Values and preferences for contraception: A global systematic review.

OBJECTIVE: To identify and synthesize original research on contraceptive user values, preferences, views, and concerns about specific family planning methods, as well as perspectives from health workers. STUDY
DESIGN: We conducted a systematic review of global contraceptive user values and preferences. We searched 10 electronic databases for qualitative and quantitative studies published from 2005 to 2020 and extracted data in duplicate using standard forms.
RESULTS: Overall, 423 original research articles from 93 countries among various groups of end-users and health workers in all 6 World Health Organization regions and all 4 World Bank income classification categories met inclusion criteria. Of these, 250 (59%) articles were from high-income countries, mostly from the United States of America (n = 139), the United Kingdom (n = 29), and Australia (n = 23). Quantitative methods were used in 269 articles, most often cross-sectional surveys (n = 190). Qualitative interviews were used in 116 articles and focus group discussions in 69 articles. The most commonly reported themes included side effects, effectiveness, and ease/frequency/duration of use. Interference in sex and partner relations, menstrual effects, reversibility, counseling/interactions with health workers, cost/availability, autonomy, and discreet use were also important. Users generally reported satisfaction with (and more accurate knowledge about) the methods they were using.
CONCLUSIONS: Contraceptive users have diverse values and preferences, although there is consistency in core themes across settings. Despite the large body of literature identified and relevance to person-centered care, varied reporting of findings limited robust synthesis and quantification of the review results.

Introduction

Understanding the values and preferences of contraceptive users is an important component of good healthcare practice at clinical, community, and health system levels, and can ultimately support contraceptive users in identifying and using a method that suits their needs and enables them to meet their family planning goals. Choice—or rather, optimizing choice—is a fundamental principle that guides efforts to strengthen the quality of family planning and contraceptive services [1]. At the clinical level, health workers will be better equipped to work with clients to meet each individual's reproductive health needs if they have an understanding of user values and preferences. Community-level support for contraceptive use, which may include awareness and access through local health workers and pharmacists, media campaigns, and large-scale training and information activities, will benefit from greater understanding of the range of values and preferences. At the health system level, service providers will be better able to respond to unmet need for family planning and empower individuals to access and use preferred contraceptive methods if they are attuned to what end-users value and prefer.

The World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use [2] and Selected Practice Recommendations for Contraceptive Use [3] guidelines present information on the safety of various contraceptive methods in the context of specific health conditions and personal characteristics, and how to safely and effectively use a particular method once a person is deemed medically eligible. WHO's guideline development process [4], considers the values and preferences of end-users of contraception and health workers—the individuals and populations affected by the intervention—within the review and development of these guidelines. To inform updated versions of these guidelines, we conducted a systematic review using systematic search, screening, and data abstraction methods to examine values and preferences for all of the contraceptive methods covered. In this manuscript, we present our overall findings from the global review [5,6]. Additional papers in this series detail values and preferences for specific populations of contraceptive end-users and health workers [7-11].

Methods

We conducted this review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines [12]. We previously published a detailed description of the methods for the review [6].

Briefly, we searched 10 electronic databases (PubMed, PsycINFO, Sociological Abstracts, CINAHL, Scopus, LILACS, WHO Global Health Libraries, Ovid Global Health, Embase, and POPLINE), secondary-searched several relevant review articles [[13], [14], [15], [16]–17], and asked experts in the field to identify articles published in a peer-reviewed journal between January 1, 2005 and July 27, 2020. Articles had to present primary data (qualitative or quantitative) on contraceptive clients’ or health workers’ values, preferences, views, or concerns regarding the contraceptive methods considered within the WHO's Medical Eligibility Criteria for Contraceptive Use and Selected Practice Recommendations for Contraceptive Use guidelines. To keep the review as broad as possible, we set no restrictions based on language of publication, country/setting, or study design. We searched using key terms for contraception and contraceptive methods, values and preferences, and elimination of irrelevant studies (such as animal studies) and adapted terms for each of the 10 databases.

We first conducted title/abstract screening, then secondary screening in duplicate with discrepancies resolved by discussion and consensus. Inclusion in the global review was determined after full-text review in duplicate. We abstracted data using standardized forms developed specifically for this project, gathering information on: citation, location, target population, study design, sample size, key quantitative or qualitative results, and study rigor (using the Evidence Project Risk of Bias tool [18] for quantitative findings and the Critical Appraisal Skills Programme qualitative research checklist [19] for qualitative findings). We iteratively coded themes that encapsulated values and preferences of end-users and health workers, and we ranked themes by frequency of mention. We summarized coded results narratively to capture main findings related to values and preferences. Due to the large number of included articles, we generally do not include citations to individual articles in the results presented below; instead, we only cite specific papers when providing illustrative quotes or statistics.

