International family planning (FP) measures, such as contraceptive prevalence, unmet need, and demand satisfied, have served as critical indicators for tracking progress and assessing the impacts of FP policies and programs. While these population-based measures have been the standard of practice for decades, they have also suffered serious limitations and have come under a strong and growing body of research offering compelling critiques. These have ranged from calling for clarified terminology and correct interpretation of current measures, to the need for new person-centered measures that seek to directly measure contraceptive need, rather than inferring need from reported fertility intentions (Speizer, Bremner, and Farid 2022; Fabic 2022; Dehlendorf et al. 2018; Corker et al. 2025). What has been missing is a clearly defined proposal for new measures that could address these critiques and offer a viable alternative to our current set of topline FP indicators.
The International Union for the Scientific Study of Population (IUSSP) Scientific Panel on Rethinking Family Planning Measurement with a Rights and Justice Lens engages a diverse pool of researchers, policymakers, and program planners from different regions to critically examine global FP indicators to inform improved collection, measurement, assessment, and communication about gaps in FP programming. As part of this work, between March 5 and 7, 2024, the IUSSP Panel convened an international expert group meeting in Mombasa, Kenya, titled “Assessing approaches to demand-side family planning measurement with a reproductive justice and rights framework.” Over 50 participants from 16 countries attended the three-day workshop.
This special issue of Studies in Family Planning incorporates both scientific papers and commentaries that were presented at the Mombasa meeting as well as papers and commentaries that surfaced from conversations that took place at the Mombasa meeting or were inspired by or connected to this work. A particular focus of the IUSSP Scientific Panel is to consider how to frame improved FP measurement within rights and justice frameworks. Human rights–based framing seeks to identify measures that assess the basic right of individuals and couples to decide freely and responsibly the number and spacing of their children (UNFPA 2023/2024). Reproductive justice–based framing seeks to identify measures that demonstrate an individual’s right to bodily autonomy, to have a child, to not have a child, and to parent their children in safe and sustainable communities.² Out of these frameworks comes the recognition of the importance of measures that are person-centered, that is, measures that are responsive to an individual’s own preferences, needs, and values.
What does it mean to consider a new alternative set of FP indicators that are person-centered? First, it means recognizing that we as researchers, program planners, monitoring and evaluation experts, donors, and other interested parties need to consider measures that are not predetermined with a positive outcome (e.g., increased contraceptive use) but rather center measurement on what people themselves want, that is, their expressed needs, values, and preferences. If our indicators are intended to track progress towards better outcomes, those better outcomes need to be based on what people define as the right thing within the context of their own lives. Thus, it is essential to consider a large set of equally valid reproductive outcomes, including the right to use a contraceptive method, the right to not use a contraceptive method, the right to switch or discontinue a method, and the right to choose to have an abortion. The papers in this special issue begin to address these important issues and help to move the conversation forward on improved measures that are more responsive to individuals’ self-identified needs. Of note, the focus of this special issue is measures of contraceptive demand, need, and use, and thus, discussions of rights and justice-informed supply-side measures are outside the scope of this special issue.
The papers in this special issue were categorized into three broad domains covering (a) conceptual reflections for informing measurement development, (b) improving and adapting standard measures, and (c) novel measures and concepts under development. This last category includes new measures around (a) acceptability of contraception, (b) intention to use contraception, (c) measures of need and use, (d) preference-based measures, and (e) agency-focused measures. Below, we briefly summarize the papers across these diverse measurement domains. Collectively, the papers and commentaries in this special issue advance conversations in the FP field in a critical new direction for measurement; they also describe not only why such new directions are necessary but offer compelling options for how we get there. This special issue provides an argument for continued investments in the development of FP measures that are person-centered that prioritize individuals’ preferences, contexts, and values.