Conceptualizing Contraceptive Agency: A Critical Step to Enable Human Rights-Based Family Planning Programs and Measurement
Kelsey Holt, Sneha Challa, Phoebe Alitubeera, Lynn Atuyambe, Christine Dehlendorf, Christine Galavotti, Ivan Idiodi, Ayobambo Jegede, Elizabeth Omoluabi, Peter Waiswa, Ushma D. Upadhyay
Abstract
<h3>Key Messages</h3> Despite widespread agreement on the importance of a human rights-based approach to contraception programming, a gap exists between the principle of valuing individual choice and what programs are held accountable for in practice. This gap is reflected in the increasingly recognized need for new rights-based measures. We discuss 6 opportunities for conceptual and measurement innovation and propose a framework for the construct of “contraceptive agency”— the ability of an individual to make and act on decisions related to whether to do something to avoid or delay pregnancy and what, if anything, to do when they are not actively trying to become pregnant. The contraceptive agency framework can serve as a guide for centering individuals’ ability to make and act on their own contraceptive choices, regardless of what those choices are, in contraception program design and evaluation.