Studies in Family Planning最新文献

{"title":"There's an App for That: Exploring the Market for Contraceptive Fertility Tracking Apps in the Philippines.","authors":"Kendal Danna, Danielle M Harris, Claire W Rothschild, Beth Brogaard, Elizabeth LaCroix, Mahesh Paudel","doi":"10.1111/sifp.12265","DOIUrl":"10.1111/sifp.12265","url":null,"abstract":"<p><p>For generations, women have relied on fertility awareness methods to plan and prevent pregnancy, for over a decade, many have been aided by digital tools to do so. New contraceptive fertility tracking apps (CFTAs)-that are backed by clinical efficacy trials to support their effectiveness as contraception-have the potential to enhance method choice and offer users a unique contraceptive option, but there is little evidence to inform the decisions around expanding access, particularly in low-and middle-income countries. We conducted a mixed methods study with quantitative online surveys (n = 1600) and qualitative interviews (n = 36) to explore the potential appeal of and demand for a hypothetical CFTA in one such market, the Philippines. Interest in using a CFTA was high among our Internet-engaged, urban study population, with 83.9% \"definitely\" or \"probably\" interested in using it. Across demographic profiles, respondents perceived the appeal of the method as \"natural\" and \"convenient.\" A majority were willing to pay for the method, though notably at a price (5.20 USD) below that of currently available CFTAs. We discuss various important factors to be considered before bringing a method like this to new markets, including the potential implications of equity constraints in reaching a wider market and the unexpected prevalence of other period-tracking apps not intended as contraception being used in this market that could complicate any future roll-out. These issues could be explored further with additional research.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"151-169"},"PeriodicalIF":2.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293726","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":"Continuation of Reversible Contraception Following Enrollment in the Zika Contraception Access Network (Z‐CAN) in Puerto Rico, 2016–2020","authors":"Lauren B. Zapata, Katherine Kortsmit, Kathryn M. Curtis, Lisa Romero, Stacey Hurst, Eva Lathrop, Edna Acosta Perez, Marizaida Sánchez Cesáreo, Maura K. Whiteman","doi":"10.1111/sifp.12262","DOIUrl":"https://doi.org/10.1111/sifp.12262","url":null,"abstract":"The Zika Contraception Access Network (Z‐CAN) provided access to high‐quality client‐centered contraceptive services across Puerto Rico during the 2016–2017 Zika virus outbreak. We sent online surveys during May 2017–August 2020 to a subset of Z‐CAN patients at 6, 24, and 36 months after program enrollment (response rates: 55–60 percent). We described contraceptive method continuation, method satisfaction, and method switching, and we identified characteristics associated with discontinuation using multivariable logistic regression. Across all contraceptive methods, continuation was 82.5 percent, 64.2 percent, and 49.9 percent at 6, 24, and 36 months, respectively. Among continuing users, method satisfaction was approximately ≥90 percent. Characteristics associated with decreased likelihood of discontinuation included: using an intrauterine device or implant compared with a nonlong‐acting reversible contraceptive method (shot, pills, ring, patch, or condoms alone); wanting to prevent pregnancy at follow‐up; and receiving as their baseline method the same method primarily used before Z‐CAN. Other associated characteristics included: receiving the method they were most interested in postcounseling (6 and 24 months) and being very satisfied with Z‐CAN services at the initial visit (6 months). Among those wanting to prevent pregnancy at follow‐up, about half reported switching to another method. Ongoing access to contraceptive services is essential for promoting reproductive autonomy, including supporting patients with continued use, method switching, or discontinuation.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"98 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140651825","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":"Effects of performance‐based financing on availability, quality, and use of family planning services in the Democratic Republic of Congo: An Impact Evaluation","authors":"Salomé Henriette Paulette Drouard, Stephan Brenner, Delphin Antwisi, Ndeye Khady Toure, Supriya Madhavan, Günther Fink, Gil Shapira","doi":"10.1111/sifp.12264","DOIUrl":"https://doi.org/10.1111/sifp.12264","url":null,"abstract":"Access to high‐quality family planning services remains limited in many low‐ and middle‐income countries, resulting in a high burden of unintended pregnancies and adverse health outcomes. We used data from a large randomized controlled trial in the Democratic Republic of Congo to test whether performance‐based financing (PBF) can increase the availability, quality, and use of family planning services. Starting at the end of 2016, 30 health zones were randomly assigned to a PBF program, in which health facilities received financing conditional on the quantity and quality of offered services. Twenty‐eight health zones were assigned to a control group in which health facilities received unconditional financing of a similar magnitude. Follow‐up data collection took place in 2021–2022 and included 346 health facility assessments, 476 direct clinical observations of family planning consultations, and 9,585 household surveys. Findings from multivariable regression models show that the PBF program had strong positive impacts on the availability and quality of family planning services. Specifically, the program increased the likelihood that health facilities offered any family planning services by 20 percentage points and increased the likelihood that health facilities had contraceptive pills, injectables, and implants available by 23, 24, and 20 percentage points, respectively. The program also improved the process quality of family planning consultations by 0.59 standard deviations. Despite these improvements, and in addition to reductions in service fees, the program had a modest impact on contraceptive use, increasing the modern method use among sexually active women of reproductive age by 4 percentage points (equivalent to a 37 percent increase), with no significant impact on adolescent contraceptive use. These results suggest that although PBF can be an effective approach for improving the supply of family planning services, complementary demand‐side interventions are likely needed in a setting with very low baseline utilization.