Standard measures used to assess family planning (FP) program success, including unmet need and demand satisfied, fail to capture women's, men's, couples', and adolescents' own expressed preferences, needs, wants, and desires. Identification is needed of person-centered fertility and FP measures that assess what individuals want, desire, need, and prefer without a researcher-ascribed value of what is the right outcome. This scoping review examines how the concept of person-centeredness has been employed as part of population-based FP measurement. For this review, we defined measures as person-centered if they assess directly a person's preferences, wants, and desires while at the same time assessing if the person can or wants to meet those preferences, wants, and desires. The review finds several studies that use or adapt standard measures of intention to use contraception and unmet need; however, a smaller number develop novel approaches that capture method preferences and satisfaction with methods to better capture individuals' needs, wants, and desires as well as their ability to attain these needs, wants, and desires. Results are used to make recommendations going forward for the design and testing of improved person-centered FP measurement at the global, national, and programmatic levels.
In the 30 years since the 1994 International Conference on Population and Development, there is no clear consensus on how to best measure population-level contraceptive use and family planning program impact. Widely used metrics have evolved relatively slowly, and some have run counter to a rights-based and person-centered approach that emphasizes individuals' self-identified contraceptive preferences. In this report, we describe the utilization of an understudied family planning measure-women's expressed intent to use (ITU) contraceptives within the next year-and explore its implications for population-level standardized comparisons and family planning programs using the Performance Monitoring for Action program data in 10 low- and middle-income geographies. Specifically, we assess the extent to which ITU captures women's near-term contraceptive needs and how it differs from the traditional demand measure of "unmet need." Building off the "demand satisfied" indicator-which itself is derived from the concept of "unmet need," we propose a new person-centered metric, "intent satisfied," to provide point estimates of population-level contraceptive use that more closely align with women's stated needs. We also discuss the limitations of the "intent satisfied" metric, making recommendations for data efforts to improve and include ITU as a routinely reported family planning indicator.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：