Unmet need is a central concept in family planning research and a key indicator for
programmatic interventions. Demographic and Health Surveys, the largest source of data on
contraceptive patterns in developing countries, compute unmet need based on responses to 18
questions included throughout the interview. This study reports on the results from a novel
mixed-methods follow-up study nested within the 2014 Ghana DHS. Women in 13 clusters who
were identified as having an unmet need, along with a sub-sample of current users, were
approached to be re-interviewed (RR=92%). Results show substantial underreporting of
traditional method use. Among women who confirmed they were not using family planning, fear
of side effects, personal or partner opposition, ambivalence about reproductive intentions, and
abstinence emerged as key themes. In several cases, revised fertility intentions would have
affected unmet need classification. Aversion to modern method use was generally more
substantial than reported to DHS.