Stud Fam Plann
· 2025 Dec · PMID 41024608
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This study examines changes in women's attitudes toward abortion in Brazil during the first year of the COVID-19 pandemic, focusing on the role of religious affiliation. Brazil provides a unique context for examining abo...This study examines changes in women's attitudes toward abortion in Brazil during the first year of the COVID-19 pandemic, focusing on the role of religious affiliation. Brazil provides a unique context for examining abortion attitudes because of its strict abortion policies, changing religious landscape, and back-to-back Zika and COVID-19 crises. We used data from a population-based sample of 2335 women ages 18-34 in Pernambuco, Brazil, collected during the onset of the COVID-19 pandemic (May-September 2020) and one year later (May-September 2021). Multivariable-adjusted multinomial logistic regression models were used to assess changes in support for abortion in cases of maternal Zika or COVID-19 infection during pregnancy. Women were less supportive of abortion in the case of maternal COVID-19 infection (34 percent) compared to Zika infection (41 percent). About half of the women changed their abortion attitudes during the year. Pentecostal Evangelicals were more likely to decrease support, while nonreligious women or those with less conservative affiliations were more likely to increase support. Greater worry about Zika and COVID-19 was associated with higher support for abortion. The study highlights the dynamic nature of abortion attitudes, which should be considered when forming policies, especially during crises.
Challa S, Upadhyay UD, Wasswa R
… +15 more, Nanono S, Idiodi I, Okoli C, Alitubeera P, Amongin D, Jegede A, Tijani A, Birabwa C, Atuyambe L, Dimowo S, Nmadu G, Dehlendorf C, Omoluabi E, Waiswa P, Holt K
Stud Fam Plann
· 2025 Sep · PMID 40984665
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To fill a gap in measures of empowered contraceptive decision-making, we developed the Agency in Contraceptive Decisions Scale in Uganda and Nigeria. We developed an item pool drawing on the previously published Contrace...To fill a gap in measures of empowered contraceptive decision-making, we developed the Agency in Contraceptive Decisions Scale in Uganda and Nigeria. We developed an item pool drawing on the previously published Contraceptive Agency framework. We refined items through cognitive interviews (N = 80) and expert feedback and piloted a reduced item pool via surveys (N = 3002). Exploratory factor analysis using a random half of the sample suggested a 15-item scale (Cronbach's α = 0.8) including four subscales: (1) Beliefs about Rights and Perceived Decision-making Control (α = 0.8), (2) Decision-making Self-efficacy (α = 0.8), (3) Knowledge Aligned with Preferences (α = 0.8), and (4) Control over Use or Non-use (α = 0.8). Confirmatory factor analysis with the other half of the sample supported this solution. Agency in Contraceptive Decisions Scale scores were significantly associated with scores on the contraceptive existence of choice and contraceptive exercise of choice subscales of the Women's and Girls Empowerment in Sexual and Reproductive Health Index, supporting construct validity. The 15-item Agency in Contraceptive Decisions Scale and individual subscales are valid and reliable for use in Nigeria and Uganda. This measure offers an innovative alternative for gauging the success of contraceptive programs and policies in advancing the right to empowered choices.
Gausman J, Saggurti N, Adanu R
… +13 more, Bandoh DAB, Berrueta M, Chakraborty S, Kenu E, Khan N, Langer A, Carolina N, Odikro MA, Pingray V, Ramesh S, Vázquez P, Williams CR, Jolivet RR
Stud Fam Plann
· 2025 Sep · PMID 40955621
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Unwanted family planning often refers to fertility desires as a proxy for contraceptive desire and lacks alignment with the tenets of person-centered care. We construct a person-centered measure of unwanted family planni...Unwanted family planning often refers to fertility desires as a proxy for contraceptive desire and lacks alignment with the tenets of person-centered care. We construct a person-centered measure of unwanted family planning by asking women whether they wanted to use a method, examine its alignment with the fertility-derived measure, and describe the characteristics of women with unwanted family planning and reasons women state for not wanting to use a method. We conducted a cross-sectional study of women aged 15-49 in Argentina, Ghana, and India. Data were collected on stated desire to use contraception and basic sociodemographic characteristics. Fertility desire was collected using the standard Demographic and Health Survey questionnaire. In total, 4794 women were included in our study. Among women using a method, 2.5 percent (n = 53) of women had unwanted family planning, with 4.2 percent in Ghana, 2.2 percent in Argentina, and 2.0 percent in India. Most unwanted family planning (85.2 percent, n = 23) occurred among women who did not want a child within the next nine months. Sexual infrequency was the most common reason behind a lack of desire to use a method. Our results highlight the substantial differences found between classifying women's contraceptive needs from a person-centered versus a fertility-derived approach.