Results

Search results

We identified 15,349 potential articles through our search process and an additional 131 through secondary reference searching of included articles, relevant reviews, and specific population subanalyses (Fig. 1). After removing duplicates, we screened the titles/abstracts of 7846 articles and reviewed the full text of 604 articles. Ultimately, 423 articles reporting data from 412 studies met our inclusion criteria. Below, we present an overview of findings from this global review.

Fig. 1

PRISMA flowchart presenting the search and screening process for the contraceptive values and preferences global review 2005-2020.

General characteristics of included studies

Summary characteristics of the included articles are provided in the study description table, organized by geographic WHO region (Tables 1A–1F). The Contraceptive Health Research of Informed Choice Experience (CHOICE) study, a large European multicountry study, was reported in 10 articles [[20], [21], [22], [23], [24], [25], [26], [27], [28], [29]–29], and the Contraceptive CHOICE study on long-acting reversible contraceptive (LARC) methods in Missouri, the United States of America (USA), was reported in 4 articles [[30], [31], [32]–33]. The 410 studies (reported in 423 articles) included 463,048 participants; individual study sample sizes ranged from 10 (a qualitative study on intrauterine devices (IUDs) in the United Kingdom [34]) to 70,016 (a cross-sectional analysis of a national household survey in India [35]).

Table 1A

Summary characteristics of articles included in the contraceptive values and preferences global systematic review which were conducted in countries in the WHO African Region 2005-2020

