Pub Date : 2025-09-01Epub Date: 2025-06-11DOI: 10.1111/sifp.70019
Ilene S Speizer, Elizabeth A Sully, Youmna M Hashem, Maame Araba A Oduro
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.
{"title":"The State of Person-Centered Measurement for Family Planning Need and Use: A Scoping Review.","authors":"Ilene S Speizer, Elizabeth A Sully, Youmna M Hashem, Maame Araba A Oduro","doi":"10.1111/sifp.70019","DOIUrl":"10.1111/sifp.70019","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"403-436"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275918","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}
Pub Date : 2025-09-01Epub Date: 2025-09-11DOI: 10.1111/sifp.70036
Ilene S Speizer, Elizabeth A Sully, Georgina Binstock, Niranjan Saggurti
{"title":"Advancing New Directions for Family Planning Measurement.","authors":"Ilene S Speizer, Elizabeth A Sully, Georgina Binstock, Niranjan Saggurti","doi":"10.1111/sifp.70036","DOIUrl":"10.1111/sifp.70036","url":null,"abstract":"","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"361-371"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041234","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}
Pub Date : 2025-09-01Epub Date: 2025-09-02DOI: 10.1111/sifp.70031
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.
{"title":"Measuring \"Intent Satisfied\": Toward a Person-Centered Metric of Contraceptive Use.","authors":"Yingyi Lin, Marita Zimmermann, Anu Mishra, Michelle L O'Brien","doi":"10.1111/sifp.70031","DOIUrl":"10.1111/sifp.70031","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"511-523"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969701","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}
Jamaica Corker,Ilene S Speizer,Jean Christophe Fotso,Niranjan Saggurti,Elizabeth Sully
The "intention to use" (ITU) contraception indicator has gained recent prominence as a proposed high-level success metric for family planning (FP) programs and as a step toward identifying measures that better capture what women want. Although ITU offers advantages over traditional indicators like contraceptive prevalence and unmet need, its elevation as a key programmatic measure requires critical examination. In this commentary, we outline advantages of ITU to measure FP demand and offer critiques and considerations for reliance on ITU as a demand metric for measuring programmatic success. We argue that while ITU may be a step toward more person-centered measurement, it is not inherently person-centered. Rather than positioning ITU as an innovative person-centered breakthrough, we argue it should be considered a transitional measure-a bridge toward more comprehensive indicators that capture the complexities of contraceptive decision-making. We recognize the current lack of viable alternatives for programs seeking a singular person-centered measure; when used, ITU should be complemented by additional topline indicators that capture access, agency, and preferences. With declining research funding and data infrastructure disruptions, it is important that ITU complement, not replace, efforts to develop the next generation of FP measurement that meaningfully reflects people's contraceptive realities.
{"title":"Intention to Use Contraception: Promises and Pitfalls of Family Planning's Emerging Demand Indicator.","authors":"Jamaica Corker,Ilene S Speizer,Jean Christophe Fotso,Niranjan Saggurti,Elizabeth Sully","doi":"10.1111/sifp.70029","DOIUrl":"https://doi.org/10.1111/sifp.70029","url":null,"abstract":"The \"intention to use\" (ITU) contraception indicator has gained recent prominence as a proposed high-level success metric for family planning (FP) programs and as a step toward identifying measures that better capture what women want. Although ITU offers advantages over traditional indicators like contraceptive prevalence and unmet need, its elevation as a key programmatic measure requires critical examination. In this commentary, we outline advantages of ITU to measure FP demand and offer critiques and considerations for reliance on ITU as a demand metric for measuring programmatic success. We argue that while ITU may be a step toward more person-centered measurement, it is not inherently person-centered. Rather than positioning ITU as an innovative person-centered breakthrough, we argue it should be considered a transitional measure-a bridge toward more comprehensive indicators that capture the complexities of contraceptive decision-making. We recognize the current lack of viable alternatives for programs seeking a singular person-centered measure; when used, ITU should be complemented by additional topline indicators that capture access, agency, and preferences. With declining research funding and data infrastructure disruptions, it is important that ITU complement, not replace, efforts to develop the next generation of FP measurement that meaningfully reflects people's contraceptive realities.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"167 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819721","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}
Caroline Deignan,Angela Odiachi,Peter Kisaakye,N I Emma Woks,Dinah Amongin,Esther Spindler,Junior Agbor Ayuk Agbor,Paul Bukuluki,Alex Bagabo,Eresi Awor,Madeleine Short Fabic,Courtney McLarnon,Rebecka Lundgren,Shannon Pryor,Elizabeth Larson,Jean Christophe Fotso,Hidayatou Mohamadou,Leah Saleta,Lotus McDougal
