Pub Date : 2025-12-01Epub Date: 2025-06-09DOI: 10.1111/sifp.70022
Christine Dehlendorf, Shashi Sarnaik, April J Bell, Alyssa Lindsey, Jamie Hart, Sheila Desai, Bilgissou Balde, Christine Galavotti, Ewenat Gebrehanna, Jennifer Hall, Renu Khanna, Anne Philpott, Lore Remmerie, Niranjan Saggurti, Zeba A Sathar, Miranda van Reeuwijk, Vicky Boydell
The well-being of individuals and communities is increasingly recognized as a core objective of economic and global development policies and programs. However, existing measures of well-being neglect sexual and reproductive experiences, which are core dimensions of people's lives. While there has been increasing attention to the concept of sexual well-being, measures of sexual and reproductive health are predominantly deficit-based and ignore whether people are having positive experiences. To consider the development of a measure of sexual and reproductive well-being, a multidisciplinary and geographically diverse group of experts was convened. Outcomes of this meeting included endorsement of a draft definition of sexual and reproductive well-being, demonstrated enthusiasm and commitment to the development of a measure capturing this construct, and delineation of core considerations in the measure development process. These included considering the diversity of normative and political contexts around sexuality and reproduction, and the critical nature of meaningful community engagement when developing this measure. A pathway for measuring development was defined, with the goal of creating a concise measure assessing people's holistic experiences of sexuality and reproduction that can draw attention to and monitor the extent to which people are having the sexual and reproductive lives they wish to have.
{"title":"What About Well-Being? Measuring What We Really Care About in Sexual and Reproductive Health.","authors":"Christine Dehlendorf, Shashi Sarnaik, April J Bell, Alyssa Lindsey, Jamie Hart, Sheila Desai, Bilgissou Balde, Christine Galavotti, Ewenat Gebrehanna, Jennifer Hall, Renu Khanna, Anne Philpott, Lore Remmerie, Niranjan Saggurti, Zeba A Sathar, Miranda van Reeuwijk, Vicky Boydell","doi":"10.1111/sifp.70022","DOIUrl":"10.1111/sifp.70022","url":null,"abstract":"<p><p>The well-being of individuals and communities is increasingly recognized as a core objective of economic and global development policies and programs. However, existing measures of well-being neglect sexual and reproductive experiences, which are core dimensions of people's lives. While there has been increasing attention to the concept of sexual well-being, measures of sexual and reproductive health are predominantly deficit-based and ignore whether people are having positive experiences. To consider the development of a measure of sexual and reproductive well-being, a multidisciplinary and geographically diverse group of experts was convened. Outcomes of this meeting included endorsement of a draft definition of sexual and reproductive well-being, demonstrated enthusiasm and commitment to the development of a measure capturing this construct, and delineation of core considerations in the measure development process. These included considering the diversity of normative and political contexts around sexuality and reproduction, and the critical nature of meaningful community engagement when developing this measure. A pathway for measuring development was defined, with the goal of creating a concise measure assessing people's holistic experiences of sexuality and reproduction that can draw attention to and monitor the extent to which people are having the sexual and reproductive lives they wish to have.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"703-714"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12700127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yingyi Lin, Emily Smith‐Greenaway, Camila Cortes Rodriguez, Shelley Clark
High levels of premarital childbearing in Africa have spurred considerable interest in its consequences for women. Premarital childbearing corresponds with women's poor health, as well as their subsequent life course outcomes, including their marriage timing and quality. However, this work has not considered the survival of women's premaritally born children, leaving unclear what happens to unmarried mothers when their children do not survive. In this paper, we ask how infant death affects unmarried mothers’ subsequent life course outcomes. We analyze recent Demographic and Health Survey data from 26 countries to examine the marital outcomes of unmarried mothers—differentiating between those whose firstborn survived infancy and those whose child did not. We find that, although premarital childbearing is generally known to correspond with marriage disadvantages, unwed mothers whose premarital births ended in the death of an infant have distinctive marital trajectories and experiences compared to their peers with a surviving child. Although child loss accelerates unmarried mothers’ entry into marriages, these bereaved mothers are more likely to marry less educated, polygynous, and violent husbands, especially among younger birth cohorts. The results demonstrate the double disadvantages unmarried women face in both bearing and losing a child.
