Institute for Disease Modeling, Bill & Melinda Gates Foundation, Seattle, USA.
Department of Sociology, Leverhulme Centre for Demographic Science and Nuffield College, University of Oxford, Oxford, UK.
Reprod Health. 2024 Nov 21;21(1):169. doi: 10.1186/s12978-024-01899-7.
Contraceptive intention is an important woman-centered indicator for family planning. Yet, few studies have examined the determinants of women or couples actualizing their contraceptive intentions. We leverage panel data from the Performance Monitoring for Action (PMA) survey in Ethiopia to examine these dynamics among a pregnancy cohort, over the first year postpartum. Using cluster analysis on intent-to-use trajectories, we find distinct patterns across wealth categories, education levels, and regions. Additionally, we find that receiving family planning counseling in both antenatal and postnatal care visits led to a higher likelihood of intending to use. However, counseling did not increase the odds of actualization. We argue that examining actualization through model-based approaches like cluster analysis generates better insight into woman-centered contraceptive demand and provides stronger evidence for strengthening postpartum family planning interventions, than quantifying contraceptive use alone. Modeling postpartum actualization trajectories can shed light on the barriers to women's and couple's reproductive autonomy and inform future investments in both upstream development of better contraceptive methods and downstream implementation.
避孕意愿是计划生育以妇女为中心的重要指标。然而，很少有研究探讨妇女或夫妇实现其避孕意愿的决定因素。我们利用来自埃塞俄比亚绩效监测行动（PMA）调查的面板数据，在产后第一年期间，在妊娠队列中研究这些动态。我们使用意向使用轨迹的聚类分析，发现不同的财富类别、教育水平和地区存在不同的模式。此外，我们发现，在产前和产后护理访问中接受计划生育咨询会增加使用的意愿。然而，咨询并不能增加实现的可能性。我们认为，通过基于模型的方法（如聚类分析）来检查实现情况，可以更好地了解以妇女为中心的避孕需求，并为加强产后计划生育干预提供更有力的证据，而不仅仅是量化避孕使用情况。对产后实现轨迹进行建模可以揭示妇女和夫妇生殖自主权的障碍，并为未来在更好的避孕方法的上游开发和下游实施方面的投资提供信息。