Cardona C, Asker J, Sanchez E
… +1 more, Anglewicz P
Stud Fam Plann
· 2025 Sep · PMID 40947775
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Despite the growing interest in person-centered measures for family planning and the importance of reproductive preferences, little is known about the measurement of contraceptive preferences. Population surveys have imp...Despite the growing interest in person-centered measures for family planning and the importance of reproductive preferences, little is known about the measurement of contraceptive preferences. Population surveys have implicitly assumed that contracepting people have achieved their method of choice. In this scoping review, we explored how contraceptive method preferences have been defined and measured in different settings. We included 55 articles focused on measuring people's preferred method of contraception or preferred attributes of contraception. Thirty-seven articles were conducted in high-income countries (HIC), five in upper-middle-income countries (UMIC), and thirteen in low- and middle-income countries (LMIC). Sixteen articles measured preferences for specific methods of contraception, 36 measured the preferred attributes of contraceptive methods, and three implemented both approaches. Four articles used consistent language to measure the preferred method of contraception, although many used synonyms of "preferences," and some constrained their questions to method availability or cost. The measurement of preferred attributes of contraception varied across articles, even within similar contexts and populations. Key attributes included side effects, effectiveness, and cost. Our results highlight the increasing interest in understanding contraceptive preferences, but gaps remain in developing best practices. This is critical as the family planning field moves toward person-centered metrics that emphasize individual choice.
Arana-Ovalle R, Dillon L, Murua A
… +1 more, Zamudio-Sánchez F
Stud Fam Plann
· 2025 Dec · PMID 40931754
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This study examines Mexico's fertility transition (1930-2015) and how socioeconomic status (SES), geography, and indigeneity shaped reproductive behaviors. Using net fertility-the number of surviving children under five-...This study examines Mexico's fertility transition (1930-2015) and how socioeconomic status (SES), geography, and indigeneity shaped reproductive behaviors. Using net fertility-the number of surviving children under five-we assess how prestige bias (adopting high-status fertility norms) and conformism bias (aligning with local norms) influenced change across distinct population groups. We introduce the time, space, and population model to analyze the combined effects of macrostructural forces, spatial diffusion, and individual decision-making. Our spatial analysis reveals a concentric diffusion pattern, where fertility changes spread outward from urban, high-SES municipalities. Findings reveal a consistent negative association between SES and fertility across all periods, though with varying intensity. Higher status populations led the fertility decline, but patterns differed by group and over time. Fertility declined at different rates across four groups: urban non-Indigenous populations transitioned rapidly, rural non-Indigenous groups stagnated, rural Indigenous populations experienced delays, and urban Indigenous groups resisted fertility decline. Evidence suggests non-Indigenous populations regulated fertility through retarding marriage before widespread contraceptive adoption, while Indigenous groups followed more conformist behaviors. This study integrates historical demographic data into a structured framework, improving research on long-term fertility transitions.
In the 30 years since the 1994 International Conference on Population and Development, there is no clear consensus on how to best measure population-level contraceptive use and family planning program impact. Widely used...In the 30 years since the 1994 International Conference on Population and Development, there is no clear consensus on how to best measure population-level contraceptive use and family planning program impact. Widely used metrics have evolved relatively slowly, and some have run counter to a rights-based and person-centered approach that emphasizes individuals' self-identified contraceptive preferences. In this report, we describe the utilization of an understudied family planning measure-women's expressed intent to use (ITU) contraceptives within the next year-and explore its implications for population-level standardized comparisons and family planning programs using the Performance Monitoring for Action program data in 10 low- and middle-income geographies. Specifically, we assess the extent to which ITU captures women's near-term contraceptive needs and how it differs from the traditional demand measure of "unmet need." Building off the "demand satisfied" indicator-which itself is derived from the concept of "unmet need," we propose a new person-centered metric, "intent satisfied," to provide point estimates of population-level contraceptive use that more closely align with women's stated needs. We also discuss the limitations of the "intent satisfied" metric, making recommendations for data efforts to improve and include ITU as a routinely reported family planning indicator.
