Moving Past a Legacy of Controlling Women: Key Frameworks to Center Women and Girls’ Choice and Agency in Sexual and Reproductive Health Measurement
by Christine Dehlendorf, Karen Hardee, Evelyne Opondo, Anita Raj
Studies in Family Planning
First published: 09 July 2025
https://doi.org/10.1111/sifp.70027
Commentary
This commentary is part of the special issue: Rethinking Family Planning Measurement with a Rights, Justice, and Person-Centered Lens.
Abstract
As the global community looks beyond the 2030 Sustainable Development Goals agenda, there is a critical opportunity to refine and elevate indicators focused on sexual and reproductive health and rights (SRHR) and to shift nations away from fertility and contraceptive targets. This commentary presents four key frameworks—drawn from a panel at an International Union for the Scientific Study of Population (IUSSP) meeting focused on SRHR measurements—that offer distinct yet complementary lenses for understanding and measuring reproductive choice and agency. These include the EMERGE Empowerment Framework (focused on measurement and evaluation), Patient-Centered Care (focused on clinical practice), the Human Rights Framework (focused on policy), and Reproductive Justice (focused on social change). While not an exhaustive list, these frameworks reflect a diversity of disciplinary perspectives and emphasize the importance of grounding reproductive health indicators in concepts of choice and agency. The empowerment framework centers on individual decision-making and collective action, while person-centered and rights-based approaches evaluate how health systems and policies support or constrain that agency. Reproductive justice expands the lens further, highlighting how structural inequalities shape differential access and outcomes across race, class, and other social determinants of health. Together, these frameworks underscore the need for multilevel, intersectional indicators or reproductive agency—spanning individuals, health systems, communities, and policies—to effectively guide and evaluate the impact of reproductive health programs and policies at scale.
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How It Was and How It Should Be: Moving Toward a Better Measurement of Contraceptive Prevalence Among Unmarried Women
by Apoorva Jadhav, Madeleine Short Fabic, Kerry MacQuarrie
Studies in Family Planning
First published: 07 July 2025
https://doi.org/10.1111/sifp.70028
This article is part of the special issue: Rethinking Family Planning Measurement with a Rights, Justice, and Person-Centered Lens.
Abstract
Contraceptive prevalence among unmarried women — calculated from the response to a version of the question — “Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?” is most accurately measured among those who report sexual recency within the previous four weeks. This approach, long adopted by the Demographic and Health Surveys Program (DHS), has recently been adopted by groups such as FP2030 and Track20. Since this shift toward increased standardization, the DHS Program has included in its core questionnaire questions to better capture contraceptive use at last sex. We use these new DHS data from seven countries to explore whether a composite contraceptive use measure (i.e., current contraceptive use + contraceptive use at last sex) provides a more meaningful assessment of contraceptive use among unmarried women. Based on our findings, we recommend that the family planning field adopt the composite contraceptive use measure as its standard approach for measuring contraceptive prevalence among unmarried women. Our findings provide a guide for more accurately measuring, reporting, and most importantly, understanding the contraceptive practices of unmarried women.