{"title":"From Birth to Death: The Marital Consequences of Child Loss for Unmarried Mothers","authors":"Yingyi Lin, Emily Smith‐Greenaway, Camila Cortes Rodriguez, Shelley Clark","doi":"10.1111/sifp.70041","DOIUrl":"https://doi.org/10.1111/sifp.70041","url":null,"abstract":"High levels of premarital childbearing in Africa have spurred considerable interest in its consequences for women. Premarital childbearing corresponds with women's poor health, as well as their subsequent life course outcomes, including their marriage timing and quality. However, this work has not considered the survival of women's premaritally born children, leaving unclear what happens to unmarried mothers when their children do not survive. In this paper, we ask how infant death affects unmarried mothers’ subsequent life course outcomes. We analyze recent Demographic and Health Survey data from 26 countries to examine the marital outcomes of unmarried mothers—differentiating between those whose firstborn survived infancy and those whose child did not. We find that, although premarital childbearing is generally known to correspond with marriage disadvantages, unwed mothers whose premarital births ended in the death of an infant have distinctive marital trajectories and experiences compared to their peers with a surviving child. Although child loss accelerates unmarried mothers’ entry into marriages, these bereaved mothers are more likely to marry less educated, polygynous, and violent husbands, especially among younger birth cohorts. The results demonstrate the double disadvantages unmarried women face in both bearing and losing a child.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In Pakistan, cultural taboos around reproductive health fuel persistent myths about oral contraceptives (OCs), limiting women's empowerment and informed decision‐making. While misconceptions affect several contraceptive methods, OCs face particular mistrust, with use far below global averages. Five widespread myths dominate public perception: that OCs cause permanent infertility, cardiovascular disease, birth defects, weight gain, and are religiously forbidden. Scientific evidence consistently disproves these claims. OC use does not impair long‐term fertility, offers some cardiovascular benefits, and does not cause congenital anomalies or permanent weight gain. Additionally, Islamic teachings—supported by respected fatwas (Islamic legal rulings)—permit family planning to safeguard maternal and child health. Yet, contraceptive prevalence remains low in Pakistan, with only 34% of married women using any method. Early pregnancies, short birth intervals, and inadequate reproductive knowledge contribute to high maternal and neonatal mortality. Misunderstanding persists, with many women misinformed or influenced by social narratives rather than evidence. Healthcare professionals, together with educators, community leaders, and religious scholars, play a crucial role in counselling and dispelling myths. Promoting dialogue and evidence‐based guidance can challenge harmful beliefs. Correcting these misconceptions is both a public health priority and a societal responsibility toward healthier families and empowered women.
{"title":"Dispelling Myths and Empowering Women: The Truth About Oral Contraceptives in Pakistan","authors":"Muhammad Burhan, Jalib Ahmed","doi":"10.1111/sifp.70042","DOIUrl":"https://doi.org/10.1111/sifp.70042","url":null,"abstract":"In Pakistan, cultural taboos around reproductive health fuel persistent myths about oral contraceptives (OCs), limiting women's empowerment and informed decision‐making. While misconceptions affect several contraceptive methods, OCs face particular mistrust, with use far below global averages. Five widespread myths dominate public perception: that OCs cause permanent infertility, cardiovascular disease, birth defects, weight gain, and are religiously forbidden. Scientific evidence consistently disproves these claims. OC use does not impair long‐term fertility, offers some cardiovascular benefits, and does not cause congenital anomalies or permanent weight gain. Additionally, Islamic teachings—supported by respected fatwas (Islamic legal rulings)—permit family planning to safeguard maternal and child health. Yet, contraceptive prevalence remains low in Pakistan, with only 34% of married women using any method. Early pregnancies, short birth intervals, and inadequate reproductive knowledge contribute to high maternal and neonatal mortality. Misunderstanding persists, with many women misinformed or influenced by social narratives rather than evidence. Healthcare professionals, together with educators, community leaders, and religious scholars, play a crucial role in counselling and dispelling myths. Promoting dialogue and evidence‐based guidance can challenge harmful beliefs. Correcting these misconceptions is both a public health priority and a societal responsibility toward healthier families and empowered women.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"18 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brooke W Bullington,Katherine Tumlinson,Leigh Senderowicz,Joanna Maselko,Kavita Shah Arora,Jessie K Edwards,Audrey Pettifor