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"301 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140608126","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":"Confirmatory Factor Analysis and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults in Kenya","authors":"Yasaman Zia, Ushma Upadhyay, Isaac Rhew, Syovata Kimanthi, Ouma Congo, Maricianah Onono, Ruanne Barnabas, Nelly Mugo, Elizabeth A. Bukusi, Elizabeth K. Harrington","doi":"10.1111/sifp.12263","DOIUrl":"https://doi.org/10.1111/sifp.12263","url":null,"abstract":"Understanding the levels of power that adolescent girls and young women exercise in their sexual and reproductive lives is imperative to inform interventions to help them meet their goals. We implemented an adapted version of the Sexual and Reproductive Health Empowerment (SRE) Scale for Adolescents and Young Adults among 500 adolescent girls and young women aged 15–20 in Kisumu, Kenya. We used confirmatory factor analysis (CFA) to assess factor structure, and logistic regression to examine construct validity through the relationship between empowerment scores and ability to mitigate risk of undesired pregnancy through consistent contraceptive use. Participants had a mean age of 17.5, and most were students (61 percent), were currently partnered (94 percent), and reported having sex in the past 3 months (70 percent). The final, 26‐item CFA model had acceptable fit. All subscales had Cronbach's alpha scores &gt;0.7, and all items had rotated factor loadings &gt;0.5, indicating good internal consistency and robust factor‐variable associations. The total SRE‐Kenya (SRE‐K) score was associated with increased odds of the consistent method used in the past three months (adjusted odds ratio: 1.98, 95 percent CI: 1.29–3.10). The SRE‐K scale is a newly adapted and valid measure of sexual and reproductive empowerment specific to adolescent girls and young women in an East African setting.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"47 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140551923","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":"ACKNOWLEDGMENTS.","authors":"","doi":"10.1111/sifp.12261","DOIUrl":"https://doi.org/10.1111/sifp.12261","url":null,"abstract":"","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040315","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":"The Relationships between Drought Exposure, Fertility Preferences, and Contraceptive Behaviors: A Multicountry Study.","authors":"Oluwaseyi Somefun, Boladé Hamed Banougnin, Emily Smith-Greenaway","doi":"10.1111/sifp.12258","DOIUrl":"10.1111/sifp.12258","url":null,"abstract":"<p><p>The interplay between population dynamics and the environment has long interested demographers. Although studies have explored how climate patterns affect macrolevel population processes, such as mortality and migration, little is known about their impact on individual-level demographic behaviors. This study fills this research gap by examining the linkages between exposure to drought and women's fertility preferences and contraceptive behaviors in sub-Saharan Africa. We analyze data from the Demographic and Health Surveys Program, focusing on 17 countries in East, Southern, and West Africa. We investigate whether women's recent exposure to drought episodes in their community affects their fertility preferences and modern contraceptive use. Generally, the findings show that drought is relevant to understanding women's fertility preferences and behaviors in the vast majority of countries; however, drought exposure has variable impacts. Moreover, whereas in some countries, drought exposure encourages contraceptive behaviors that align with women's preferences, in select countries it is associated with behavior that is misaligned with women's stated preferences. Overall, the study emphasizes the importance of examining climate events as complex forces that have localized meanings for demographic outcomes.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"5-21"},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983780","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":"Evaluation of Emergency Contraceptive Pill Use with Health Management Information Systems Data in Pakistan.","authors":"Shiza Farid, Khan Mohammed, Kristin Bietsch, Priya Emmart","doi":"10.1111/sifp.12260","DOIUrl":"10.1111/sifp.12260","url":null,"abstract":"<p><p>According to the WHO, all clients should have access to a range of contraceptive methods, including at least one short-term, one long-term, one permanent, and one emergency method of contraception. While there are data on the contraceptive method mix available for many low- and middle-income countries, there are limited data on emergency contraception (EC). This is likely due to some surveys not routinely collecting this information, how survey questions are asked, dual method use, and/or low levels of reported use of EC pill (ECP). Even with low reported use in surveys, contraceptive social marketing statistics from DKT International. show a trend in recent years of increasing product sales of ECPs. To understand a more complete scope of ECP use, we use Pakistan as a case study and analyze Pakistan's Demographic Health Survey (DHS) surveys and Pakistan's Contraceptives Logistics Management Systems. Based on commodities dispensed data for ECPs in 2021, about 0.4 percent of all married women in Pakistan use ECPs. While there is currently a small proportion of women, it is growing and the use of ECPs is not zero as indicated by the DHS. Therefore, where available, countries should review their health management information systems data alongside survey data for ECP use.