Measuring family planning norms in Zambia: A mixed methods vignette study.

Vignettes have increasingly been used in social norms research, but it is unknown whether vignettes are a valid, culturally appropriate, and effective approach for measuring family planning norms in Zambia. In this mixed methods, cross-sectional study, surveys (n = 438) and focus groups (n = 135) were conducted with married women in two, purposively selected districts in the Central Province, the rural district of Mkushi and the urban district of Kabwe. Social norms constructs measured included: reference groups, descriptive norms, injunctive norms, collective norms, and outcome expectations. Vignettes covered reaching desired family size, using modern contraception for birth spacing, and seeking family planning services. The results complemented each other suggesting vignettes may indeed be a valid approach for measuring family planning norms in this setting, although further research is needed. Successful vignette administration requires translating and back-translating, pretesting in the local language, adapting to the local context, and training. The findings hold implications for future family planning norms measurement, both in Zambia and across global settings.