Measuring autonomy: An overlooked dimension in contraceptive indicators
Awarded 2017
Large Research Grants
Ana Langer, MD
Harvard University

Though important progress has been made toward advancing women-centered, rights-based family planning since the 1994 ICPD in Cairo, the indicators that we use to evaluate family planning remain stubbornly focused on the pre-Cairo agenda of contraceptive coverage and fertility. The lack of a macro-level indicator that captures what women actually want may create perverse incentives for programs to prioritize contraceptive coverage above other important goals. We seek to conduct a study in both rural and urban Burkina Faso on autonomy and women- centeredness in family planning programs. Strongly informed by the results of a formative, qualitative research phase, we will draft a quantitative survey questionnaire that seeks to measure women’s experiences with autonomy and coercion at the population level. Cognitive interviews and respondent de-brief will be used to pre-test the questions, before they are deployed to a sample of more than 1,100 women in the Nouna and Ouagadougou Health and Demographic Surveillance Systems. Results of this quantitative survey will be used to calculate an “autonomy score” to adjust contraceptive prevalence rates (CPR). This research will serve as the basis for future stages of a project to test and validate an autonomy-adjusted CPR indicator. The ultimate goal of this project is to develop a set of concise questions that reflect the reproductive justice framework, and can easily be incorporated into population-based household surveys. This new indicator will be measured across both time and place, allowing for comparison between programs, as well as for the tracking of progress over time.