Family planning programs in the Global South promote long-acting reversible contraception (LARC), but research suggests that women face barriers to LARC discontinuation, inhibiting their reproductive autonomy. Scholars have called for improved data visibility around LARC removal access. We use data from the Postpartum Intrauterine Device (PPIUD) Study, a randomized trial of a PPIUD intervention conducted in Nepal, Sri Lanka, and Tanzania from 2015 to 2018. Among women who adopted PPIUDs, we describe PPIUD status (in-use, expelled, deliberately removed) at three follow-up points. We report the proportion of participants who sought PPIUD removal and, among those, whether they faced barriers to removal. About three-quarters of 5370 participants had their PPIUD in use 18 months following insertion; one-fifth had their PPIUD deliberately removed, and 6 percent had their PPIUD expelled. Of the 22 percent of participants who sought PPIUD removal, a quarter faced a barrier to removal; most barriers were provider-imposed. In conjunction with existing literature, our findings highlight that barriers to LARC removal are structural, rooted in larger public health and demographic goals that aim to promote contraceptive uptake. We call for safeguards to ensure that people who desire LARC removal can discontinue their method.
{"title":"Postpartum Intrauterine Device Removal and Access to Removal in the 18 Months Following an Intervention in Tanzania, Sri Lanka, and Nepal.","authors":"Brooke W Bullington,Katherine Tumlinson,Leigh Senderowicz,Joanna Maselko,Kavita Shah Arora,Jessie K Edwards,Audrey Pettifor","doi":"10.1111/sifp.70038","DOIUrl":"https://doi.org/10.1111/sifp.70038","url":null,"abstract":"Family planning programs in the Global South promote long-acting reversible contraception (LARC), but research suggests that women face barriers to LARC discontinuation, inhibiting their reproductive autonomy. Scholars have called for improved data visibility around LARC removal access. We use data from the Postpartum Intrauterine Device (PPIUD) Study, a randomized trial of a PPIUD intervention conducted in Nepal, Sri Lanka, and Tanzania from 2015 to 2018. Among women who adopted PPIUDs, we describe PPIUD status (in-use, expelled, deliberately removed) at three follow-up points. We report the proportion of participants who sought PPIUD removal and, among those, whether they faced barriers to removal. About three-quarters of 5370 participants had their PPIUD in use 18 months following insertion; one-fifth had their PPIUD deliberately removed, and 6 percent had their PPIUD expelled. Of the 22 percent of participants who sought PPIUD removal, a quarter faced a barrier to removal; most barriers were provider-imposed. In conjunction with existing literature, our findings highlight that barriers to LARC removal are structural, rooted in larger public health and demographic goals that aim to promote contraceptive uptake. We call for safeguards to ensure that people who desire LARC removal can discontinue their method.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"12 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Every two years, the United Nations publishes World Contraceptive Use, a harmonized data compilation of survey-based estimates of contraceptive use by method, age, and marital status. These data are used by the United Nations for the global monitoring of the progress towards achieving internationally agreed goals, including Sustainable Development Goal 3, and are aimed as a resource for policymakers, advocates, and researchers. The goal of the data compilation is to include estimates of contraceptive use from any nationally representative survey carried out in countries and areas of the world since 1950. As of the 2024 revision, World Contraceptive Use contains 1464 survey estimates from 200 countries or areas between 1950 and 2023. This article describes briefly how the data are compiled and processed, the breadth and scope of their coverage, and presents some examples of how this rich and unique global data source can be used to glean insights about contraceptive use worldwide.