Corker J, Speizer IS, Fotso JC
… +2 more, Saggurti N, Sully E
Stud Fam Plann
· 2025 Sep · PMID 40789976
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The "intention to use" (ITU) contraception indicator has gained recent prominence as a proposed high-level success metric for family planning (FP) programs and as a step toward identifying measures that better capture wh...The "intention to use" (ITU) contraception indicator has gained recent prominence as a proposed high-level success metric for family planning (FP) programs and as a step toward identifying measures that better capture what women want. Although ITU offers advantages over traditional indicators like contraceptive prevalence and unmet need, its elevation as a key programmatic measure requires critical examination. In this commentary, we outline advantages of ITU to measure FP demand and offer critiques and considerations for reliance on ITU as a demand metric for measuring programmatic success. We argue that while ITU may be a step toward more person-centered measurement, it is not inherently person-centered. Rather than positioning ITU as an innovative person-centered breakthrough, we argue it should be considered a transitional measure-a bridge toward more comprehensive indicators that capture the complexities of contraceptive decision-making. We recognize the current lack of viable alternatives for programs seeking a singular person-centered measure; when used, ITU should be complemented by additional topline indicators that capture access, agency, and preferences. With declining research funding and data infrastructure disruptions, it is important that ITU complement, not replace, efforts to develop the next generation of FP measurement that meaningfully reflects people's contraceptive realities.
Deignan C, Odiachi A, Kisaakye P
… +16 more, Woks NIE, Amongin D, Spindler E, Ayuk Agbor JA, Bukuluki P, Bagabo A, Awor E, Short Fabic M, McLarnon C, Lundgren R, Pryor S, Larson E, Fotso JC, Mohamadou H, Saleta L, McDougal L
Stud Fam Plann
· 2025 Sep · PMID 40753587
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Although empowerment-focused reproductive health measures have expanded in recent years, gaps exist in measuring person-centered contraceptive desire and demand. We address this gap by examining the degree to which indiv...Although empowerment-focused reproductive health measures have expanded in recent years, gaps exist in measuring person-centered contraceptive desire and demand. We address this gap by examining the degree to which individuals feel that contraception is acceptable. This study explores women's and men's experiences of contraceptive acceptability and tests the applicability of the "5C" framework of vaccine hesitancy to contraceptive demand and behaviors. We conducted 60 in-depth interviews and 12 focus group discussions with women and men in Kenya and Cameroon. A multi-country team thematically coded and analyzed data using inductive and deductive approaches. Our findings show that three domains of the "5C" vaccine hesitancy framework were particularly salient to participants' experiences of contraceptive acceptability. Perceptions of contraceptive safety and effectiveness (confidence), personal and others' experiences with contraception (calculation), and contraceptive services quality (constraints) all influenced contraceptive acceptability. Additionally, three new domains emerged: family responsibility, partner engagement, and childbearing expectations. Taken together, these six domains comprise the construct of contraceptive acceptability, which influences contraceptive demand and consequent contraceptive behaviors. This work offers a conceptual underpinning to inform the development of a contraceptive acceptability measure that centers choice and agency in family planning programs and research.
Strong J, Coast E, Corker J
… +1 more, Weinberger M
Stud Fam Plann
· 2025 Sep · PMID 40660800
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Emergency contraceptive pills (ECP) are an essential and unique postcoital method of preventing pregnancy. Trends in supply data show that sales of ECP are increasing at faster rates globally than many other contraceptiv...Emergency contraceptive pills (ECP) are an essential and unique postcoital method of preventing pregnancy. Trends in supply data show that sales of ECP are increasing at faster rates globally than many other contraceptives. Yet nationally representative survey data suggest that ECP use has remained relatively static overtime, suggesting significant measure and reporting issues. Accurate measurement of ECP use is critical for informing policies and programs that provide people the choice and freedom to exercise their reproductive rights. There is an urgent need for a revision of ECP measurement to better capture the realities of people's contraceptive needs and desires. In this commentary, we outline the key reasons why surveys may be underreporting and misreporting ECP. We focus on issues around current method-specific measurements, definition issues around "use" and problems with survey questions and prompt phraseology. We illustrate the importance of recognizing other postcoital methods and strategies that people use when trying to prevent a pregnancy, and the implications this has for ECP measurement. As ECP use evolves, we offer recommendations for survey revisions and further research that can ensure that ECP measurement is robust and able to provide accurate reporting in the future.
