{"title":"Unwanted Family Planning Including Unwanted Sterilization: Preliminary Prevalence Estimates for India.","authors":"Mahesh Karra, David Canning","doi":"10.1111/sifp.12274","DOIUrl":"10.1111/sifp.12274","url":null,"abstract":"<p><p>Estimates of unwanted family planning (UFP), which are based on a desire to have a child in the next nine months among current contraceptive users, exclude women who are sterilized since these women are not asked about their fertility preferences; all sterilized women are assumed to have a \"met need\" for family planning. However, the India National Family Health Survey asks sterilized women if they regret being sterilized and whether they were told that the operation would result in their permanent inability to have children. We extend the concept of UFP by classifying sterilized women who express regret or who were not informed about the procedure's permanence, as having UFP. When limiting our analysis of UFP to nonsterilized contraceptive users, we find that 0.9 percent of Indian women had UFP in 2019-2021. In this period, 29.9 percent of Indian women were sterilized. We estimate that 4.9 percent of sterilized women express regret and 16.3 percent were not told of the procedure's permanence. Adding sterilized women who express regret raises our UFP estimate in India to 2.3 percent, while also including sterilized women who were not told about the procedure's permanence yields an overall UFP estimate of 6.9 percent in India.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"349-359"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856597","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}
{"title":"The Reliability of Contraceptive Discontinuation Reporting in Burkina Faso, Kenya, and Uganda.","authors":"Dana Sarnak, Sophia Magalona, Phil Anglewicz","doi":"10.1111/sifp.12272","DOIUrl":"10.1111/sifp.12272","url":null,"abstract":"<p><p>Family planning researchers have been studying the discontinuation of contraception-the prevalence and reasons for it-for decades, as it has implications for contraceptive prevalence, total fertility, and unintended fertility. However little is known about the reliability of contraceptive discontinuation reporting: only two studies have examined the reliability of reported discontinuation in low-resource contexts. We use longitudinal and overlapping data from reproductive calendars to test the reliability of women's reporting of contraceptive discontinuation in Burkina Faso, Kenya, and Uganda. We test whether recent discontinuations reported at baseline are reported one year later, and if the same reason for discontinuation is reported. Results reveal moderate reliability at the aggregate level of reporting of the index discontinuation; however, reliability is low when the timing of discontinuation is considered. There is variability across the reliability of reasons for discontinuation; discontinuation due to desired pregnancy is reported reliably while other reasons are less reliably reported. Our findings have important implications for the field, particularly in how the data are used and interpreted; we urge caution around event-level analyses of contraceptive discontinuation and reasons for discontinuation, given low reliability.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"333-348"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875956","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}
{"title":"Contraceptive Care Visit Objectives and Outcomes: Evidence From Burkina Faso, Pakistan, and Tanzania.","authors":"Corrina Moucheraud, Alexandra Wollum, Mohamad Brooks, Manisha Shah, Jessica Gipson, Zachary Wagner","doi":"10.1111/sifp.12279","DOIUrl":"10.1111/sifp.12279","url":null,"abstract":"<p><p>Globally, care experiences of the growing population of contraceptive users are not well-understood. We leverage a large client dataset (n = 71,602) from three countries (Burkina Faso, Pakistan, and Tanzania) to characterize contraceptive services sought (visit objective and method preference), assess whether these visit objectives were met and for whom, and explore if visit objective fulfillment was associated with care quality. Most people in all three countries said they were seeking to continue their current method or adopt a method for the first time. Clients seeking to change their method were least likely to have their objective met: 63.7 percent of clients in Burkina Faso, 73.3 percent in Pakistan, and 61.1 percent in Tanzania who wanted to switch actually achieved this during the visit. In Burkina Faso, people with lower socioeconomic standing, lower educational attainment, and lower parity less commonly had their switching objective, fulfilled. Method preference fulfillment was generally high, although approximately 15 percent of Tanzanian clients were given implants despite wanting another method. Among those seeking to adopt or restart a method in Pakistan and Tanzania, having this visit objective fulfilled, was correlated with better perceived treatment and higher person-centeredness of care.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"315-332"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772405","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}