Author year	DOI	Location	Population	Study design
Schaan 2014	10.2989/16085906.2014.952654	Botswana	PLHIV	Quantitative
Ajong 2018	10.1371/journal.pone.0202967	Cameroon: Biyem-Assi	General (female)	Quantitative
Thomson 2012	10.1186/1471-2458-12-959	Democratic Republic of the Congo: Idjwi Island	General (female)	Mixed methods
Alene 2018	10.1186/s12905-018-0608-y	Ethiopia: Amhara	PLHIV	Quantitative
Asfaw 2014	10.1186/1471-2458-14-566	Ethiopia: Addis Ababa	PLHIV	Quantitative
Belda 2017	10.1186/s12913-017-2115-5	Ethiopia: Oromia Regional State, Bale Eco-Region	General (female)	Quantitative
Both 2015	10.1016/j.rhm.2015.06.005	Ethiopia: Addis Ababa	General (female)	Mixed methods
Davidson 2016	10.1007/s10995-016-2018-9	Ethiopia	General (mixed gender), Special social conditions	Qualitative
Endriyas 2018	10.1186/s12884-018-1731-3	Ethiopia: Southern Nations, Nationalities and People's Region	General (female), Providers	Mixed methods
Gebremariam 2014	10.1155/2014/878639	Ethiopia: Tigray: Adigrat Town, Tigray	General (mixed gender), Providers	Qualitative
Keith 2014	10.1016/j.contraception.2013.12.010	Ethiopia: Oromia Region (rural and peri-urban)	General (female), Providers	Qualitative
Tsehaye 2011	10.1155/2013/317609	Ethiopia: Tigray Region: Shire Indaselassie Town	General (female)	Quantitative
Weldegerima 2008	10.1016/j.sapharm.2007.10.001	Ethiopia: Fogera District: Woreta	General (female)	Quantitative
Adu 2018	10.4314/gmj.v52i4.3	Ghana: Central Region	General (female)	Quantitative
Agyei-Baffour 2015	10.1186/s12978-015-0022-y	Ghana: Kumasi	General (male)	Mixed methods
Krakowiak-Redd 2011	PMID: 22574499	Ghana: Kumasi	General (female)	Quantitative
L'Engle 2011	10.1136/jfprhc-2011-0077	Ghana: Accra	Women seeking emergency contraception	Qualitative
Opare-Addo 2011	PMID: 21987939	Ghana: Kumasi	General (female)	Quantitative
Osei 2014	10.1363/4013514	Ghana: Accra	General (mixed gender), Previously had abortions	Qualitative
Rominski 2017	10.9745/GHSP-D-16-00281	Ghana: Kumasi, Accra	General (female)	Quantitative
Staveteig 2017	10.1371/journal.pone.0182076	Ghana: greater Accra	General (female)	Mixed methods
Teye 2013	PMID: 24069752	Ghana: Asuogyaman District	General (female)	Mixed methods
van der Geugten 2017	10.1007/s12119-017-9432-z	Ghana: Bolgatanga municipality	Young people (mixed gender), General (mixed gender)	Qualitative
Hubacher 2013	10.1016/j.contraception.2013.03.001	Kenya: Nairobi	Postpartum	Quantitative
Hubacher 2015a	10.1016/j.contraception.2015.01.009	Kenya: Nairobi	Postpartum	Quantitative
Keesara 2017	10.1080/13691058.2017.1340669	Kenya: Nairobi	Postpartum	Qualitative
Mayhew 2017	http://dx.doi.org/10.1186/s12889-017-4514-2	Kenya	PLHIV	Mixed methods
Ndegwa 2014	PMID: 26859013	Kenya: Embu	Pregnant	Quantitative
Newmann 2013	10.1155/2013/915923	Kenya: Nyanza Province: Migori, Rongo, Siba districts: government-run HIV care and treatment clinics and patient support centers	Providers, PLHIV	Mixed methods
Odwe 2020	10.1016/j.conx.2020.100030	Kenya: Homa Bay County	General (female), Special social conditions	Quantitative
Patel 2014	10.1089/apc.2014.0046	Kenya: Nyanza Province: Kisumu East, Nyatike, Rongo, and Suba districts	PLHIV, General (male)	Qualitative
Roxby 2016	10.1136/jfprhc-2015-101233	Kenya: Nairobi	General (mixed gender), PLHIV, Pregnant	Qualitative
Ruminjo 2005	10.1016/j.contraception.2005.04.001	Kenya: Nairobi, Riruta, Thika	General (female)	Quantitative
Shabiby 2015	10.1186/s12905-015-0222-1	Kenya: Naivasha (rural), Mbagathi (urban) districts	PLHIV, Postpartum, General (female)	Quantitative
Shapley-Quinn 2019	10.2147/IJWH.S185712	Kenya: Kisuma; South Africa: Soshanguve	General (female)	Qualitative
RamaRao 2018	10.1111/sifp.12046	Kenya, Nigeria, Senegal	Postpartum	Mixed methods
Chipeta 2010	10.4314/mmj.v22i2.58790	Malawi: Mangochi district: Lungwena, Makanjira	General (mixed gender), Young people (mixed gender)	Qualitative
Haddad 2013	10.1016/j.contraception.2013.08.006	Malawi: Lilongwe	PLHIV	Quantitative
Haddad 2014	10.1016/j.ijgo.2014.03.026	Malawi: Lilongwe	PLHIV	Quantitative
O'Shea 2015	10.1080/09540121.2014.972323	Malawi: Lilongwe	General (female), PLHIV, Postpartum	Quantitative
Brunie 2019	10.1371/journal.pone.0216797	Multicountry: India: New Dehli; Nigeria: Ibadan	General (female), Providers	Qualitative
Burke 2014a	10.1016/j.contraception.2014.01.009	Multicountry: Senegal: Mbour, Thies, and Tivaouane; Uganda: Mubende, Nakasongola	Providers	Qualitative
Burke 2014b	10.1016/j.contraception.2014.01.022	Multicountry: Senegal; Uganda	General (female)	Quantitative
Callahan 2019	10.1371/journal.pone.0217333	Multicountry: Burkina Faso; Uganda	General (female), General (male), Providers	Mixed methods
Cartwright 2020	10.12688/gatesopenres.13045.2	Multicountry: unspecified	Young people (mixed gender), Special social conditions	Mixed methods
Chin-Quee 2014	10.1136/jfprhc-2013-100687	Multicountry: Kenya: Nairobi; Nigeria: Lagos	General (female)	Quantitative
Coffey 2006	10.1016/j.contraception.2005.10.017	Multicountry: Mexico: Cuernavaca; South Africa: Durban; Thailand: Khon Kaen	General (mixed gender)	Quantitative
Cover 2013	10.1016/j.contraception.2016.10.007	Multicountry: India: Lucknow, Uttar Pradesh; Uganda: Kampala	General (mixed gender)	Qualitative
Lendvay 2014	10.1016/j.contraception.2013.11.002	Multicountry: Kenya: Nairobi; Pakistan: Sindh, Punjab	General (female)	Quantitative
Machiyama 2018	10.1186/s12978-018-0514-7	Multicountry: Kenya: Nairobi, Homa Bay; Bangladesh: Matlab	General (female), Special social conditions	Quantitative
Montgomery 2010a	10.1007/s10461-009-9609-z	Multicountry: South Africa: Durban, Soweto; Zimbabwe: near Harare	General (female)	Quantitative
