Abstract
Family planning (FP) programs are used to promote safe sexual practices, reduce unintended pregnancies, determine the spacing of pregnancies and supply a broader set of services related to sexual and reproductive health. Family planning (services include contraception, abortion and fertility treatments. Initially the aim of FP programs was to reduce population growth through decreased fertility rates to spur economic growth and poverty reduction. FP programs have sought to increase contraception use and, over time, have also tried to include rights-based approaches within project targets. The main indicator in FP projects is the unmet need indicator. According to the World Health Organization (WHO), 鈥淲omen with unmet need are those who are fecund and sexually active but are not using any method of contraception, and report not wanting any more children or wanting to delay the next child鈥�. Critics have highlighted that the unmet need indicator rests on the assumption that women who do not want children want to use contraception.
This project included 3 rounds of interviews with healthcare practitioners, Non-Governmental Organization (NGO) workers, advocates and government officials regarding ethical challenges encountered in FP programs in Francophone West Africa (FWA). This project also included a qualitative study with a total of 256 participants aimed at exploring the reproductive wishes and lived experiences of women and men in Senegal.
The study uncovered evidence that women in Senegal often feel unheard and unseen by both their partners and family planning providers. NGOs and health care providers from FWA used the 鈥渦nmet need鈥� indicator to justify targets and used counselling sessions as an indicator of informed consent and free choice. Senegalese women reported having short counselling sessions, strong societal pressures to have children. They also feared infertility and side effects generated by FP. The study also uncovered evidence that providers in FWA might at times prompt users to adopt long- acting reversible contraceptive methods (LARCs) over other methods.
FP interventions should further include women鈥檚 voices, actively engage men and address healthcare provider caring burnout.