedy for individuals, couples and communities. In the event of a child death, women are mostly encouraged to have replacement except such women have been declared infecund. Such practice often elevates the risk of many women of advanced reproductive age. However, this practice and its associated risk could be addressed by taken more actions to ensure child survival in West Africa. Five, community contexts have effects on the extent of unmet contraceptive need among urban women of advanced reproductive age. In several communities, women usually have similar perception and attitude towards issues of childbearing. In many instances, women tend to compare experiences and reacts in like manners. This provides basis for more community-based family planning programmes across West Africa. However, it is important to consider developing specific community-based proThis chapter examined drivers of unmet need for family planning among urban women of advanced reproductive age. Though, the chapter analysed a cross-sectional data which usually limits a cause-effect relationship between variables, nonetheless, the analyses provided sufficient empirical associations between the research variables. Individual and community factors are important for explaining variations in unmet contraceptive need among urban women of advanced reproductive age. The key drivers are gender norms that justify men's control over women, partner education, fertility desire, child mortality, age at first marriage, community literacy level, community wealth level, community childcare burden and exposure to mass media family planning messages. The development of interventions to specifically target women of advanced reproductive age is imperative in urban West Africa.
