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The role of evidence in shaping reproductive health policy in the U.S.

Katie Woodruff, University of California School of Public Health

Project abstract

Background: Despite availability of modern contraception, many women remain at risk for unintended pregnancy throughout sub-Saharan Africa due to unmet need for modern contraception. While we have data about general barriers to contraceptive use among non-users of contraception, we lack evidence about factors for each specific method that prevent non-users from using and motivate users to continue using. The purpose of this study is to create, administer, and validate an innovative tool to measure method-specific barriers and facilitators and to examine the relationship between these factors, use, non-use, and discontinuation.

Methods: Leveraging the infrastructure of the Umoyo wa Thanzi (UTHA) cohort study of sexual and reproductive health decision making, the proposed study will administer a new wave of data collection amongst a subset of participants to measure method-specific barriers and facilitators in Malawi. We will administer the tool to 600 women (both users and non-users) in rural Lilongwe district. We will use factor analysis techniques to validate the instrument and conduct bivariate and multivariate statistics to investigate associations between method-specific factors and contraceptive use.

Results: This study will provide a comprehensive understanding of the role that method-specific barriers and facilitators play in women's contraceptive decisions. Working with colleagues in Malawian family planning programs and faculty in the University of Malawi, we will use our findings for improving contraceptive provision. These data will serve as the basis for my doctoral dissertation. We will publish findings in peer-reviewed journals, present them at national and international conferences, and share them with key informants.


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