Maria Dieci, Zachary Wagner, Willa Friedman, Sarah Burgess, Jessica Vandermark, Sandra I McCoy, Manisha Shah, William H Dow
{"title":"Measuring Family Planning Provider Bias: A Discrete Choice Experiment among Burkinabé, Pakistani, and Tanzanian Providers.","authors":"Maria Dieci, Zachary Wagner, Willa Friedman, Sarah Burgess, Jessica Vandermark, Sandra I McCoy, Manisha Shah, William H Dow","doi":"10.1111/sifp.12170","DOIUrl":"https://doi.org/10.1111/sifp.12170","url":null,"abstract":"<p><p>The unmet need for modern contraception remains high around the world, particularly for youth. While some of this unmet need is driven by limited health infrastructure and method mix availability, many adolescents who visit family planning providers still do not receive methods that fit their needs. This suggests that providers may be biased against youth and that interventions to change provider behavior could help close this gap. However, it is unclear if this bias is a result of age or other characteristics common among young women such as not being married and not having children. We use a discrete choice experiment in Burkina Faso, Pakistan, and Tanzania to disentangle the effects of age on providers' decisions to provide contraception from the effects of other potential confounding factors. We find that, although young women may experience the most bias, age is not the main driver. Rather, marital status and parity seem to influence provider decisions to offer services or counsel on modern methods. These findings suggest that interventions to reduce provider bias should focus on changing behavior towards unmarried and nulliparous women, regardless of their age.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 3","pages":"299-320"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/sifp.12170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39379290","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}
Megan Douthwaite, Olalere Alabi, Kingsley Odogwu, Kate Reiss, Anne Taiwo, Ebere Ubah, Anthony Uko-Udoh, Kayode Afolabi, Kathryn Church, Justin Fenty, Erik Munroe
{"title":"Safety, Quality, and Acceptability of Contraceptive Implant Provision by Community Health Extension Workers versus Nurses and Midwives in Two States in Nigeria.","authors":"Megan Douthwaite, Olalere Alabi, Kingsley Odogwu, Kate Reiss, Anne Taiwo, Ebere Ubah, Anthony Uko-Udoh, Kayode Afolabi, Kathryn Church, Justin Fenty, Erik Munroe","doi":"10.1111/sifp.12168","DOIUrl":"https://doi.org/10.1111/sifp.12168","url":null,"abstract":"<p><p>Task sharing is a strategy with potential to increase access to effective modern contraceptive methods. This study examines whether community health extension workers (CHEWs) can insert contraceptive implants to the same safety and quality standards as nurse/midwives. We analyze data from 7,691 clients of CHEWs and nurse/midwives who participated in a noninferiority study conducted in Kaduna and Ondo States, Nigeria. Adverse events (AEs) following implant insertions were compared. On the day of insertion AEs were similar among CHEW and nurse/midwife clients-0.5 percent and 0.4 percent, adjusted odds ratio (aOR) 0.92 (95 percent CI 0.38-2.23)-but noninferiority could not be established. At follow-up 6.6 percent of CHEW clients and 2.1 percent of nurse/midwife clients experienced AEs. There was strong evidence of effect modification by State. In the final adjusted model, odds of AEs for CHEW clients in Kaduna was 3.34 (95 percent CI 1.53-7.33) compared to nurse/midwife clients, and 0.72 (95 percent CI 0.19-2.72]) in Ondo. Noninferiority could not be established in either State. Implant expulsions were higher among CHEW clients (142/2987) compared to nurse/midwives (40/3517). Results show the feasibility of training CHEWs to deliver implants in remote rural settings but attention must be given to provider selection, training, supervision, and follow-up to ensure safety and quality of provision.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 3","pages":"259-280"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/sifp.12168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39212812","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}
Amy O Tsui, Carolina Cardona, Varsha Srivatsan, Funmilola OlaOlorun, Elizabeth Omoluabi, Pierre Akilimali, Peter Gichangi, Mary Thiongo, Scott Radloff, Philip Anglewicz
{"title":"Is Client Reporting on Contraceptive Use Always Accurate? Measuring Consistency and Change with a Multicountry Study.","authors":"Amy O Tsui, Carolina Cardona, Varsha Srivatsan, Funmilola OlaOlorun, Elizabeth Omoluabi, Pierre Akilimali, Peter Gichangi, Mary Thiongo, Scott Radloff, Philip Anglewicz","doi":"10.1111/sifp.12172","DOIUrl":"https://doi.org/10.1111/sifp.12172","url":null,"abstract":"The consistency of self-reported contraceptive use over short periods of time is important for understanding measurement reliability. We assess the consistency of and change in contraceptive use using longitudinal data from 9,390 urban female clients interviewed in DR Congo, India, Kenya, Niger, Nigeria, and Burkina Faso. Clients were interviewed in-person at a health facility and four to six months later by phone. We compared reports of contraceptive use at baseline with recall of baseline contraceptive use at follow-up. Agreement between these measures ranged from 59.1 percent in DR Congo to 84.4 percent in India. Change in both contraceptive method type (sterilization, long-acting, short-acting, nonuse) and use status (user, nonuser, discontinuer, adopter, switcher) was assessed comparing baseline to follow-up reports and retrospective versus current reports within the follow-up survey. More change in use was observed with panel reporting than within the cross section. The percent agreement between the two scenarios of change ranged from 64.8 percent in DR Congo to 84.5 percent in India, with cross-site variation. Consistently reported change in use status was highest for nonusers, followed by users, discontinuers, adopters, and switchers. Inconsistency in self-reported contraceptive use, even over four to six months, was nontrivial, indicating that studying measurement reliability of contraceptive use remains important.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 3","pages":"361-382"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/sifp.12172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39304021","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}
