There is a gap between goals of supporting reproductive agency and empowerment within family planning programs and measures able to track progress toward those goals. Commonly used family planning measures are beset by imprecise terminology and oversimplification and are often not person centered.

Measuring contraceptive acceptability, which offers a means of understanding if and how contraceptive desire translates into contraceptive demand, requires a conceptual framework identifying the diverse factors that contribute to it.

In assessing how the 5C framework of vaccine hesitancy (confidence, calculation, constraints, complacency, and collective responsibility) may inform our conceptualization of contraceptive acceptability in sub-Saharan Africa, we found that it has relevance, with confidence, calculation, and constraints appearing particularly salient.

However, contraceptive acceptability is informed by additional social and gendered factors, including gender roles, gendered power dynamics, and social norms.

This work represents a first step toward developing and testing a measure of contraceptive acceptability that can more precisely diagnose and support the achievement of self-determined reproductive goals and track progress toward those goals within family planning programs and at individual, community, and population levels.

See related article by Short Fabic and Tsui.

Thirty years after the International Conference on Population and Development (ICPD), ICPD-related themes of reproductive rights, individual agency, and reproductive empowerment remain central to family planning (FP) efforts.1–3 However, measurement of these themes remains a challenge, in large part because of their complexity and contextual nuance.4–7 As the FP community continues to move toward ensuring alignment of goals, indicators, and measurement approaches with these ICPD themes, we see opportunities to overcome some of our long-standing measurement challenges by learning from other health sectors.

Here, we present results from our recent literature review, which builds from a suggestion made by the World Health Organization’s Strategic Advisory Group of …