Vincent S, Herrera-Almanza C, Anukriti S
… +1 more, Karra M
Stud Fam Plann
· 2025 Sep · PMID 40635291
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We propose an indicator of contraceptive concordance that identifies the alignment between stated preferences for contraception and concurrent contraceptive behavior. Our indicator departs from traditional approaches to...We propose an indicator of contraceptive concordance that identifies the alignment between stated preferences for contraception and concurrent contraceptive behavior. Our indicator departs from traditional approaches to measurement in family planning that infer concordance to be the alignment between women's contraceptive (non-)use and their fertility preferences. We estimate our indicator using data from a cross-sectional survey that was conducted with 1,958 married women in rural India. More than half of all women in our sample (51.2 percent) report that they are currently using a contraceptive method. More than three in five women (60.8 percent) were classified as wanting to use a contraceptive method at the time of the survey. We find that 60 percent of women in our sample are classified to be concordant (either wanted users or wanted nonusers), while almost 1 in 4 women (24.8 percent) state a preference for using contraception but are not users (unwanted nonusers), and 15.2 percent of women in our sample state a preference for not using contraception but are users (unwanted users). We discuss the comparative advantages and limitations of our approach relative to traditional measures and other recently developed indicators.
Stud Fam Plann
· 2025 Sep · PMID 40631486
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As the global community looks beyond the 2030 Sustainable Development Goals agenda, there is a critical opportunity to refine and elevate indicators focused on sexual and reproductive health and rights (SRHR) and to shif...As the global community looks beyond the 2030 Sustainable Development Goals agenda, there is a critical opportunity to refine and elevate indicators focused on sexual and reproductive health and rights (SRHR) and to shift nations away from fertility and contraceptive targets. This commentary presents four key frameworks-drawn from a panel at an International Union for the Scientific Study of Population (IUSSP) meeting focused on SRHR measurements-that offer distinct yet complementary lenses for understanding and measuring reproductive choice and agency. These include the EMERGE Empowerment Framework (focused on measurement and evaluation), Patient-Centered Care (focused on clinical practice), the Human Rights Framework (focused on policy), and Reproductive Justice (focused on social change). While not an exhaustive list, these frameworks reflect a diversity of disciplinary perspectives and emphasize the importance of grounding reproductive health indicators in concepts of choice and agency. The empowerment framework centers on individual decision-making and collective action, while person-centered and rights-based approaches evaluate how health systems and policies support or constrain that agency. Reproductive justice expands the lens further, highlighting how structural inequalities shape differential access and outcomes across race, class, and other social determinants of health. Together, these frameworks underscore the need for multilevel, intersectional indicators or reproductive agency-spanning individuals, health systems, communities, and policies-to effectively guide and evaluate the impact of reproductive health programs and policies at scale.
Wood F, McLarnon C, Smith S
… +2 more, Yerabandi N, McDougal L
Stud Fam Plann
· 2025 Sep · PMID 40631465
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Improving women's agency in family planning is an integral component of empowerment, requiring culturally relevant, reliable, and valid measures. Measuring agency-action towards the achievement of self-determined goals-i...Improving women's agency in family planning is an integral component of empowerment, requiring culturally relevant, reliable, and valid measures. Measuring agency-action towards the achievement of self-determined goals-is key to tracking progress as highlighted by its inclusion in the Sustainable Development Goals. Yet, agency measurement within low- and middle-income contexts has all too often involved applying measures developed and tested in high-income contexts, and conceptual confusion has also led to both overlapping measures and those that omit key facets of agency. To examine the construction and application of agency measures in family planning research and programs, we conducted a scoping review of studies in low-and middle-income countries. Of 9,289 articles and abstracts screened, 72 met our inclusion criteria and included family planning outcomes. We identified 58 unique measures. Most measures were summative and described psychometric testing. Measures often included family planning-specific items, generally focused on contraceptive use with less attention to areas such as communication, access to services, or fertility timing. While increased interest in measuring family planning agency is evident, inconsistencies in measurement hinder cross-contextual comparisons. As family planning research and programs adopt empowerment-focused benchmarks, validated measures of agency are needed to accurately assess impact.
