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.

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 …