Although empowerment-focused reproductive health measures have expanded in recent years, gaps exist in measuring person-centered contraceptive desire and demand. We address this gap by examining the degree to which individuals feel that contraception is acceptable. This study explores women's and men's experiences of contraceptive acceptability and tests the applicability of the "5C" framework of vaccine hesitancy to contraceptive demand and behaviors. We conducted 60 in-depth interviews and 12 focus group discussions with women and men in Kenya and Cameroon. A multi-country team thematically coded and analyzed data using inductive and deductive approaches. Our findings show that three domains of the "5C" vaccine hesitancy framework were particularly salient to participants' experiences of contraceptive acceptability. Perceptions of contraceptive safety and effectiveness (confidence), personal and others' experiences with contraception (calculation), and contraceptive services quality (constraints) all influenced contraceptive acceptability. Additionally, three new domains emerged: family responsibility, partner engagement, and childbearing expectations. Taken together, these six domains comprise the construct of contraceptive acceptability, which influences contraceptive demand and consequent contraceptive behaviors. This work offers a conceptual underpinning to inform the development of a contraceptive acceptability measure that centers choice and agency in family planning programs and research.
{"title":"Capturing the Dynamic Nature of Choice: Qualitative Perspectives on Contraceptive Acceptability from Cameroon and Kenya.","authors":"Caroline Deignan,Angela Odiachi,Peter Kisaakye,N I Emma Woks,Dinah Amongin,Esther Spindler,Junior Agbor Ayuk Agbor,Paul Bukuluki,Alex Bagabo,Eresi Awor,Madeleine Short Fabic,Courtney McLarnon,Rebecka Lundgren,Shannon Pryor,Elizabeth Larson,Jean Christophe Fotso,Hidayatou Mohamadou,Leah Saleta,Lotus McDougal","doi":"10.1111/sifp.70030","DOIUrl":"https://doi.org/10.1111/sifp.70030","url":null,"abstract":"Although empowerment-focused reproductive health measures have expanded in recent years, gaps exist in measuring person-centered contraceptive desire and demand. We address this gap by examining the degree to which individuals feel that contraception is acceptable. This study explores women's and men's experiences of contraceptive acceptability and tests the applicability of the \"5C\" framework of vaccine hesitancy to contraceptive demand and behaviors. We conducted 60 in-depth interviews and 12 focus group discussions with women and men in Kenya and Cameroon. A multi-country team thematically coded and analyzed data using inductive and deductive approaches. Our findings show that three domains of the \"5C\" vaccine hesitancy framework were particularly salient to participants' experiences of contraceptive acceptability. Perceptions of contraceptive safety and effectiveness (confidence), personal and others' experiences with contraception (calculation), and contraceptive services quality (constraints) all influenced contraceptive acceptability. Additionally, three new domains emerged: family responsibility, partner engagement, and childbearing expectations. Taken together, these six domains comprise the construct of contraceptive acceptability, which influences contraceptive demand and consequent contraceptive behaviors. This work offers a conceptual underpinning to inform the development of a contraceptive acceptability measure that centers choice and agency in family planning programs and research.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"53 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769611","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}
Joe Strong, Ernestina Coast, Jamaica Corker, Michelle Weinberger
Emergency contraceptive pills (ECP) are an essential and unique postcoital method of preventing pregnancy. Trends in supply data show that sales of ECP are increasing at faster rates globally than many other contraceptives. Yet nationally representative survey data suggest that ECP use has remained relatively static overtime, suggesting significant measure and reporting issues. Accurate measurement of ECP use is critical for informing policies and programs that provide people the choice and freedom to exercise their reproductive rights. There is an urgent need for a revision of ECP measurement to better capture the realities of people's contraceptive needs and desires. In this commentary, we outline the key reasons why surveys may be underreporting and misreporting ECP. We focus on issues around current method‐specific measurements, definition issues around “use” and problems with survey questions and prompt phraseology. We illustrate the importance of recognizing other postcoital methods and strategies that people use when trying to prevent a pregnancy, and the implications this has for ECP measurement. As ECP use evolves, we offer recommendations for survey revisions and further research that can ensure that ECP measurement is robust and able to provide accurate reporting in the future.