Contraceptive prevalence among unmarried women-calculated from the response to a version of the question-"Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?" is most...Contraceptive prevalence among unmarried women-calculated from the response to a version of the question-"Are you or your partner currently doing something or using any method to delay or avoid getting pregnant?" is most accurately measured among those who report sexual recency within the previous four weeks. This approach, long adopted by The Demographic and Health Surveys Program (DHS), has recently been adopted by groups such as FP2030 and Track20. Since this shift toward increased standardization, the DHS Program has included in its core questionnaire questions to better capture contraceptive use at last sex. We use these new DHS data from seven countries to explore whether a composite contraceptive use measure (i.e., current contraceptive use + contraceptive use at last sex) provides a more meaningful assessment of contraceptive use among unmarried women. Based on our findings, we recommend that the family planning field adopt the composite contraceptive use measure as its standard approach for measuring contraceptive prevalence among unmarried women. Our findings provide a guide for more accurately measuring, reporting, and most importantly, understanding the contraceptive practices of unmarried women.
Mulhern O, Hussain R, Strong J
… +5 more, Moore AM, Tignor M, Afsana K, Mondal PP, Hossain A
Stud Fam Plann
· 2025 Sep · PMID 40605238
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The standard measure of unmet need for contraception is not person-centered and may not adequately represent women's contraceptive needs. To demonstrate the strength of a modified measure, we replicated the standard algo...The standard measure of unmet need for contraception is not person-centered and may not adequately represent women's contraceptive needs. To demonstrate the strength of a modified measure, we replicated the standard algorithm for unmet need, then created a person-centered algorithm that considers (1) whether nonusers want to use contraception and (2) whether users want to use a different method. We applied the standard and person-centered algorithms to a sample of 847 married Rohingya women aged 15-49 years living in camps in Cox's Bazar, Bangladesh, a population about whom little is known regarding contraceptive need. Forty-six percent of respondents were currently using contraception. Among users, 14 percent wanted to use a different method and 36 percent of nonusers wanted to use a method. Using the standard algorithm, 39 percent had "unmet need," 18 percent had "no need," and 44 percent had "met need." Using the person-centered measure, 24 percent had "unmet need," 38 percent had "no need," and 38 percent had "met need." The standard algorithm may overestimate unmet need among Rohingya nonusers, and the person-centered measure provides evidence of method dissatisfaction among users. This measure also complements existing person-centered measures of need and is an example of how incremental change can improve our understanding of women's contraceptive needs.
Rothschild CW, Holt K, OlaOlorun FM
… +3 more, Njogu J, Musau A, Dehlendorf C
Stud Fam Plann
· 2025 Sep · PMID 40551444
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Despite growing enthusiasm for measurement approaches that capture individuals' needs, values, and preferences, there remains a lack of conceptual clarity regarding person-centered measurement in the global field of cont...Despite growing enthusiasm for measurement approaches that capture individuals' needs, values, and preferences, there remains a lack of conceptual clarity regarding person-centered measurement in the global field of contraception. In this commentary, we propose a working definition of person-centered measurement within the contraceptive field and describe how this definition can be applied to existing and novel contraceptive indicators. We argue that person-centered measures of contraception must both reflect an individual's self-identified values, needs, and/or preferences related to contraception and allow an individual to assess the extent to which these values, needs, and/or preferences have been fulfilled. As a result, a person-centered measure allows the individual to define for themselves whether a "good" outcome has been achieved. While person-centered measures are a critical component of measuring the performance of contraceptive programs, measurement frameworks must also include non-person-centered measures that allow evaluation of normative constructs such as human rights and reproductive justice.
Pearson E, Uysal J, Boyce S
… +5 more, Robinson A, Piay-Fernandez N, Ramanarayanan D, Barnes S, Silverman JG
Stud Fam Plann
· 2025 Sep · PMID 40542459
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The term reproductive violence (RV) unifies forms of gender-based violence that compromise reproductive autonomy. This study developed a multilevel quantitative measurement framework for RV comprised of indicators at the...The term reproductive violence (RV) unifies forms of gender-based violence that compromise reproductive autonomy. This study developed a multilevel quantitative measurement framework for RV comprised of indicators at the interpersonal, community, institutional, and law and policy levels. We conducted a systematized literature review, extracting and scoring existing indicators based on prior testing in a low- and middle-income country setting, psychometric data, feasibility, and face validity. The literature review identified 84 peer-reviewed studies, inclusive of 448 indicators that were extracted and scored. Ultimately, 112 indicators were included in the RV measurement framework. Indicators were organized by level of the social-ecological model and across three categories: (1) pregnancy-promoting RV, (2) pregnancy-preventing RV, and (3) legal and social liabilities of pregnancy and parenthood. This study provides the first multilevel measurement framework for RV. Further research is needed to develop indicators for understudied RV constructs and validate the framework. The resulting framework will be used at the subnational, national, and regional levels to understand barriers to reproductive autonomy.