{"title":"World Contraceptive Use: A Global Compilation of Survey-Based Estimates on Contraceptive Use by Method, Age, and Marital Status.","authors":"Joseph Molitoris,Vladimíra Kantorová","doi":"10.1111/sifp.70039","DOIUrl":"https://doi.org/10.1111/sifp.70039","url":null,"abstract":"Every two years, the United Nations publishes World Contraceptive Use, a harmonized data compilation of survey-based estimates of contraceptive use by method, age, and marital status. These data are used by the United Nations for the global monitoring of the progress towards achieving internationally agreed goals, including Sustainable Development Goal 3, and are aimed as a resource for policymakers, advocates, and researchers. The goal of the data compilation is to include estimates of contraceptive use from any nationally representative survey carried out in countries and areas of the world since 1950. As of the 2024 revision, World Contraceptive Use contains 1464 survey estimates from 200 countries or areas between 1950 and 2023. This article describes briefly how the data are compiled and processed, the breadth and scope of their coverage, and presents some examples of how this rich and unique global data source can be used to glean insights about contraceptive use worldwide.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"23 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study examines changes in women's attitudes toward abortion in Brazil during the first year of the COVID‐19 pandemic, focusing on the role of religious affiliation. Brazil provides a unique context for examining abortion attitudes because of its strict abortion policies, changing religious landscape, and back‐to‐back Zika and COVID‐19 crises. We used data from a population‐based sample of 2335 women ages 18–34 in Pernambuco, Brazil, collected during the onset of the COVID‐19 pandemic (May–September 2020) and one year later (May–September 2021). Multivariable‐adjusted multinomial logistic regression models were used to assess changes in support for abortion in cases of maternal Zika or COVID‐19 infection during pregnancy. Women were less supportive of abortion in the case of maternal COVID‐19 infection (34 percent) compared to Zika infection (41 percent). About half of the women changed their abortion attitudes during the year. Pentecostal Evangelicals were more likely to decrease support, while nonreligious women or those with less conservative affiliations were more likely to increase support. Greater worry about Zika and COVID‐19 was associated with higher support for abortion. The study highlights the dynamic nature of abortion attitudes, which should be considered when forming policies, especially during crises.
{"title":"Evidence of Abortion Attitude Flexibility during COVID‐19 in Pernambuco, Brazil","authors":"Brooke Whitfield, Raquel Zanatta Coutinho, Leticia Marteleto","doi":"10.1111/sifp.70037","DOIUrl":"https://doi.org/10.1111/sifp.70037","url":null,"abstract":"This study examines changes in women's attitudes toward abortion in Brazil during the first year of the COVID‐19 pandemic, focusing on the role of religious affiliation. Brazil provides a unique context for examining abortion attitudes because of its strict abortion policies, changing religious landscape, and back‐to‐back Zika and COVID‐19 crises. We used data from a population‐based sample of 2335 women ages 18–34 in Pernambuco, Brazil, collected during the onset of the COVID‐19 pandemic (May–September 2020) and one year later (May–September 2021). Multivariable‐adjusted multinomial logistic regression models were used to assess changes in support for abortion in cases of maternal Zika or COVID‐19 infection during pregnancy. Women were less supportive of abortion in the case of maternal COVID‐19 infection (34 percent) compared to Zika infection (41 percent). About half of the women changed their abortion attitudes during the year. Pentecostal Evangelicals were more likely to decrease support, while nonreligious women or those with less conservative affiliations were more likely to increase support. Greater worry about Zika and COVID‐19 was associated with higher support for abortion. The study highlights the dynamic nature of abortion attitudes, which should be considered when forming policies, especially during crises.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"97 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145188357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To fill a gap in measures of empowered contraceptive decision-making, we developed the Agency in Contraceptive Decisions Scale in Uganda and Nigeria. We developed an item pool drawing on the previously published Contraceptive Agency framework. We refined items through cognitive interviews (N = 80) and expert feedback and piloted a reduced item pool via surveys (N = 3002). Exploratory factor analysis using a random half of the sample suggested a 15-item scale (Cronbach's α = 0.8) including four subscales: (1) Beliefs about Rights and Perceived Decision-making Control (α = 0.8), (2) Decision-making Self-efficacy (α = 0.8), (3) Knowledge Aligned with Preferences (α = 0.8), and (4) Control over Use or Non-use (α = 0.8). Confirmatory factor analysis with the other half of the sample supported this solution. Agency in Contraceptive Decisions Scale scores were significantly associated with scores on the contraceptive existence of choice and contraceptive exercise of choice subscales of the Women's and Girls Empowerment in Sexual and Reproductive Health Index, supporting construct validity. The 15-item Agency in Contraceptive Decisions Scale and individual subscales are valid and reliable for use in Nigeria and Uganda. This measure offers an innovative alternative for gauging the success of contraceptive programs and policies in advancing the right to empowered choices.
