Studies in Family Planning最新文献

{"title":"The Educational Differentiation of African Birth Timing.","authors":"Margaret Frye, Sara Lopus","doi":"10.1111/sifp.12281","DOIUrl":"10.1111/sifp.12281","url":null,"abstract":"<p><p>As educational access has expanded across Africa, birth timing has remained quite stable. Using data representing 51 birth years and 34 countries, we show that these modest aggregate changes mask more dramatic changes within educational groups. Over time, educational attainment has become an increasingly salient predictor of birth timing, as highly educated women have delayed first births and lengthened subsequent birth intervals more. The educational differentiation of birth timing also varies across contextual factors (educational access and family planning effort). In recent cohorts, women of all educational levels have experienced earlier first births in higher education contexts, suggesting that entry into motherhood is influenced by relative position within one's peer group. Aggregating across educational levels, however, women experience later first births in higher education contexts, driven by the greater share of highly educated women. For women at all levels of educational attainment, first birth timing is responsive to family planning context; in aggregate, women in countries with high family planning investments become mothers one year later than those in countries with lower family planning efforts. Notably, highly educated women lengthen their second birth intervals more when education and family planning are widely available, suggesting further potential for public investments to enable women to achieve their reproductive preferences.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":" ","pages":"87-111"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123728","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":"Mothers Time: A Cluster Randomized Controlled Trial of the Effects of a Community-Based Cognitive Behavioral Therapy Intervention on Postpartum Mental Health and Family Planning in Northwest Ethiopia.","authors":"Leah Holmes, Tesera Bitew, Andenet Haile, Lynn M Van Lith, Sarah Burgess, Jessica Vandermark, Stella Babalola, Hermon Amare, Asaye Tilahun, Dominick Shattuck, Zoé Mistrale Hendrickson","doi":"10.1111/sifp.70000","DOIUrl":"https://doi.org/10.1111/sifp.70000","url":null,"abstract":"<p><p>Depression and anxiety symptoms are associated with increased unmet need for family planning (FP) postpartum, yet solutions promoting the integration of mental health into FP service settings remain scarce. The aims of this study were to quantitatively examine the immediate and longer term effects of participation in a group-based cognitive behavioral therapy (CBT) intervention called Mothers Time on (1) symptoms of depression and anxiety, (2) the use of a modern family planning method, and (3) intermediate FP-related factors among postpartum women in Ethiopia. Building from lessons learned during a feasibility study, we implemented a cluster randomized controlled design, with structured interviews delivered before (baseline), immediately following (endline), and fourxst months after implementation of the intervention (follow-up). A total of 302 postpartum women were recruited from 10 health clusters in northwest Ethiopia. In comparison to control clusters where participants received standard of care, intervention clusters showed significantly greater reductions in symptoms for both depression and anxiety from baseline to follow-up. Modern FP use also increased significantly more in intervention clusters as compared to control clusters from baseline to follow-up. Results suggest that more holistic FP services that consider postpartum mental health can both reduce postpartum depression and anxiety and support women in fulfilling their reproductive intentions.</p>","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"56 1","pages":"9-39"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754571","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.12283","DOIUrl":"https://doi.org/10.1111/sifp.12283","url":null,"abstract":"","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"10 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143393062","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":"Exploring Adolescents’ Contraceptive Preferences and Trade‐Offs: Findings From a Discrete Choice Experiment in Kenya","authors":"Elizabeth K. Harrington, Dismas Congo Ouma, Mindy Pike, Merceline Awuor, Syovata Kimanthi, Maricianah Onono, Ruanne V. Barnabas, Nelly Mugo, Elizabeth A. Bukusi, Brett Hauber","doi":"10.1111/sifp.12280","DOIUrl":"https://doi.org/10.1111/sifp.12280","url":null,"abstract":"A focus on contraceptive preferences is essential to the provision of person‐centered care. Adolescent girls and young women (AGYW) in the WHO African Region experience disparities in contraceptive access and use and reproductive health outcomes. Despite increasing recognition of AGYW needs as unique, their preferences are understudied, limiting strategies to improve contraceptive care access and quality among marginalized youth populations. We designed and conducted a discrete choice experiment among five hundred 15–20‐year‐old AGYW in Kisumu, Kenya, to examine the relative importance of trade‐offs between contraceptive methods and service delivery attributes. Participants answered eight choice sets including three alternatives: two hypothetical contraceptive options characterized by seven attributes (effectiveness, bleeding pattern, duration of use, privacy, access location, counseling source, and cost) and a “no method” opt‐out. We used random‐parameters logit models to estimate preference weights and trade‐offs among alternatives. The bleeding pattern was the most important determinant of stated choice, with a strong preference for unchanged or irregular bleeding over heavier bleeding or amenorrhea. Participants preferred the lowest chance of method failure as well as the longest duration of use (one year) over daily use or use during/after sex. Parous AGYW were more likely to prefer the longest duration of use. The ability to keep method use completely private was also an influential choice, particularly among 15–17‐year‐olds. AGYW traded effectiveness and increased cost for preferred bleeding patterns and privacy. The opt‐out “no method” alternative was chosen only 2.7 percent of the time, indicating a strong preference for pregnancy prevention. Our findings highlight key insights for enhancing the person‐centeredness of contraceptive care for AGYW: Kenyan AGYW place a high value on preferred menstrual bleeding patterns, high method effectiveness, longer duration of use, and the ability to keep method use private. Preference data can inform programs, including contraceptive decision‐support interventions, to improve AGYW access to quality preference‐sensitive contraceptive services.","PeriodicalId":22069,"journal":{"name":"Studies in Family Planning","volume":"15 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939857","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":"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}

{"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}