Nel 2016	10.1371/journal.pone.0147743	Multicountry: Kenya; Malawi; South Africa; Tanzania	General (female)	Quantitative
Todd 2011	10.1007/s10461-010-9848-z	Multicountry: Brazil: Rio de Janiero; Kenya: Kericho; South Africa: Soweto	PLHIV	Qualitative
Tolley 2014	10.9745/GHSP-D-13-00147	Multicountry: Kenya (peri-urban and urban sites); Rwanda (rural, peri-urban, and urban sites)	General (female), Providers	Qualitative
Urdl 2005	10.1016/j.ejogrb.2005.01.021	Multicountry: Austria; Belgium; Finland; France; Germany; Hungary; Netherlands; Poland; South Africa; Switzerland	General (female)	Quantitative
Woodsong 2014	10.1111/1471-0528.12875	Multicountry: Malawi: Lilongwe; Zimbabwe: Harare	General (mixed gender), Providers	Qualitative
Mayaki 2014	10.1080/02646838.2014.888545	Niger	General (female)	Quantitative
Aisien 2010	PMID: 20857796	Nigeria: Edo State: Benin-City	General (female)	Quantitative
Egede 2015	10.2147/PPA.S72952	Nigeria: Ebonyi State: Abakaliki	General (female)	Quantitative
Ezugwu 2019	10.1002/ijgo.13027	Nigeria: Enugu	Postpartum	Quantitative
Iyoke 2014	10.2147/PPA.S67585	Nigeria: Enugu	General (mixed gender)	Quantitative
Lanre-Babalola 2015	proquest.com/scholarly-journals/dynamics-knowledge-use-preference-birth-control/docview/1709681040/se-2?accountid=11752	Nigeria: Ibadan	General (female)	Quantitative
Okunlola 2006	10.1080/01443610600613516	Nigeria: Ibadan	General (female), Young people (female)	Quantitative
Olajide 2014	PMID: 25022145	Nigeria: Osun State; primary and secondary schools	Young people (mixed gender), Other special medical conditions	Quantitative
Orji 2005	10.1080/13625180500331259	Nigeria: Southwest	Young people (mixed gender)	Quantitative
Sodje 2016	10.1016/j.ijgo.2016.05.005	Nigeria: Edo, Delta, Anambra, Ebonyi, Abia states	Postpartum	Quantitative
Sunmola 2005	10.1080/09540120412331319732	Nigeria: Ibadan	Young people (mixed gender)	Quantitative
Ujuju 2011	10.1111/j.1466-7657.2011.00900.x	Nigeria: Katsina state: Rimi, Katsina, Kaita; Enugu state: Nkanu West, Enugu East, Igbo-Etiti	Providers, General (mixed gender)	Qualitative
Kestelyn 2018	10.1371/journal.pone.0199096	Rwanda: Kigali	General (female)	Mixed methods
Shattuck 2014	10.1016/j.contraception.2014.02.003	Rwanda	General (mixed gender), Vasectomies	Quantitative
Leye 2015 FRENCH	PMID: 26164961	Senegal: Diourbel region: Mbacke district	General (female)	Mixed methods
Crede 2012	10.1186/1471-2458-12-197	South Africa: Cape Town: Khaylitsha and Mitchell's Plain	Postpartum, PLHIV	Quantitative
de Bruin 2017	10.1080/09540121.2017.1327647	South Africa	Young people (mixed gender)	Qualitative
Harries 2019	10.1186/s12978-019-0830-6	South Africa: Western Cape	General (female)	Qualitative
Joanis 2011	10.1016/j.contraception.2010.08.002	South Africa: Durban	General (female)	Quantitative
Laher 2009	10.1007/s10461-009-9544-z	South Africa: Soweto	PLHIV	Qualitative
Mahlalela 2016	10.11564/30-2-873	South Africa: Durban	general (female)	Qualitative
Morroni 2006	10.1016/j.contraception.2006.01.005	South Africa: Western Cape Province	General (female)	Quantitative
Ndinda 2017	10.3390/ijerph14040353	South Africa: Kwa-Zulu-natal (rural)	General (mixed gender)	Qualitative
Schwartz 2016	10.1177/0956462415604091	South Africa: Johannesburg	General (mixed gender), PLHIV	Qualitative
Smit 2006	10.1016/j.contraception.2005.10.019	South Africa: KwaZulu-Natal: Durban	General (female), Special social conditions	Quantitative
Mathenjwa 2012	10.3109/13625187.2012.694147	Swaziland: Lavusima	special social conditions	Qualitative
Ziyane 2006	10.4102/hsag.v11i1.213	Swaziland	Young people (mixed gender)	Qualitative
Bunce 2007	10.1363/3301307	Tanzania: Kigoma Region	Vasectomies, General (mixed gender)	Qualitative
Cooper 2019	10.1111/mcn.12735	Tanzania: Mara, Kagera	General (mixed gender), Postpartum, Providers	Qualitative
Rusibamayila 2016	10.1080/13691058.2016.1187768	Tanzania: Kilombero District	General (mixed gender), Providers	Qualitative
Sato 2020	10.1080/26410397.2020.1723321	Tanzania: Arusha Region	General (female)	Quantitative
Sheff 2019	10.1186/s12978-019-0836-0	Tanzania: Kilombero, Rufiji, and Ulanga	General (mixed gender)	Qualitative
Akol 2014	10.9745/ghsp-d-14-00085	Uganda: multiple sites	Providers, General (mixed gender)	Quantitative
Byamugisha 2010	10.3109/00016341003611220	Uganda: Kampala	Women seeking emergency contraception	Quantitative
Cover 2017	10.1363/3919513	Uganda: Gulu district, Mubende	General (female)	Quantitative
Higgins 2014	10.2105/AJPH.2007.115790	Uganda: Rakai District	Young people (mixed gender)	Qualitative
Kabagenyi 2016	10.11604/pamj.2016.25.78.6613	Uganda: Mpigi, Bugiri (rural)	General (mixed gender)	Qualitative
Kakaire 2016	10.3109/13625187.2016.1146249	Uganda: Kampala	PLHIV	Quantitative
Lester 2015	10.1016/j.contraception.2014.12.002. Epub 2014 Dec 12.; ID: 106	Uganda: Kampala	Pregnant	Quantitative
Mbonye 2012	10.1258/ijsa.2009.009357	Uganda: Central region (rural, semi-urban, and urban)	PLHIV, General (mixed gender)	Mixed methods
Nattabi 2011	10.1186/1752-1505-5-18	Uganda: Gulu health facilities	Special social conditions, PLHIV	Mixed methods
Paul 2016	10.3402/gha.v9.30283	Uganda: Central region (rural, semi-urban, and urban)	Providers	Qualitative
Polis 2014	10.1016/j.contraception.2013.11.008	Uganda: Rakai	PLHIV	Quantitative
Wanyenze 2013	10.1186/1471-2458-13-98	Uganda: Kampala	PLHIV	Qualitative
Montgomery 2010b	10.1186/1758-2652-13-30	Zimbabwe: Epworth	General (female)	Quantitative
van der Straten 2010	10.1783/147118910790290966	Zimbabwe: Harare	Young people (female)	Mixed methods
van der Straten 2012	10.1007/s10461-012-0256-4	Zimbabwe: Harare: peri-urban township	General (female)	Mixed methods

