Evidence map›Paper›PMID 41035057›Full record

ArticleContraception and reproductive medicine2025

Piloting measures of provider-imposed contraceptive coercion among reproductive-aged contraceptive users in Kisumu, Kenya: a cross-sectional, population-based study.

Brooke W Bullington, Stephanie Chung, Dickens Otieno Onyango, Leigh Senderowicz, Emilia Goland, Claire W Rothschild, Abigael Mwanyiro, Ben Wekesa, Brian Frizzelle, Ginger Golub and 1 more

Abstract read
In one paragraph

Article in Contraception and reproductive medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Brooke W BullingtonDivision of Family Planning, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA. brooke.bullington@hsc.utah.edu.
Stephanie ChungDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Dickens Otieno OnyangoKisumu County Department of Health, Kisumu, Kenya.
Leigh SenderowiczDepartment of Gender and Women's Studies, University of Wisconsin, Madison, WI, USA.
Emilia GolandDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Claire W RothschildPopulation Services International, Washington, D.C., USA.
Abigael MwanyiroInnovations for Poverty Action (IPA), Nairobi, Kenya.
Ben WekesaInnovations for Poverty Action (IPA), Nairobi, Kenya.
Brian FrizzelleCarolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Ginger GolubInnovations for Poverty Action (IPA), Nairobi, Kenya.
Katherine TumlinsonCarolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Funding

Randomized Controlled Trial to Address Unintended Pregnancy Rates in Low Resource SettingsR01HD101453 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI TUMLINSON, KATHERINE M · 2021 to 2025
$3.2M
Research Training Program in Reproductive and Sexual HealthR25HD115514 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI JESSICA N SANDERS, David Turok · 2024 to 2026
$474k
Contraceptive Autonomy: A Mixed-Methods Approach to Developing a Novel Family Planning MeasureK01HD113818 · NICHD · UNIVERSITY OF WISCONSIN-MADISON · PI Leigh Gabrielle Senderowicz · 2024 to 2026
$411k
National Institute of Child Health and Human Development R01HD101453NICHD NIH HHS K01 HD113818NICHD NIH HHS R01 HD101453NICHD NIH HHS R25 HD115514
6 · The paper itself

Abstract

introductionLittle research has focused on measuring free contraceptive choice, or whether individuals can make decisions about contraception without barriers or coercion. To advance measurement, we pilot survey questions focused on experiences of provider-imposed contraceptive coercion using population-based data collected among contraceptive users in Kisumu, Kenya.

methodsWe describe the percentage of women who reported provider-imposed coercion-related outcomes. We then examine demographic and facility-level correlates of feeling pressured or unable to say no to contraception and compare the extent that measures of feeling pressured and unable to say no to contraception overlap using 2 × 2 tables and Cohen's Kappa Statistic.

resultsThe percentage of participants who reported provider-imposed coercion ranged by question from 1% to 57%. There were no associations between demographic or facility characteristics, including age, marital status, parity, and facility type (public or private), and either reporting feeling pressured or reporting feeling unable to say no to using contraception. There was no agreement between measures of feeling pressured and unable to say no to contraception (Kappa statistic - 0.11).

conclusionsOur findings suggest that many women in Kisumu report experiencing some form of provider-imposed contraceptive coercion, though the proportion who report such experiences varies based on survey question. Further research is needed to improve reliable measurement of free contraceptive choice.

Indexed as

AutonomyCoercionContraceptionFamily planningMeasurementQuality of care

Identifiers

PMID41035057
PMCPMC12487480

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.