Margaret Giorgio, Solomon Shiferaw, Fredrick Makumbi, Assefa Seme, Simon Peter Sebina Kibira, Sarah Nabukeera, Selena Anjur‐Dietrich, Mahari Yihdego, Niguse Tadele, Elizabeth Sully
{"title":"Estimating the Social Visibility of Abortions in Uganda and Ethiopia Using the Game of Contacts","authors":"Margaret Giorgio, Solomon Shiferaw, Fredrick Makumbi, Assefa Seme, Simon Peter Sebina Kibira, Sarah Nabukeera, Selena Anjur‐Dietrich, Mahari Yihdego, Niguse Tadele, Elizabeth Sully","doi":"10.1111/sifp.12278","DOIUrl":"https://doi.org/10.1111/sifp.12278","url":null,"abstract":"Social network–based data collection methods that rely on third‐party reporting have emerged as a promising approach for measuring abortion in restrictive settings. In order for these methods to accurately measure abortion incidence, they must also assess the visibility of abortions within social networks. Failure to do so may result in estimates affected by transmission bias, caused by imperfect knowledge of all abortions within one's social network. In this paper, we present exploratory research that uses respondent‐driven sampling (RDS) and the game of contacts method to measure abortion visibility in four sites in Uganda and Ethiopia. We assess the existence of potential biases in the game of contacts estimate of abortion visibility in each site by conducting several internal and external validity tests. While these tests provided some promising results, other factors such as the representativeness of the RDS samples, direct versus indirect abortion knowledge transfers, and the generalizability of the study sites may have introduced biases into the final estimates of abortion visibility in this study. We conclude by making recommendations on how applications of this methodology could be improved to better estimate abortion‐related transmission bias.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"36 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142610738","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}
{"title":"Women's Perspectives on the Unique Benefits and Challenges of Self‐Injectable Contraception: A Four‐Country In‐Depth Interview Study in Sub‐Saharan Africa","authors":"Emily Himes, Lauren Suchman, Martha Kamanga, Catherine Birabwa, Serah Gitome, Elizabeth Omoluabi, Sarah Okumu, Grace Nmadu, Zachary Kwena, Jenny Liu, Sneha Challa, Dinah Amongin, Pauline Wekesa, Louisa Ndunyu, Elizabeth Bukusi, Address Malata, Lynn Atuyambe, Mandayachepa Nyando, Chioma Okoli, Aminat Tijani, Janelli Vallin, Ayobambo Jegede, Shakede Dimowo, Alfred Maluwa, Phoebe Alitubeera, Betty Kaudha, Agnes Kayego, Tamandani Jumbe, Innocencia Mtalimanja, Peter Waiswa, Beth Phillips, Kelsey Holt","doi":"10.1111/sifp.12277","DOIUrl":"https://doi.org/10.1111/sifp.12277","url":null,"abstract":"Implementing self‐injection (SI) of subcutaneous depot‐medroxyprogesterone acetate (DMPA‐SC) is a key self‐care strategy for sexual and reproductive health, but SI uptake remains low, and assertions about the potential of SI to increase women's control over contraceptive use lack evidence. We sought to qualitatively explore how women with diverse contraceptive experiences—including those with and without experience using SI—view the benefits and challenges of SI as compared to other methods. We conducted 241 in‐depth interviews with women across four sub‐Saharan African countries and found alignment between the perceived and experienced benefits of SI across our diverse sample. Through the benefits of privacy, easier access, and self‐management, we found SI can promote greater control over the contraceptive experience by facilitating a woman's ability to act on her preferences and control who is involved in or aware of her contraceptive use. Interviews revealed SI's potential is, however, constrained by inherent limitations in the method; for example, it is often not private or accessible <jats:italic>enough</jats:italic> and many fear injecting themselves. SI has the most potential when implemented with programmatic solutions that mitigate challenges women experience or anticipate and allow more women to benefit from the privacy, easier access, and self‐management that SI offers.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"80 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142596613","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}
