Intention to Use Contraception: Promises and Pitfalls of Family Planning's Emerging Demand Indicator.

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.