{"title":"Capturing Emergency Contraceptive Pill Use: Critical Reflections on Measurement and Reporting","authors":"Joe Strong, Ernestina Coast, Jamaica Corker, Michelle Weinberger","doi":"10.1111/sifp.70026","DOIUrl":"https://doi.org/10.1111/sifp.70026","url":null,"abstract":"Emergency contraceptive pills (ECP) are an essential and unique postcoital method of preventing pregnancy. Trends in supply data show that sales of ECP are increasing at faster rates globally than many other contraceptives. Yet nationally representative survey data suggest that ECP use has remained relatively static overtime, suggesting significant measure and reporting issues. Accurate measurement of ECP use is critical for informing policies and programs that provide people the choice and freedom to exercise their reproductive rights. There is an urgent need for a revision of ECP measurement to better capture the realities of people's contraceptive needs and desires. In this commentary, we outline the key reasons why surveys may be underreporting and misreporting ECP. We focus on issues around current method‐specific measurements, definition issues around “use” and problems with survey questions and prompt phraseology. We illustrate the importance of recognizing other postcoital methods and strategies that people use when trying to prevent a pregnancy, and the implications this has for ECP measurement. As ECP use evolves, we offer recommendations for survey revisions and further research that can ensure that ECP measurement is robust and able to provide accurate reporting in the future.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"29 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629780","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}
Sarah Vincent, Catalina Herrera‐Almanza, S. Anukriti, Mahesh Karra
We propose an indicator of contraceptive concordance that identifies the alignment between stated preferences for contraception and concurrent contraceptive behavior. Our indicator departs from traditional approaches to measurement in family planning that infer concordance to be the alignment between women's contraceptive (non‐)use and their fertility preferences. We estimate our indicator using data from a cross‐sectional survey that was conducted with 1,958 married women in rural India. More than half of all women in our sample (51.2 percent) report that they are currently using a contraceptive method. More than three in five women (60.8 percent) were classified as wanting to use a contraceptive method at the time of the survey. We find that 60 percent of women in our sample are classified to be concordant (either wanted users or wanted nonusers), while almost 1 in 4 women (24.8 percent) state a preference for using contraception but are not users (unwanted nonusers), and 15.2 percent of women in our sample state a preference for not using contraception but are users (unwanted users). We discuss the comparative advantages and limitations of our approach relative to traditional measures and other recently developed indicators.