{"title":"Development and Validation of the Agency in Contraceptive Decisions Scale in Uganda and Nigeria.","authors":"Sneha Challa,Ushma D Upadhyay,Ronald Wasswa,Sylvia Nanono,Ivan Idiodi,Chioma Okoli,Phoebe Alitubeera,Dinah Amongin,Ayobambo Jegede,Aminat Tijani,Catherine Birabwa,Lynn Atuyambe,Shakede Dimowo,Grace Nmadu,Christine Dehlendorf,Elizabeth Omoluabi,Peter Waiswa,Kelsey Holt","doi":"10.1111/sifp.70033","DOIUrl":"https://doi.org/10.1111/sifp.70033","url":null,"abstract":"To fill a gap in measures of empowered contraceptive decision-making, we developed the Agency in Contraceptive Decisions Scale in Uganda and Nigeria. We developed an item pool drawing on the previously published Contraceptive Agency framework. We refined items through cognitive interviews (N = 80) and expert feedback and piloted a reduced item pool via surveys (N = 3002). Exploratory factor analysis using a random half of the sample suggested a 15-item scale (Cronbach's α = 0.8) including four subscales: (1) Beliefs about Rights and Perceived Decision-making Control (α = 0.8), (2) Decision-making Self-efficacy (α = 0.8), (3) Knowledge Aligned with Preferences (α = 0.8), and (4) Control over Use or Non-use (α = 0.8). Confirmatory factor analysis with the other half of the sample supported this solution. Agency in Contraceptive Decisions Scale scores were significantly associated with scores on the contraceptive existence of choice and contraceptive exercise of choice subscales of the Women's and Girls Empowerment in Sexual and Reproductive Health Index, supporting construct validity. The 15-item Agency in Contraceptive Decisions Scale and individual subscales are valid and reliable for use in Nigeria and Uganda. This measure offers an innovative alternative for gauging the success of contraceptive programs and policies in advancing the right to empowered choices.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"82 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145116741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jewel Gausman,Niranjan Saggurti,Richard Adanu,Delia A B Bandoh,Mabel Berrueta,Suchandrima Chakraborty,Ernest Kenu,Nizamuddin Khan,Ana Langer,Nigri Carolina,Magdalene A Odikro,Veronica Pingray,Sowmya Ramesh,Paula Vázquez,Caitlin R Williams,R Rima Jolivet
Unwanted family planning often refers to fertility desires as a proxy for contraceptive desire and lacks alignment with the tenets of person-centered care. We construct a person-centered measure of unwanted family planning by asking women whether they wanted to use a method, examine its alignment with the fertility-derived measure, and describe the characteristics of women with unwanted family planning and reasons women state for not wanting to use a method. We conducted a cross-sectional study of women aged 15-49 in Argentina, Ghana, and India. Data were collected on stated desire to use contraception and basic sociodemographic characteristics. Fertility desire was collected using the standard Demographic and Health Survey questionnaire. In total, 4794 women were included in our study. Among women using a method, 2.5 percent (n = 53) of women had unwanted family planning, with 4.2 percent in Ghana, 2.2 percent in Argentina, and 2.0 percent in India. Most unwanted family planning (85.2 percent, n = 23) occurred among women who did not want a child within the next nine months. Sexual infrequency was the most common reason behind a lack of desire to use a method. Our results highlight the substantial differences found between classifying women's contraceptive needs from a person-centered versus a fertility-derived approach.
