Measuring Nuance in Individual Contraceptive Need: A Case Study from a Cohort in Malawi. Issue 1 (31st January 2023)

• Record Type: Journal Article
• Authors: Bornstein, Marta; Huber‐Krum, Sarah; Gipson, Jessica D.; Norris, Alison H.
• Other Names: Bingenheimer Jeffrey B. guestEditor.; Hardee Karen guestEditor.; Hindin Michelle guestEditor.; Jain Aparna guestEditor.; Mumah Joyce guestEditor.; Dam Johannes van guestEditor.
• Is Part Of: Studies in family planning. Volume 54:Issue 1(2023)
• Page Start: 63
• Page End: 74
• Publication Date: 2023-01-31
• Subjects: Birth control -- Periodicals; 363.9605
• DOI: 10.1111/sifp.12223
• Languages: English
• ISSNs: 0039-3665

Abstract

Abstract: Contraceptive counseling protocols tend to focus narrowly on pregnancy intentions, which may overlook other factors that contribute to whether an individual wants or needs contraception. In this report, we demonstrate the potential of two measures of individual contraceptive need that could be assessed as part of contraceptive counseling: (1) a composite score constructed from pregnancy intentions, sexual frequency, and perceived fecundity and (2) a direct measure of contraceptive need ( "do you feel it is necessary for you to be using contraception right now?") We compare the two measures using data from Umoyo wa Thanzi, a cohort study in Central Malawi (N = 906; 2017–2018). More frequent sex, perceptions of being more fecund, and a stronger desire to avoid pregnancy were associated with directly reporting contraceptive need (p < 0.001). Women who directly reported contraceptive need had a higher average composite score than women who directly reported they had no need (mean = 7.4 vs. 6.3; p < 0.01), but nearly all participants had scores indicating some risk of unintended pregnancy. Contraceptive counseling protocols should consider assessing women's direct report of contraceptive need, along with risk factors for unintended pregnancy, such as sexual frequency, perceived fecundity, and desire to avoid pregnancy, to better counsel clients.