{"title":"Contraceptive Concordance","authors":"Sarah Vincent, Catalina Herrera‐Almanza, S. Anukriti, Mahesh Karra","doi":"10.1111/sifp.70018","DOIUrl":"https://doi.org/10.1111/sifp.70018","url":null,"abstract":"We propose an indicator of contraceptive concordance that identifies the alignment between stated preferences for contraception and concurrent contraceptive behavior. Our indicator departs from traditional approaches to measurement in family planning that infer concordance to be the alignment between women's contraceptive (non‐)use and their fertility preferences. We estimate our indicator using data from a cross‐sectional survey that was conducted with 1,958 married women in rural India. More than half of all women in our sample (51.2 percent) report that they are currently using a contraceptive method. More than three in five women (60.8 percent) were classified as wanting to use a contraceptive method at the time of the survey. We find that 60 percent of women in our sample are classified to be concordant (either wanted users or wanted nonusers), while almost 1 in 4 women (24.8 percent) state a preference for using contraception but are not users (unwanted nonusers), and 15.2 percent of women in our sample state a preference for not using contraception but are users (unwanted users). We discuss the comparative advantages and limitations of our approach relative to traditional measures and other recently developed indicators.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"158 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144594487","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}
As the global community looks beyond the 2030 Sustainable Development Goals agenda, there is a critical opportunity to refine and elevate indicators focused on sexual and reproductive health and rights (SRHR) and to shift nations away from fertility and contraceptive targets. This commentary presents four key frameworks—drawn from a panel at an International Union for the Scientific Study of Population (IUSSP) meeting focused on SRHR measurements—that offer distinct yet complementary lenses for understanding and measuring reproductive choice and agency. These include the EMERGE Empowerment Framework (focused on measurement and evaluation), Patient‐Centered Care (focused on clinical practice), the Human Rights Framework (focused on policy), and Reproductive Justice (focused on social change). While not an exhaustive list, these frameworks reflect a diversity of disciplinary perspectives and emphasize the importance of grounding reproductive health indicators in concepts of choice and agency. The empowerment framework centers on individual decision‐making and collective action, while person‐centered and rights‐based approaches evaluate how health systems and policies support or constrain that agency. Reproductive justice expands the lens further, highlighting how structural inequalities shape differential access and outcomes across race, class, and other social determinants of health. Together, these frameworks underscore the need for multilevel, intersectional indicators or reproductive agency—spanning individuals, health systems, communities, and policies—to effectively guide and evaluate the impact of reproductive health programs and policies at scale.
{"title":"Moving Past a Legacy of Controlling Women: Key Frameworks to Center Women and Girls’ Choice and Agency in Sexual and Reproductive Health Measurement","authors":"Christine Dehlendorf, Karen Hardee, Evelyne Opondo, Anita Raj","doi":"10.1111/sifp.70027","DOIUrl":"https://doi.org/10.1111/sifp.70027","url":null,"abstract":"As the global community looks beyond the 2030 Sustainable Development Goals agenda, there is a critical opportunity to refine and elevate indicators focused on sexual and reproductive health and rights (SRHR) and to shift nations away from fertility and contraceptive targets. This commentary presents four key frameworks—drawn from a panel at an International Union for the Scientific Study of Population (IUSSP) meeting focused on SRHR measurements—that offer distinct yet complementary lenses for understanding and measuring reproductive choice and agency. These include the EMERGE Empowerment Framework (focused on measurement and evaluation), Patient‐Centered Care (focused on clinical practice), the Human Rights Framework (focused on policy), and Reproductive Justice (focused on social change). While not an exhaustive list, these frameworks reflect a diversity of disciplinary perspectives and emphasize the importance of grounding reproductive health indicators in concepts of choice and agency. The empowerment framework centers on individual decision‐making and collective action, while person‐centered and rights‐based approaches evaluate how health systems and policies support or constrain that agency. Reproductive justice expands the lens further, highlighting how structural inequalities shape differential access and outcomes across race, class, and other social determinants of health. Together, these frameworks underscore the need for multilevel, intersectional indicators or reproductive agency—spanning individuals, health systems, communities, and policies—to effectively guide and evaluate the impact of reproductive health programs and policies at scale.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"8 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586320","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}
Francine Wood, Courtney McLarnon, Sarah Smith, Nitya Yerabandi, Lotus McDougal
Improving women's agency in family planning is an integral component of empowerment, requiring culturally relevant, reliable, and valid measures. Measuring agency—action towards the achievement of self‐determined goals—is key to tracking progress as highlighted by its inclusion in the Sustainable Development Goals. Yet, agency measurement within low‐ and middle‐income contexts has all too often involved applying measures developed and tested in high‐income contexts, and conceptual confusion has also led to both overlapping measures and those that omit key facets of agency. To examine the construction and application of agency measures in family planning research and programs, we conducted a scoping review of studies in low‐and middle‐income countries. Of 9,289 articles and abstracts screened, 72 met our inclusion criteria and included family planning outcomes. We identified 58 unique measures. Most measures were summative and described psychometric testing. Measures often included family planning‐specific items, generally focused on contraceptive use with less attention to areas such as communication, access to services, or fertility timing. While increased interest in measuring family planning agency is evident, inconsistencies in measurement hinder cross‐contextual comparisons. As family planning research and programs adopt empowerment‐focused benchmarks, validated measures of agency are needed to accurately assess impact.