{"title":"[Un]met Need and [Un]wanted Family Planning: A Cross-Sectional Study Among Women in Argentina, Ghana, and India Examining Characteristics, Reasons, and Alignment With Fertility Desires.","authors":"Jewel Gausman,Niranjan Saggurti,Richard Adanu,Delia A B Bandoh,Mabel Berrueta,Suchandrima Chakraborty,Ernest Kenu,Nizamuddin Khan,Ana Langer,Nigri Carolina,Magdalene A Odikro,Veronica Pingray,Sowmya Ramesh,Paula Vázquez,Caitlin R Williams,R Rima Jolivet","doi":"10.1111/sifp.70035","DOIUrl":"https://doi.org/10.1111/sifp.70035","url":null,"abstract":"Unwanted family planning often refers to fertility desires as a proxy for contraceptive desire and lacks alignment with the tenets of person-centered care. We construct a person-centered measure of unwanted family planning by asking women whether they wanted to use a method, examine its alignment with the fertility-derived measure, and describe the characteristics of women with unwanted family planning and reasons women state for not wanting to use a method. We conducted a cross-sectional study of women aged 15-49 in Argentina, Ghana, and India. Data were collected on stated desire to use contraception and basic sociodemographic characteristics. Fertility desire was collected using the standard Demographic and Health Survey questionnaire. In total, 4794 women were included in our study. Among women using a method, 2.5 percent (n = 53) of women had unwanted family planning, with 4.2 percent in Ghana, 2.2 percent in Argentina, and 2.0 percent in India. Most unwanted family planning (85.2 percent, n = 23) occurred among women who did not want a child within the next nine months. Sexual infrequency was the most common reason behind a lack of desire to use a method. Our results highlight the substantial differences found between classifying women's contraceptive needs from a person-centered versus a fertility-derived approach.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"72 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite the growing interest in person-centered measures for family planning and the importance of reproductive preferences, little is known about the measurement of contraceptive preferences. Population surveys have implicitly assumed that contracepting people have achieved their method of choice. In this scoping review, we explored how contraceptive method preferences have been defined and measured in different settings. We included 55 articles focused on measuring people's preferred method of contraception or preferred attributes of contraception. Thirty-seven articles were conducted in high-income countries (HIC), five in upper-middle-income countries (UMIC), and thirteen in low- and middle-income countries (LMIC). Sixteen articles measured preferences for specific methods of contraception, 36 measured the preferred attributes of contraceptive methods, and three implemented both approaches. Four articles used consistent language to measure the preferred method of contraception, although many used synonyms of "preferences," and some constrained their questions to method availability or cost. The measurement of preferred attributes of contraception varied across articles, even within similar contexts and populations. Key attributes included side effects, effectiveness, and cost. Our results highlight the increasing interest in understanding contraceptive preferences, but gaps remain in developing best practices. This is critical as the family planning field moves toward person-centered metrics that emphasize individual choice.
{"title":"How Do We Measure Contraceptive Method Preferences? Evidence From a Scoping Review.","authors":"Carolina Cardona,Jamila Asker,Emily Sanchez,Philip Anglewicz","doi":"10.1111/sifp.70034","DOIUrl":"https://doi.org/10.1111/sifp.70034","url":null,"abstract":"Despite the growing interest in person-centered measures for family planning and the importance of reproductive preferences, little is known about the measurement of contraceptive preferences. Population surveys have implicitly assumed that contracepting people have achieved their method of choice. In this scoping review, we explored how contraceptive method preferences have been defined and measured in different settings. We included 55 articles focused on measuring people's preferred method of contraception or preferred attributes of contraception. Thirty-seven articles were conducted in high-income countries (HIC), five in upper-middle-income countries (UMIC), and thirteen in low- and middle-income countries (LMIC). Sixteen articles measured preferences for specific methods of contraception, 36 measured the preferred attributes of contraceptive methods, and three implemented both approaches. Four articles used consistent language to measure the preferred method of contraception, although many used synonyms of \"preferences,\" and some constrained their questions to method availability or cost. The measurement of preferred attributes of contraception varied across articles, even within similar contexts and populations. Key attributes included side effects, effectiveness, and cost. Our results highlight the increasing interest in understanding contraceptive preferences, but gaps remain in developing best practices. This is critical as the family planning field moves toward person-centered metrics that emphasize individual choice.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"15 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yingyi Lin,Marita Zimmermann,Anu Mishra,Michelle L O'Brien
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.
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