Table 1F

Summary characteristics of articles included in the contraceptive values and preferences global systematic review which were conducted in countries in the WHO Western Pacific Region 2005-2020

Author year	DOI	Location	Population	Study design
Bateson 2016	10.1111/ajo.12534	Australia: New South Wales: Queensland	General (female)	Quantitative
Dixon 2014	10.3109/13625187.2014.919380	Australia	General (female)	Qualitative
Garrett 2015	10.1186/s12905-015-0227-9	Australia	Young people (female), Providers	Qualitative
Inoue 2017	10.1136/jfprhc-2014-101132	Australia: New South Wales	General (female)	Qualitative
Kelly 2016	10.1136/jfprhc-2015-101356	Australia: New South Wales: Sydney	Providers	Qualitative
Knox 2012	10.1016/j.socscimed.2012.12.025	Australia	General (female), Providers	Quantitative
Knox 2013	10.2165/11598040-000000000-00000	Australia	General (female)	Quantitative
Larkins 2007	10.5694/j.1326-5377.2007.tb01025.x	Australia: New South Wales: Queensland	Young people (mixed gender), Special social conditions	Quantitative
Mills 2006	10.1080/07399330600629468	Australia	General (female)	Qualitative
Olsen 2014	10.1186/1472-6874-14-5	Australia	PWID	Qualitative
Ong 2013	10.1363/4507413	Australia: Victoria	General (female)	Quantitative
Philipson 2011	10.1089/jwh.2010.2455	Australia	General (female)	Quantitative
Russo 2020	10.1080/13691058.2019.1643498	Australia: Victoria: Melbourne	Special social conditions, General (mixed gender)	Qualitative
Watts 2014	10.1093/jrs/feu040	Australia: Victoria: Melbourne	Providers, Young people (female), Pregnant	Qualitative
Weisberg 2005a	10.1016/s1701-2163(16)30462-5	Australia: New South Wales: Queensland; South Australia	General (female)	Quantitative
Weisberg 2013	10.3109/13625187.2013.777830	Australia	General (female), providers	Quantitative
Weisberg 2014	PMID: 16113711	Australia: New South Wales	General (female)	Quantitative
Wigginton 2016	10.1136/jfprhc-2015-101184	Australia	Young people (female)	Qualitative
Wong 2009	10.1016/j.contraception.2009.03.021	Australia: Victoria	General (female)	Quantitative
Thyda 2015	10.1097/QAI.0000000000000635	Cambodia: Chhouk Sar	PLHIV	Quantitative
Hou 2010	10.1016/j.ijgo.2009.09.020	China: Guandong Province: Enping City	Special social conditions	Quantitative
Nian 2010	PMID: 21073077	China: Sichuan Province	Providers, General (mixed gender), Vasectomies	Qualitative
Cartwright 2020	10.12688/gatesopenres.13045.2	Multicountry: unspecified	Young people (mixed gender), Special social conditions	Mixed methods
Crosby 2013	10.1258/ijsa.2008.008120	Multicountry (online): mostly USA; Australia; Canada; New Zealand; United Kingdom; Western Europe	General (mixed gender)	Quantitative
Festin 2016	10.1093/humrep/dev341	Multicountry: Thailand, Brazil, Singapore, Hungary	General (female)	Quantitative
Gemzell-Danielsson 2012	10.1016/j.contraception.2012.06.002	Multicountry: Australia, Brazil, Canada, France, Germany, Korea, Mexico, Spain, Sweden, United Kingdom	Providers	Quantitative
Xu 2014	10.1016/j.fertnstert.2011.08.019	Multicountry: China, Taiwan, Hong Kong, Indonesia, Malaysia, Pakistan, South Korea, Thailand	Menstrual Issues	Quantitative
Roke 2016	10.1071/HC15040	New Zealand	General (female)	Quantitative
Rose 2011	10.1089/jwh.2010.2658	New Zealand: Wellington	Women seeking abortion services, Young people (female)	Qualitative
Terry 2011	10.1177/0959353511419814	New Zealand	Vasectomies	Qualitative
Gupta 2017	10.1111/ajo.12596	Papua New Guinea: Madang Island, Milne Bay (mainland)	General (female)	Quantitative
Lee 2019	10.5468/ogs.2019.62.3.173	South Korea	Providers	Quantitative
Park 2011	10.2147/IJWH.S26620	Vietnam: Thai Nguyen, Khanh Hoa, Vinh Long provinces	General (female)	Quantitative

