Contraceptive counseling protocols tend to focus narrowly on pregnancy intentions, which may overlook other factors that contribute to whether an individual wants or needs contraception. In this report, we demonstrate the potential of two measures of individual contraceptive need that could be assessed as part of contraceptive counseling: (1) a composite score constructed from pregnancy intentions, sexual frequency, and perceived fecundity and (2) a direct measure of contraceptive need (“do you feel it is necessary for you to be using contraception right now?”) We compare the two measures using data from Umoyo wa Thanzi, a cohort study in Central Malawi (N = 906; 2017–2018). More frequent sex, perceptions of being more fecund, and a stronger desire to avoid pregnancy were associated with directly reporting contraceptive need (p < 0.001). Women who directly reported contraceptive need had a higher average composite score than women who directly reported they had no need (mean = 7.4 vs. 6.3; p < 0.01), but nearly all participants had scores indicating some risk of unintended pregnancy. Contraceptive counseling protocols should consider assessing women's direct report of contraceptive need, along with risk factors for unintended pregnancy, such as sexual frequency, perceived fecundity, and desire to avoid pregnancy, to better counsel clients.

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衡量个人避孕需求的细微差别：马拉维队列的案例研究

避孕咨询方案往往狭隘地关注怀孕意图，这可能会忽视影响个人是否想要或需要避孕的其他因素。在本报告中，我们展示了两种衡量个人避孕需求的潜力，可以将其作为避孕咨询的一部分进行评估：（1）根据怀孕意图、性行为频率和感知的生育力构建的综合评分，以及（2）直接衡量避孕需求（“您觉得现在有必要采取避孕措施吗？”）我们使用马拉维中部的一项队列研究Umoyo wa Thanzi的数据（N = 906；2017-2018）对这两种措施进行了比较。更频繁的性行为、对生育能力更强的看法以及更强烈的避免怀孕的愿望与直接报告避孕需求相关（p < 0.001）。直接报告需要避孕的女性比直接报告不需要避孕的女性平均综合得分更高（平均值 = 7.4 vs. 6.3；p < 0.01），但几乎所有参与者的分数都表明存在意外怀孕的风险。避孕咨询方案应考虑评估女性对避孕需求的直接报告，以及意外怀孕的风险因素，例如性行为频率、感知的生育能力和避免怀孕的愿望，以便更好地为客户提供咨询。