ArticleContraception2025
Validation of the contraception-focused Preference-aligned Fertility Management Index in Uganda and Nigeria.
Article in Contraception, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Social influence on women's contraceptive use: Population-based, sociocentric network study in rural Uganda.Social science & medicine (1982) · 2026Article
- It's Time to Get Practical: A Call for Shorter Measures in the Family Planning Community.Studies in family planning · 2026Article
- Rethinking family planning success metrics: moving beyond coverage.Frontiers in global women's health · 2026Article
- What About Well-Being? Measuring What We Really Care About in Sexual and Reproductive Health.Studies in family planning · 2025Article
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19 authors.
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Abstract
objectivesThis study aimed to evaluate construct validity of the contraception-focused "Preference-aligned Fertility Management" (PFM) Index, a new person-centered and rights-based outcome measure, in Nigeria and Uganda. STUDY
designWe analyzed survey data from convenience samples of new users of contraception and nonusers of contraception in Uganda and users of contraception in Nigeria. PFM Index scores were calculated by combining two indicators: indicator 1 assessing alignment between desire to use contraception and actual use; indicator 2 evaluating whether users' current methods are desired. We developed a nomological network of related constructs and conducted bivariable logistic regressions, predicting the odds of PFM associated with each variable.
resultsA total of 71.3% of contraception users in Nigeria, 99.2% of new users in Uganda, and 42.9% of nonusers in Uganda were practicing contraception-focused PFM. In Nigeria, high Women's and Girls' Empowerment in Sexual and Reproductive Health Index scores and permission to visit a health center were significantly associated with higher odds of contraception-focused PFM (odds ratio [OR] = 2.72; 95% CI = 1.01-7.31; OR = 2.64; 95% CI = 1.04-6.73, respectively). In Uganda, women's and partner's secondary school education were significantly associated with higher odds of contraception-focused PFM (OR = 2.58, 95% CI = 1.58-4.24; OR = 2.01; 95% CI = 1.54-2.62, respectively); as were concordance with partner's desired number of children, recent experience of gender-based violence, and satisfaction with what (if anything) one is doing to prevent pregnancy (OR = 1.48, 95% CI = 1.30-1.69; OR = 2.33; 95% CI = 1.52-3.56; OR = 4.44, 95% CI = 2.77-7.12, respectively).
conclusionsThe contraception-focused PFM Index demonstrated construct validity in Nigeria and Uganda. PFM and other new measures of self-defined need contribute to the paradigm shift underway to align contraception indicators with human rights principles. IMPLICATIONS: The contraception-focused PFM Index is a novel person-centered, rights-based measure that can be used to gauge whether individuals' self-defined needs related to contraception are met by programs and policies. Our study finds evidence for construct validity of the index among contraceptive users in Nigeria and Uganda and nonusers in Uganda.
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