Studies were conducted in 93 countries (Fig. 2). Fifty-one articles reported data from multiple countries, mostly in Europe; 10 articles were from the 11-country European CHOICE study. All 6 WHO regions1 were represented: the African Region (AFRO) (n = 103), the Region of the Americas (PAHO) (n = 172), the South-East Asia Region (SEARO) (n = 27), the European Region (EURO) (n = 99), the Eastern Mediterranean Region (EMRO) (n = 14), and the Western Pacific Region (WPRO) (n = 34). A plurality of articles reported studies that took place in the USA (n = 139), followed by the United Kingdom (n = 29) and Australia (n = 23). Most articles reported studies that were primarily conducted in high-income countries (n = 250), but studies were also conducted in upper-middle (n = 67), lower-middle (n = 78), and low- (n = 44) income countries as classified by the World Bank. (Note: numbers do not add to 423 because of studies taking place in multiple countries.)

Fig. 2

Countries where studies presenting primary data on contraceptive values and preferences were conducted. Sources were published between January 2005 and July 2020. Green indicates data available; gray, data not identified.

While most articles presented quantitative findings (269/423, 63%), 121 (29%) used qualitative methods, and 34 (8%) used mixed- or multimethods. A range of study designs and methods were used: the most common quantitative design was cross-sectional surveys (n = 190), followed by qualitative in-depth interviews (n = 116) and focus group discussions (n = 69); however, prospective cohort studies, randomized trials, and other observational designs were also represented. The mixed/multimethods studies generally involved a cross-sectional quantitative survey with additional qualitative analysis of open-ended survey responses or additional data collection from focus group discussions or in-depth interviews.

3.3. Risk of bias varied by study design.

We generally found that studies involving qualitative analyses presented the 9 rigor domains assessed by the Critical Appraisal Skills Programme qualitative checklist. Cross-sectional studies generally did not include comparison groups (22%); of those which did, only a few compared across sociodemographic characteristics (16%) or outcomes (5%). Studies employing quantitative analyses sometimes followed participants over time (36%), used a control or comparison group (39%), or compared outcomes pre- and postexposure to a contraceptive method (19%). Quantitative studies rarely randomly selected participants for assessment (15%) or randomly allocated participants to the intervention or control arm (if applicable) (14%). Of quantitative studies that followed participants over time (n = 90), 55 (61%) had a follow-up rate of 80% or more. Of quantitative studies including a control or comparison group (n = 106), 35 (33%) compared groups across sociodemographic characteristics and 6 (5%) compared groups on outcome measures at baseline.

