Senderowicz Leigh, Bullington Brooke W, Sawadogo Nathalie, Tumlinson Katherine
Department of Obstetrics and Gynecology, Department of Gender and Women's Studies, University of Wisconsin-Madison, Madison, WI (Senderowicz).
Department of Epidemiology, Carolina Population Center, University of North Carolina Gillings School of Global Health, Chapel Hill, NC (Bullington).
AJOG Glob Rep. 2024 Jul 6;4(4):100376. doi: 10.1016/j.xagr.2024.100376. eCollection 2024 Nov.
Family planning programs are foundationally important to public health, but like any medical intervention, contraception has drawbacks in addition to its benefits. Knowledge of these drawbacks in addition to benefits is essential for informed choice. Despite a general consensus among family planning researchers and providers that contraceptive counseling should be unbiased, little quantitative research has assessed the extent of bias in contraceptive counseling, and in people's contraceptive knowledge more broadly.
To understand the extent to which women report being told more about the advantages of contraception than the disadvantages-a concept we call "asymmetry" in contraceptive counseling, at two research sites in Burkina Faso.
We use data from a cross-sectional population-based survey of 3,929 women residing in the catchment areas of the Ouagadougou (urban) and the Nouna (rural) Health and Demographic Surveillance Systems in Burkina Faso. We use descriptive statistics to explore asymmetry in knowledge of the benefits/advantages and risks/disadvantages of contraceptive use overall, as well as method-specific asymmetry among current method users regarding their counseling experience.
Results show substantial asymmetry in knowledge of advantages/benefits of contraception compared to disadvantages/risks. 86% of respondents said they could name any advantage of family planning, while half of that proportion (43%) could name any disadvantage. We find a similarly stark asymmetry in method-specific results among contraceptive users, especially for hormonal/biomedical methods. We also find substantial variation between research sites, with urban respondents much less likely to self-report complete family planning knowledge than their rural counterparts.
Our results suggest that family planning messaging in Burkina Faso may place an emphasis on the advantages without a commensurate focus on disadvantages. Family planning programs worldwide must ensure that people can make informed choices based on balanced, accurate information about both the benefits and the disadvantages of contraception.
计划生育项目对公共卫生至关重要，但与任何医疗干预措施一样，避孕除了有好处外也有缺点。了解这些优缺点对于做出明智的选择至关重要。尽管计划生育研究人员和提供者普遍认为避孕咨询应该公正无偏见，但很少有定量研究评估避孕咨询中的偏见程度，以及更广泛地说人们的避孕知识中的偏见程度。
在布基纳法索的两个研究地点，了解女性报告被告知的避孕优点比缺点更多的程度——我们将避孕咨询中的这一概念称为“不对称”。
我们使用了对居住在布基纳法索瓦加杜古（城市）和努纳（农村）健康与人口监测系统集水区的3929名女性进行的基于人群的横断面调查数据。我们使用描述性统计来探讨总体上避孕使用的益处/优点和风险/缺点知识的不对称性，以及当前方法使用者在其咨询经历方面特定方法的不对称性。
结果显示，与缺点/风险相比，避孕优点/益处的知识存在很大的不对称性。86%的受访者表示他们能说出计划生育的任何一个优点，而能说出任何一个缺点的比例为该比例的一半（43%）。我们在避孕使用者的特定方法结果中也发现了类似的明显不对称，尤其是对于激素/生物医学方法。我们还发现研究地点之间存在很大差异，城市受访者自我报告完全了解计划生育知识的可能性远低于农村受访者。
我们的结果表明，布基纳法索的计划生育宣传可能强调优点而没有相应地关注缺点。全球的计划生育项目必须确保人们能够基于关于避孕益处和缺点的平衡、准确信息做出明智的选择。