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"61-69"},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132622","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":"Child Fostering and Family Size Preferences in Uganda.","authors":"Cassandra Cotton","doi":"10.1111/sifp.12259","DOIUrl":"10.1111/sifp.12259","url":null,"abstract":"<p><p>Mothers who exceed their ideal family size (IFS) may find themselves caring for more children than desired. In the absence of reliable and desirable prenatal controls of family size, mothers may foster-out children to reduce burdens of childrearing, particularly in contexts where fostering is common. Using six rounds of Demographic and Health Surveys collected in Uganda between 1988 and 2016, I explore the relationship between exceeding IFS and child out-fostering, proposing that fostering-out may serve to manage excess fertility and that this relationship may change as actual and desired fertility declines. Models are run separately for mothers and children aged 0-17 to explore mothers' overall out-fostering behavior versus out-fostering strategies for children. Results at the mother level suggest a strong positive relationship between exceeding IFS and out-fostering that remains relatively stable over time, but results at the child level indicate children's age explains the relationship between mothers' exceeding IFS and being fostered-out, demonstrating the nuances of how family size preferences might impact family life in practice. Though mothers report a desire for smaller families over time, childbearing and childrearing behaviors, including high fertility and child out-fostering, remain consistent over the course of Uganda's fertility transition, signifying the central role out-fostering plays in Ugandan families.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"23-43"},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730574","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":"Identifying Profiles of Support for Legal Abortion Services in Zambia: A Latent Class Analysis.","authors":"Joseph G Rosen, Michael T Mbizvo, Nachela Chelwa, Lyson Phiri, Jenny A Cresswell, Veronique Filippi, Nkomba Kayeyi","doi":"10.1111/sifp.12257","DOIUrl":"10.1111/sifp.12257","url":null,"abstract":"<p><p>Relative to neighboring countries, Zambia has among the most progressive abortion policies, but numerous sociopolitical constraints inhibit knowledge of pregnancy termination rights and access to safe abortion services. Multistage cluster sampling was used to randomly select 1,486 women aged 15-44 years from households in three provinces. We used latent class analysis (LCA) to partition women into discrete groups based on patterns of endorsed support for legalized abortion on six socioeconomic and health conditions. Predictors of probabilistic membership in latent profiles of support for legal abortion services were identified through mixture modeling. A three-class solution of support patterns for legal abortion services emerged from LCA: (1) legal abortion opponents (∼58 percent) opposed legal abortion across scenarios; (2) legal abortion advocates (∼23 percent) universally endorsed legal protections for abortion care; and (3) conditional supporters of legal abortion (∼19 percent) only supported legal abortion in circumstances where the pregnancy threatened the fetus or mother. Advocates and Conditional supporters reported higher exposure to family planning messages compared to opponents. Relative to opponents, advocates were more educated, and Conditional supporters were wealthier. Findings reveal that attitudes towards abortion in Zambia are not monolithic, but women with access to financial/social assets exhibited more receptive attitudes towards legal abortion.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"45-59"},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730575","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":"Adjusting Injectable Contraceptive Use for Months Since the Last Injection.","authors":"Mahesh Karra, David Canning","doi":"10.1111/sifp.12256","DOIUrl":"10.1111/sifp.12256","url":null,"abstract":"<p><p>Injectables are one of the most popular methods of contraception worldwide, particularly in sub-Saharan Africa. An advantage of injectables over shorter-acting methods is that they provide additional flexibility by not requiring re-supply as frequently. However, there is a risk that injectable users may delay their next injection and may therefore have reduced or no protection from pregnancy. In surveys, women may report that they are using contraception in the form of injectables when the time since they had their last injection (more than four months) would imply that they have reduced protection against the risk of pregnancy. We carried out two field studies in urban Malawi, and we record reported injectable contraceptive use while also asking the number of months since women received their last injection. We observe that 13.8 percent of women who report using injectables also report that they received their last injection more than four months ago, and 11 percent report that they received their last injection more than six months ago. Our analysis highlights the need for additional follow-up with women who report using injectables in surveys to confirm whether they are, in fact, using the method effectively.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"71-77"},"PeriodicalIF":2.1,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139681585","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}