The articles explored the values and preferences of contraceptive users in the general female population (n = 220), general male population (n = 10), general population (not disaggregating between male and female participants) (n = 44), women with specific reproductive health experiences (n = 52), adolescents and young adults (n = 76), people living with HIV (n = 22), sex workers (n = 6), transmasculine individuals (n = 1), people who inject drugs (n = 2), and those living in humanitarian contexts (n = 4), as well as perspectives of health workers (n = 53) (Table 2). (Note: numbers do not add to 423 because some articles included perspectives from multiple population groups.) Separate systematic reviews examining the values and preferences of women with specific reproductive health experiences (i.e., pregnant, postpartum, seeking emergency contraception, or seeking abortion) [9], adolescents and young adults [7], people living with HIV [10], other end-users in specific circumstances (i.e., sex workers, transmasculine individuals, people who inject drugs, and those living in humanitarian contexts) [8], and health workers [11] are published in this same journal issue.

Table 2

Number of articles included in the contraceptive values and preferences global systematic review that provide data on different populations 2005-2020

Population category	Number of articlesa (% out of 423 total included articles)
General population
Female contraceptive users	220 (52%)
Male contraceptive users	10 (2.4%)
Both male and female (not disaggregated by gender)	44 (10.4%)
Women with specific reproductive health experiences
Women who are nulliparous	4 (0.9%)
Women who are pregnant	7 (1.7%)
Postpartum women	23 (5.4%)
Women seeking abortion services	7 (1.7%)
Women seeking emergency contraception	5 (1.2%)
Women who previously had abortion(s)	6 (1.4%)
Adolescents and young adults
Female young people	55 (13%)
Male young people	2 (0.5%)
Both male and female (not disaggregated by gender)	19 (4.5%)
People in specific social conditions or humanitarian settings
People living with HIV	22 (5.2%)
Sex workers	6 (1.4%)
Transmasculine individuals	1 (0.2%)
People who inject drugs	2 (0.5%)
Those living in humanitarian contexts	4 (0.9%)
Health workers	53 (12.5%)

Studies that reported any findings on contraceptive values and preferences for this specific population group. Note that studies often reported data for multiple population groups, so percentages do not add up to 100.

Included articles mentioned end-users' and health workers’ values and preferences related to all of the methods covered by WHO's guidelines, including male condoms (n = 161), female condoms (n = 41), oral contraceptive pills, i.e., combined oral contraceptive pills (n = 204) and progestogen-only pills (POP) (n = 105), intrauterine devices (IUD) or hormone-releasing intrauterine systems (IUS) (n = 221), implants (n = 139), injectable contraceptives (n = 140), diaphragm (n = 37), vaginal ring (n = 82), transdermal patch (n = 74), male sterilization or vasectomy (n = 39), female sterilization or tubal ligation (n = 72), fertility awareness-based methods (e.g., rhythm method, calendar method) (n = 64), emergency contraception (n = 42), withdrawal (n = 67), and other contraceptive methods, including abstinence, lactational amenorrhea method, and other (often unspecified) traditional methods (n = 42).

Commonly reported values among contraceptive users

Contraceptive users across geographic regions and population subgroups consistently prioritized several thematic issues (Table 3). Overall, people wanted choice: they desired a range of options from which to choose, especially since different people preferred different methods at different times for different reasons.

Table 3

Common themes related to values and preferences, listed in order of frequency, described by articles included in the contraceptive values and preferences global systematic review 2005-2020

Values and preferences themes	Number of articles (% out of 423 total included articles)
Side effects and safety	246 (58.2%)
Method effectiveness/reliability	191 (45.2%)
Ease, duration, or frequency of use	179 (42.3%)
Noninterference in sex and partner relations	141 (33.3%)
Effects on menstruation	83 (19.6%)
Cost/affordability	71 (16.8%)
Control and autonomy	67 (15.8%)
Private, discreet, or covert use	50 (11.8%)

Side effects and safety was the most commonly reported issue (mentioned in 246 articles) when considering contraceptive methods. Contraceptive users and health workers were concerned about pain. They desired minimal side effects or adverse events (relating to changes in libido, bleeding, menstrual cycles, acne, weight gain, etc.); if these were unavoidable, they wanted to be able to anticipate, manage, and tolerate side effects. Women often asked how commonly used contraceptive methods were, and how safe or healthy they were.

Method effectiveness and reliability were the next most commonly reported (mentioned in 191 articles), especially for preventing pregnancy (e.g., “security in not getting pregnant” [36], “having had a false alarm [about pregnancy] in the past” [37]), but also for providing dual protection against HIV and other STIs [38]. Women in some studies expressed interest in contraceptive methods that were effective, despite experiencing uncomfortable side effects like vomiting or diarrhea. Participants expressed varying acceptability levels for percent efficacy—or conversely, varying tolerance levels for likelihood of contraceptive failure.