Erica Sedlander, Jeffrey B Bingenheimer, Shaon Lahiri, Mary Thiongo, Peter Gichangi, Wolfgang Munar, Rajiv N Rimal
{"title":"Does the Belief That Contraceptive Use Causes Infertility Actually Affect Use? Findings from a Social Network Study in Kenya.","authors":"Erica Sedlander, Jeffrey B Bingenheimer, Shaon Lahiri, Mary Thiongo, Peter Gichangi, Wolfgang Munar, Rajiv N Rimal","doi":"10.1111/sifp.12157","DOIUrl":"https://doi.org/10.1111/sifp.12157","url":null,"abstract":"<p><p>The belief that contraceptive use causes infertility has been documented across sub-Saharan Africa, but its quantitative association with actual contraceptive use has not been examined. We collected and analyzed sociocentric network data covering 74 percent of the population in two villages in rural Kenya. We asked respondents to nominate people from their village (their network), and then we matched their network (alters) to the individual participant (ego) to understand how their beliefs and behaviors differ. We asked about contraceptive use and level of agreement with a statement about contraceptive use causing infertility. We calculated the average nominated network contraceptive use score and the average nominated network belief score. Holding the individual belief that contraceptive use causes infertility was associated with lower odds of using contraceptive (AOR = 0.82, p = < 0.01); however, when one's own nominated network connections held this belief, the odds of using contraceptive were even lower (AOR = 0.75, p <0.01). Our findings show that this belief is associated with lower odds of contraceptive use and highlights the role that other people in one's network play in reinforcing it. Sexual and reproductive health programs should address this misperception at the individual and social network level.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 3","pages":"343-359"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/sifp.12157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39179538","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":"Women's Education, Spousal Agreement on Future Fertility Intentions, and Contraceptive Use in Pakistan.","authors":"Saima Bashir, Karen Guzzo","doi":"10.1111/sifp.12167","DOIUrl":"https://doi.org/10.1111/sifp.12167","url":null,"abstract":"<p><p>In less egalitarian countries such as Pakistan, reproductive behaviors are gendered, with couples often disagreeing about their fertility goals. However, the dramatic changes in women's empowerment and messaging around reproductive behaviors in Pakistan in recent years may have affected how women's own characteristics and their concordance with their spouse on fertility goals are linked to contraception. Using matched couple data from two cycles of the Pakistan Demographic Health Survey (1990-1991 and 2017-2018), this paper examines the relative influence of husbands' and wives' fertility preferences, as well as women's education, on contraceptive use using linear probability models. Disagreement between couples declined modestly, by about four percentage points, over time. When disagreement about future fertility intentions occurs, wife's fertility preferences are more strongly related to contraceptive behavior, and this association has not changed over time. Although contraceptive use is positively associated with education, the link between women's education and contraceptive use has weakened over time due to increased use among uneducated women. Pakistani women's own fertility preferences are reflected in their contraceptive behavior, and contraceptive use is increasing among all women, even less educated women. Diffusion processes are likely at play, though more work is needed to identify these processes and potential barriers to contraceptive use.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 3","pages":"281-298"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/sifp.12167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39186673","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}
Rodrigo Ceni, Cecilia Parada, Ivone Perazzo, Eliana Sena
{"title":"Birth Collapse and a Large-Scale Access Intervention with Subdermal Contraceptive Implants.","authors":"Rodrigo Ceni, Cecilia Parada, Ivone Perazzo, Eliana Sena","doi":"10.1111/sifp.12171","DOIUrl":"https://doi.org/10.1111/sifp.12171","url":null,"abstract":"<p><p>Between 2016 and 2018, we observe in Uruguay a steep decline of almost 20 percent in the number of total births, leading to the collapse of the adolescent fertility rate after decades of relative stagnation. We estimate the quantitative contribution on birth rates, especially teen births, of a policy of expanded availability of subdermal contraceptive implants. We exploit the expansion schedule of a large-scale policy of free-of-charge access to subdermal implants in the country's public health system through an event study to capture causal effects. We use detailed birth administrative records for the past 20 years. We document an average reduction of 3 percent in the birth rate in public health facilities across the two years after the policy was implemented in each department. These reductions were notably higher among teens and first births. Although changes in women's fertility decisions are a multicausal phenomenon, we claim that the expanded availability of subdermal contraceptive implants accounted for one-third of the teen and young women's birth collapse.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 3","pages":"321-342"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39268758","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}