{"title":"Searching for Needles in a Haystack: Exploring Alternative Operational Approaches to Classify the Safety of Induced Abortions Using Respondent-Driven Sampling Data From Two Sub-Saharan African Settings.","authors":"Onikepe O Owolabi,Clémentine Rossier,Rachidatou Compaore,Caron Kim,Bela Ganatra,Ramatou Ouedraogo,Moussa Zan,Martin Bangha,Adama Baguiya,","doi":"10.1111/sifp.12276","DOIUrl":"https://doi.org/10.1111/sifp.12276","url":null,"abstract":"This study aims to describe the circumstances under which women obtained abortions in two sites, explore more nuanced approaches to classify abortion safety and examine the relationship between safety and self-reported health outcomes. We analyze data on the most recent abortion or only abortion reported by 551 women in Nairobi slums and 479 women in rural Kaya ages 15-49 years within the three years preceding the study, recruited via respondent-driven sampling. Using the most liberal safety classification, there were very few safe abortions (8 percent in Nairobi and 5 percent in Burkina Faso). A significant proportion of women reported using unidentified pills which we hypothesize may be medication abortion. Although a smaller proportion of women with safe abortions reported side effects, more of them reported side effects suggestive of infections and sought care for their symptoms. It is important that we explore and move towards more nuanced global safety classifications that more accurately reflect the risk associated with different methods and can capture women's access to comprehensive abortion care and its impact on their health.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"191 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328677","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}
Carolina Cardona, Dana Sarnak, Alison Gemmill, Peter Gichangi, Mary Thiongo, Philip Anglewicz
{"title":"Are Contraceptive Method Preferences Stable? Measuring Change in the Preferred Method among Kenyan Women.","authors":"Carolina Cardona, Dana Sarnak, Alison Gemmill, Peter Gichangi, Mary Thiongo, Philip Anglewicz","doi":"10.1111/sifp.12271","DOIUrl":"10.1111/sifp.12271","url":null,"abstract":"<p><p>Contraceptive preferences are important for reproductive outcomes, such as contraceptive continuation and pregnancy. Current approaches to measuring reproductive preferences in population surveys are limited to exploring only fertility preferences and implicitly assume that contracepting people are using a method they want. We know that people change their fertility preferences over the life course as a response to life events, but there is no information about changes in contraceptive preferences, given the limited evidence about the measurement and distribution of contraceptive preferences. In this study, we examined the extent of change in women's contraceptive preferences over one year and identified characteristics associated with this change in Kenya using three rounds of nationally representative longitudinal data. Over one year, 18 percent of contraceptive users and 46 percent of contraceptive nonusers reported changes in their preferred contraceptive. Experiencing a pregnancy or birth and changes in marital status were associated with changes in contraceptive preferences for users and nonusers. We found that contraceptive preferences are dynamic, suggesting that family planning programs should ensure people's access to various methods to respond to women's changing circumstances and preferences.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"193-214"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620961","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}
Ann Gottert, Sanyukta Mathur, Mayi Gnofam, Jim Sailer, Julie Pulerwitz, Lisa B Haddad
{"title":"Men's Willingness to Use and Preferences for Novel Male Contraceptive Methods in Malawi.","authors":"Ann Gottert, Sanyukta Mathur, Mayi Gnofam, Jim Sailer, Julie Pulerwitz, Lisa B Haddad","doi":"10.1111/sifp.12275","DOIUrl":"10.1111/sifp.12275","url":null,"abstract":"<p><p>Evidence is needed in low- and middle-income countries regarding men's willingness to use new male contraceptive methods in development, preferences regarding method attributes, and what shapes willingness/preferences. We analyzed data from cross-sectional surveys with 611 men in Malawi, concerning willingness to use each of four types of new male methods. Mean age was 24.5 years; half (50 percent) were married/cohabiting. Over