Identification of latent contraceptive ideational profiles among urban women in Senegal: Transitions and implications for family planning programs

Background Latent ideational segmentation is an important technique that can enhance family planning (FP) communication campaigns by providing insight into prototypical “profiles” of women among heterogenous populations based on shared ideational characteristics that underpin contraceptive decision-making. This can improve the development of responsive, tailored content and help programs connect with intended audiences. In Senegal, 24% of married women who want to avoid pregnancy are not using modern contraceptive methods and in 2020, the Government of Senegal fell short of reaching its goal of increasing the modern contraceptive prevalence to 45%. Social, cultural, and cognitive factors are probable deterrents to contraceptive use. The objective of this study was to identify and interpret meaningful contraceptive ideational profiles (CIPs) among urban Senegalese women and examine how and why CIP structure, interpretation, and membership changed over time. Methods Using longitudinal data from 4,047 urban, in-union Senegalese women of reproductive age in 2011 and 2015, we applied latent transition analysis to identify and interpret prototypical profiles of women based on their contraceptive awareness, beliefs, self-efficacy, partner FP acceptance, partner communication, and community support. Results We identified four longitudinal CIPs and labeled them “CIP1: Lowest efficacy and FP awareness, highest misconceptions, unsupported,” “CIP2: Low efficacy and FP awareness, rejects misconceptions, unsupported,” “CIP3: Moderate efficacy, high FP awareness, high misconceptions, moderate support,” and “CIP4: Highest efficacy and FP awareness, fewest misconceptions, most supported.” At endline, more women were in higher-order CIPs compared to baseline. Exposure to FP communication via TV, radio, religious leaders, and health workers was associated with lower odds of membership in lower-order CIPs at endline, as was exposure to messages about FP and birth spacing. Conclusions This study demonstrated the potential of latent CIP methodologies to enhance current social and behavior change approaches by identifying and responding to unique and complex ideational attributes.