Measuring "Intent Satisfied": Toward a Person-Centered Metric of Contraceptive Use.

Abstract

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.