half (51 percent) of men expressed willingness to use at least one new male method, including a topical contraceptive gel (33 percent), injection (32 percent), pill (29 percent), and implant (14 percent). Many male product attributes were considered important (with 59-67 percent endorsement), including ease of use, comfort of use, side effects, partner approval, type of method, frequency of facility visits, and cost. A prevalent reported reason for willingness was to \"share responsibility for family planning with my partner\" (44 percent). In multivariate regression analyses, willingness was inversely associated with inequitable gender attitudes (p < 0.001) and was not associated with married/cohabiting status, using condoms, or perceived risk for HIV. These findings add to growing evidence that a majority of men express willingness to use new male contraceptive methods like a topical gel, injectable, or pill. Reflection around gender roles is likely critical within future education about male contraceptive methods.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"215-227"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907758","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}
John B Casterline, Laila El-Zeini, Mobolaji Ibitoye
{"title":"Assessing Trends in the Desire to Avoid Pregnancy: A Cautionary Note.","authors":"John B Casterline, Laila El-Zeini, Mobolaji Ibitoye","doi":"10.1111/sifp.12270","DOIUrl":"10.1111/sifp.12270","url":null,"abstract":"<p><p>The desire to avoid pregnancy-to delay the next birth or have no further births-is a fundamental sexual and reproductive health indicator. We show that two readily available measures-prospective fertility preferences and the demand for contraception [Demand] construct-provide substantially different portraits of historical trends. They also yield correspondingly different assessments of the sources of contraceptive change. We argue, with supporting empirical evidence, that Demand enormously overstates the historical trend in the desire to avoid pregnancy because Demand as currently constructed is in part a function of contraceptive prevalence. This makes for \"reverse causality\" in decompositions of contraceptive change, producing an upward distortion on the order of 25 percentage points in the amount of contraceptive change attributed to a change in fertility desires. Decomposition of contraception change free of the distortion reveals that contraceptive change has been due almost entirely to more complete implementation of fertility preferences. This is explained in part by the surprisingly slight historical change in preferences, a fact we document and then show is a consequence of a historical shift in parity composition toward lower parities.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"175-191"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752778","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}
Thomas Spoorenberg, Ellen Øen Carlsen, Martin Flatø, Marcin Stonawski, Vegard Skirbekk
{"title":"The Global Adolescent Fertility Decline is Counteracted by Increasing Teen Births in Sub-Saharan Africa.","authors":"Thomas Spoorenberg, Ellen Øen Carlsen, Martin Flatø, Marcin Stonawski, Vegard Skirbekk","doi":"10.1111/sifp.12273","DOIUrl":"10.1111/sifp.12273","url":null,"abstract":"<p><p>There is a lack of understanding of the persistence of elevated teen fertility rates in certain regions and countries, in contrast to the significant decline observed in other regions globally. This report considers fertility trends among 15- to 19-year olds in the period 1950-2020 and explores potential driving factors behind the significant shifts that occurred over this period. The countries where teen fertility remains high are those with fast-growing populations, primarily located in sub-Saharan Africa. Countries with higher teen fertility are typically characterized by limited use of modern contraception, lower education levels, and early marriage. Sub-Saharan Africa has emerged as the world region with the most teen births, increasing its proportion of global teen births from 12 percent in 1950 to 47 percent in 2020, a time during which this region's share of the global adolescent (15-19) population grew from 7.5 percent to 19 percent. By 2035, 67 percent of all teen births globally are projected to occur in this region. Consequently, the future number of births to teenage mothers will to a large extent depend on the development in sub-Saharan Africa over the coming decades.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"229-245"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620962","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}