{"title":"Agency in Family Planning: A Scoping Review of the Measurement of Agency in Low‐ and Middle‐Income Countries","authors":"Francine Wood, Courtney McLarnon, Sarah Smith, Nitya Yerabandi, Lotus McDougal","doi":"10.1111/sifp.70025","DOIUrl":"https://doi.org/10.1111/sifp.70025","url":null,"abstract":"Improving women's agency in family planning is an integral component of empowerment, requiring culturally relevant, reliable, and valid measures. Measuring agency—action towards the achievement of self‐determined goals—is key to tracking progress as highlighted by its inclusion in the Sustainable Development Goals. Yet, agency measurement within low‐ and middle‐income contexts has all too often involved applying measures developed and tested in high‐income contexts, and conceptual confusion has also led to both overlapping measures and those that omit key facets of agency. To examine the construction and application of agency measures in family planning research and programs, we conducted a scoping review of studies in low‐and middle‐income countries. Of 9,289 articles and abstracts screened, 72 met our inclusion criteria and included family planning outcomes. We identified 58 unique measures. Most measures were summative and described psychometric testing. Measures often included family planning‐specific items, generally focused on contraceptive use with less attention to areas such as communication, access to services, or fertility timing. While increased interest in measuring family planning agency is evident, inconsistencies in measurement hinder cross‐contextual comparisons. As family planning research and programs adopt empowerment‐focused benchmarks, validated measures of agency are needed to accurately assess impact.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"33 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586319","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}
Apoorva Jadhav, Madeleine Short Fabic, Kerry MacQuarrie
Contraceptive prevalence among unmarried women—calculated from the response to a version of the question—“Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?” is most accurately measured among those who report sexual recency within the previous four weeks. This approach, long adopted by The Demographic and Health Surveys Program (DHS), has recently been adopted by groups such as FP2030 and Track20. Since this shift toward increased standardization, the DHS Program has included in its core questionnaire questions to better capture contraceptive use at last sex. We use these new DHS data from seven countries to explore whether a composite contraceptive use measure (i.e., current contraceptive use + contraceptive use at last sex) provides a more meaningful assessment of contraceptive use among unmarried women. Based on our findings, we recommend that the family planning field adopt the composite contraceptive use measure as its standard approach for measuring contraceptive prevalence among unmarried women. Our findings provide a guide for more accurately measuring, reporting, and most importantly, understanding the contraceptive practices of unmarried women.
{"title":"How It Was and How It Should Be: Moving Toward a Better Measurement of Contraceptive Prevalence Among Unmarried Women","authors":"Apoorva Jadhav, Madeleine Short Fabic, Kerry MacQuarrie","doi":"10.1111/sifp.70028","DOIUrl":"https://doi.org/10.1111/sifp.70028","url":null,"abstract":"Contraceptive prevalence among unmarried women—calculated from the response to a version of the question—<jats:italic>“Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?”</jats:italic> is most accurately measured among those who report sexual recency within the previous four weeks. This approach, long adopted by The Demographic and Health Surveys Program (DHS), has recently been adopted by groups such as FP2030 and Track20. Since this shift toward increased standardization, the DHS Program has included in its core questionnaire questions to better capture contraceptive use at last sex. We use these new DHS data from seven countries to explore whether a composite contraceptive use measure (i.e., current contraceptive use + contraceptive use at last sex) provides a more meaningful assessment of contraceptive use among unmarried women. Based on our findings, we recommend that the family planning field adopt the composite contraceptive use measure as its standard approach for measuring contraceptive prevalence among unmarried women. Our findings provide a guide for more accurately measuring, reporting, and most importantly, understanding the contraceptive practices of unmarried women.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"277 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577696","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}
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