Joanna Skinner, Hope Hempstone, Laura Raney, Christine Galavotti, Benedict Light, Michelle Weinberger, Lynn Van Lith
{"title":"Elevating Social and Behavior Change as an Essential Component of Family Planning Programs.","authors":"Joanna Skinner, Hope Hempstone, Laura Raney, Christine Galavotti, Benedict Light, Michelle Weinberger, Lynn Van Lith","doi":"10.1111/sifp.12169","DOIUrl":"https://doi.org/10.1111/sifp.12169","url":null,"abstract":"<p><p>The global family planning community has made significant progress towards enabling 120 million more women and girls to use contraceptives by 2020, though we enter the decade ahead with a long road yet to travel. While investment in strong health systems and supply chains is still needed, the supply-driven approach dominant in family planning fails to address the individual, relational, and social barriers faced by women and couples in achieving their reproductive intentions and desired family size. Overcoming these barriers will require a better understanding of behavioral drivers and the social environment in which family planning decisions are made, and an increased investment in the proven, yet underutilized, approach of social and behavior change (SBC). We make the case that a more intentional focus on the science of human behavior in family planning can help advance the achievement of global, regional, and national goals while also calling for strategic and sustained investment that reflects the critical importance and proven impact of SBC approaches.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 3","pages":"383-393"},"PeriodicalIF":2.1,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/sifp.12169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39190802","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":"Issue Information","authors":"","doi":"10.1111/sifp.12130","DOIUrl":"https://doi.org/10.1111/sifp.12130","url":null,"abstract":"","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"1 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/sifp.12130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42178646","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}
Marta Bornstein, Sarah Huber-Krum, Alison H Norris, Jessica D Gipson
{"title":"Infertility, Perceived Certainty of Pregnancy, and Contraceptive Use in Malawi.","authors":"Marta Bornstein, Sarah Huber-Krum, Alison H Norris, Jessica D Gipson","doi":"10.1111/sifp.12152","DOIUrl":"https://doi.org/10.1111/sifp.12152","url":null,"abstract":"<p><p>Infertility and unintended pregnancy are dual burdens in Malawi, where 41% of pregnancies are unintended and approximately 20% of people report infertility. Although preventing unintended pregnancy has been a focus in public health, infertility has rarely been explored as a factor that may be associated with contraceptive use. Using cross-sectional survey data (2017-2018; N = 749), we report on the prevalence of and sociodemographic characteristics associated with infertility and certainty of becoming pregnant among women in Malawi. We conducted multivariable logistic regressions examining the relationship between infertility, certainty of becoming pregnant, and contraceptive use. Approximately 16% of women experienced infertility, and three-quarters (78%) were certain they could become pregnant within one year. Women who experienced infertility had lower odds of contraceptive use than women who did not (Adjusted Odds Ratio [AOR]: 0.56; 95% Conficence Interval [CI]: 0.39-0.83). Women who said there was \"no chance\" or they were \"unlikely\" to become pregnant also had lower odds of contraceptive use compared to women who were certain they would become pregnant (AOR: 0.30; 95% CI: 0.10-0.92). Our findings indicate that experiences and perceptions surrounding fertility are associated with contraceptive use, underscoring their importance in understanding how people manage their fertility to reach their reproductive goals.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 2","pages":"143-163"},"PeriodicalIF":2.1,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/sifp.12152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10365589","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}
Ann K Blanc, Katharine J McCarthy, Charlotte Warren, Ashish Bajracharya, Benjamin Bellows
{"title":"The Validity of Women's Reports of Family Planning Service Quality in Cambodia and Kenya.","authors":"Ann K Blanc, Katharine J McCarthy, Charlotte Warren, Ashish Bajracharya, Benjamin Bellows","doi":"10.1111/sifp.12148","DOIUrl":"10.1111/sifp.12148","url":null,"abstract":"<p><p>Population-based indicators of the coverage of key elements of high-quality family planning services are tracked via household surveys with female respondents, yet little work has been done to establish their validity. We take advantage of existing data sets from Cambodia and Kenya to compare women's responses at exit interviews following a health facility visit against the observations of a trained third-party observer during the visit. The results, which treat the observations as the reference standard, show that indicators that measure contraceptive methods received are accurately reported while indicators of whether the woman received her preferred method and whether information was \"discussed\" or \"explained\" during counseling are less reliably reported. Studies designed explicitly to assess the validity of family planning questions in household surveys, especially questions in large survey programs critical for monitoring demographic trends and programmatic coverage, are needed.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"52 1","pages":"77-93"},"PeriodicalIF":1.9,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25482663","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}