article · Global Health Science and Practice
This research addresses a gap between the principle of human rights-based contraception programming and its practical implementation, highlighting the need for new rights-based measurement tools. It proposes a framework for "contraceptive agency", defined as an individual's ability to make and act on decisions about avoiding or delaying pregnancy, and what to do when not actively trying to conceive. The framework offers a guide for designing and evaluating contraception programmes, ensuring they focus on individuals' capacity to make and act on their own contraceptive choices, irrespective of those choices. Six opportunities for conceptual and measurement innovation are also discussed.
This work is important because it seeks to align contraception programmes with human rights principles, ensuring individuals can genuinely make and act on their own reproductive choices. By providing a clear framework and measurement approach, it can lead to more ethical and effective family planning services that truly empower people.
This conceptual framework is an early-stage tool for organisations involved in public health, family planning, and policy development. It could be used by programme designers, evaluators, and policymakers to create and assess contraception initiatives that genuinely empower individuals. The framework aims to improve the effectiveness and ethical grounding of family planning programmes by focusing on individual choice and agency.
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<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.
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DOI: 10.9745/ghsp-d-23-00299
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