Potter JE, Burke KL, Eilers MA
… +1 more, Powers DA
Stud Fam Plann
· 2025 Sep · PMID 40542458
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Many people at risk of an undesired pregnancy are not using their preferred contraceptive method. On its own, discordant use is an important indicator of reproductive autonomy. It may also affect reproductive outcomes, a...Many people at risk of an undesired pregnancy are not using their preferred contraceptive method. On its own, discordant use is an important indicator of reproductive autonomy. It may also affect reproductive outcomes, although little research has explored the consequences of unsatisfied contraceptive preferences. Using prospective data for the two years following delivery for a cohort of low-income postpartum women in Texas, many of whom would have preferred to be using a more effective method than the one they were using, we ask: How would the pregnancy trajectories of those not using their preferred contraceptive have differed had they been able to access their preferred method? Taking an inverse probability of treatment weighting approach, we show that using a preferred method was associated with half the likelihood of conceiving a pregnancy likely to result in a birth within 21 months postpartum (adjusted hazard ratio 0.43; 95 percent confidence interval 0.32, 0.57). Our findings highlight the consequences of failing to provide people with their preferred method and reveal how, in a context where people face substantial barriers to reproductive healthcare, discordant use increases the risk that people will have a baby that they did not desire at that time or, in some cases, ever.
Speizer IS, Sully EA, Hashem YM
… +1 more, Oduro MAA
Stud Fam Plann
· 2025 Sep · PMID 40500980
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Standard measures used to assess family planning (FP) program success, including unmet need and demand satisfied, fail to capture women's, men's, couples', and adolescents' own expressed preferences, needs, wants, and de...Standard measures used to assess family planning (FP) program success, including unmet need and demand satisfied, fail to capture women's, men's, couples', and adolescents' own expressed preferences, needs, wants, and desires. Identification is needed of person-centered fertility and FP measures that assess what individuals want, desire, need, and prefer without a researcher-ascribed value of what is the right outcome. This scoping review examines how the concept of person-centeredness has been employed as part of population-based FP measurement. For this review, we defined measures as person-centered if they assess directly a person's preferences, wants, and desires while at the same time assessing if the person can or wants to meet those preferences, wants, and desires. The review finds several studies that use or adapt standard measures of intention to use contraception and unmet need; however, a smaller number develop novel approaches that capture method preferences and satisfaction with methods to better capture individuals' needs, wants, and desires as well as their ability to attain these needs, wants, and desires. Results are used to make recommendations going forward for the design and testing of improved person-centered FP measurement at the global, national, and programmatic levels.
Dehlendorf C, Sarnaik S, Bell AJ
… +14 more, Lindsey A, Hart J, Desai S, Balde B, Galavotti C, Gebrehanna E, Hall J, Khanna R, Philpott A, Remmerie L, Saggurti N, Sathar ZA, van Reeuwijk M, Boydell V
Stud Fam Plann
· 2025 Dec · PMID 40490859
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The well-being of individuals and communities is increasingly recognized as a core objective of economic and global development policies and programs. However, existing measures of well-being neglect sexual and reproduct...The well-being of individuals and communities is increasingly recognized as a core objective of economic and global development policies and programs. However, existing measures of well-being neglect sexual and reproductive experiences, which are core dimensions of people's lives. While there has been increasing attention to the concept of sexual well-being, measures of sexual and reproductive health are predominantly deficit-based and ignore whether people are having positive experiences. To consider the development of a measure of sexual and reproductive well-being, a multidisciplinary and geographically diverse group of experts was convened. Outcomes of this meeting included endorsement of a draft definition of sexual and reproductive well-being, demonstrated enthusiasm and commitment to the development of a measure capturing this construct, and delineation of core considerations in the measure development process. These included considering the diversity of normative and political contexts around sexuality and reproduction, and the critical nature of meaningful community engagement when developing this measure. A pathway for measuring development was defined, with the goal of creating a concise measure assessing people's holistic experiences of sexuality and reproduction that can draw attention to and monitor the extent to which people are having the sexual and reproductive lives they wish to have.