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COMMENTARY
Open Access

Recognizing and Addressing the Contraceptive Hesitancy-Acceptability Continuum: Adopting Lessons Learned From the Immunization Field

Madeleine Short Fabic and Amy Ong Tsui
Global Health: Science and Practice December 2024, 12(6):e2400220; https://doi.org/10.9745/GHSP-D-24-00220
Madeleine Short Fabic
aU.S. Agency for International Development, Washington, DC, USA.
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  • For correspondence: mshort@usaid.gov
Amy Ong Tsui
bJohns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Key Messages

  • Given the similarities the family planning (FP) and immunization fields share, we recommend that the FP community consider adopting vaccine hesitancy lessons to take a promising new measurement, investigation, and programming direction.

  • Specifically, building from the 5C scale for measuring vaccine hesitancy—with its components of confidence, constraints, complacency, calculation, and collective responsibility—the FP community can develop and use a new framework to identify and track the major drivers of contraceptive-related behaviors at individual- and community-levels, dubbed the “contraceptive hesitancy-acceptability continuum.”

  • The continuum helps to reorient FP’s measurement approach from a largely binary focus on contraceptive use/non-use, need/met need to a multifaceted focus on the psychosocial context in which individuals make and act on decisions about their reproductive lives. Ultimately, this measurement reorientation will better position FP programs to help address individuals’ sexual and reproductive health needs, aspirations, and rights.

See related article by McDougal et al.

INTRODUCTION

Family planning (FP) programs are generally designed to support individuals and couples in enacting their pregnancy prevention intentions and are often premised on an ideal that everyone who wants to avoid pregnancy can be protected by voluntary, safe, and effective contraception, which includes fertility awareness-based methods (i.e., standard days, 2-day, and lactational amenorrhea methods); barrier methods (i.e., male and female condoms, diaphragms and spermicides, and cervical caps); hormonal methods (i.e., pills, injectables, implants, combined patch, vaginal ring, and hormonal intrauterine device [IUD]); and other nonhormonal methods (i.e., copper IUD, vasectomy, and tubal ligation).1 As program managers and policymakers direct limited resources toward achieving that ideal, data are needed to inform the investments, including data to identify numbers and types of contraceptive users and potential users, as well as barriers to use. Two key indicators—contraceptive prevalence and unmet need—provide some insight into the numbers and types of contraceptive users and potential users; however, both …

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Global Health: Science and Practice: 12 (6)
Global Health: Science and Practice
Vol. 12, No. 6
December 20, 2024
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Recognizing and Addressing the Contraceptive Hesitancy-Acceptability Continuum: Adopting Lessons Learned From the Immunization Field
Madeleine Short Fabic, Amy Ong Tsui
Global Health: Science and Practice Dec 2024, 12 (6) e2400220; DOI: 10.9745/GHSP-D-24-00220

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Recognizing and Addressing the Contraceptive Hesitancy-Acceptability Continuum: Adopting Lessons Learned From the Immunization Field
Madeleine Short Fabic, Amy Ong Tsui
Global Health: Science and Practice Dec 2024, 12 (6) e2400220; DOI: 10.9745/GHSP-D-24-00220
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  • Article
    • INTRODUCTION
    • WORLD HEALTH ORGANIZATION STRATEGIC ADVISORY GROUP OF EXPERTS ON IMMUNIZATION RECOMMENDATIONS
    • VACCINATION AND CONTRACEPTION SIMILARITIES
    • CONTRACEPTIVE HESITANCY-ACCEPTABILITY CONTINUUM FRAMEWORK
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  • Using the 5C Vaccine Hesitancy Framework to Elucidate and Measure Contraceptive Acceptability in sub-Saharan Africa
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