Ease and duration/frequency of use (mentioned in 179 articles) was also very important. Many people desired contraceptive methods that were comfortable or convenient to use. Conversely, others expressed fears of the contraceptive method “falling off” [39] or forgetting to use or administer it. One hundred forty-four articles mentioned accessibility as a factor in their contraceptive preference, considering logistical issues in getting advice on, obtaining, maintaining, or changing contraceptive methods. Reversibility was very important to current and hypothetical contraceptive users (mentioned in 73 articles), both in terms of duration of contraceptive effectiveness and frequency of use (whether taken once a day, administered weekly or monthly or longer, or a permanent contraceptive method) and how difficult it was to start, switch, or stop the contraceptive method (e.g., stop taking a daily oral contraceptive pill versus getting an IUD removed). Women preferred choosing a method that “they are in control of stopping” [40]. For many women, it was important that they be able to resume fertility immediately after discontinuation or at least that using a contraceptive method for a period of time would not “affect the ability to have children in the future” [41].

A contraceptive method's noninterference in sex and partner relations was valued as well, mentioned in 141 articles. Contraceptive users often reported considering whether they or their partner(s) could feel the contraceptive method/device during intercourse, and how the contraceptive method affected the spontaneity, pleasure, and frequency of sex. Partner's influence towards women's contraceptive choice was also highlighted, where oftentimes “[m]en's disapproval over contraceptive use restricted preferences for women” [42], particularly in low- and middle-income countries regarding “non-natural” or hormonal contraceptives. Even in the USA, though, young women mentioned using withdrawal because of their male partners, though it “did not align with their own contraceptive desires,” since using a condom would imply lack of trust or relationship intimacy and they were embarrassed about using withdrawal as a contraceptive method [43].

Women were concerned about the impact of hormonal contraceptives on menstruation (mentioned in 83 articles), whether they desired regular menstrual cycles (to alleviate dysmenorrhea) or amenorrhea (to stop menstrual bleeding altogether for a specified time) or pain relief during menses; for example, a multimethod study in the US found contraceptive choice linked to menstrual control, suppression, and symptoms [44]. Some preferred “natural” or “nonartificial” nonhormonal methods in order to retain menstruation as a tangible symbol of health and fertility [45].

Cost—the financial burden to pay for the contraceptive method itself and the services of a health worker, in addition to time and transport/distance—was important to users (reported in 71 articles). Two-thirds of the mentions of cost/affordability/accessibility appeared in articles originating from the USA and other high-income countries, with two-thirds of such articles (29/45, 64%) discussing LARCs. However, among articles that ranked the contraceptive attributes that end-users considered important, cost/affordability usually ranked below effectiveness and side effects.

In 67 articles, people expressed the desire to have a sense of control and autonomy over contraceptive decision-making or usage. For example, one article noted that users wanted to make the choice of birth control method that was “right for them when given the proper information and options” [36]. In choosing a contraceptive method, women also considered whether they needed a health worker to insert/remove or administer the method or if they could self-administer—and what training or education was needed prior to use (e.g., demonstration, training, supervision, product storage, waste management).

Fifty articles highlighted that women also wanted the ability to use a contraceptive method discreetly, privately, or covertly, without others—whether partners, family members, or community members—being able to discern which, if any, contraceptive method they were using. This is particularly significant for contraceptive methods that may be easily observable by others (e.g., patches, sub-dermal implants), for which contraceptive visibility could jeopardize the end-user's physical safety in some extreme cases [46].

Contraceptive values and preferences varied across the 6 WHO regions. Across the 3 regions in which included articles were most commonly conducted (AFRO, EURO, and PAHO), clients most typically reported side effects to be the most important issue when deciding which contraceptive method to use. The least commonly reported feature was cost/access in AFRO, privacy/discretion/covert use in PAHO, and control/autonomy in EURO. In AFRO, EURO, and PAHO, the most preferred options of contraceptive methods were the injection, pill, and IUD. The least preferred choice in PAHO and EURO was male sterilization, while the patch was least preferred in AFRO.

Contraceptive values and preferences also varied by country income level as classified by the World Bank. Across all income levels, side effects followed by effectiveness, ease of use, and duration were the most commonly reported issues considered by clients when deciding what contraceptive method to use. In high- and upper-middle-income countries, privacy/discretion/covert use was the least commonly reported factor, while control/autonomy was the least commonly reported factor in low- and lower-middle income countries. Where studies reported rankings of contraceptive methods, the most preferred contraceptive choice was IUDs in high-income countries, male condoms in upper-middle-income countries, the combined oral contraceptive pill in lower-middle-income countries, and injectable contraceptives in low-income countries, while the least preferred contraceptive method was male sterilization in high-income countries and the patch in lower-middle and low-income countries.

Preferences for specific contraceptive methods

Preferences for specific contraceptive methods varied by country and population subgroup. Preferences depended on people's knowledge of contraceptive methods—both knowledge of what options are available, and general awareness of how those methods work.

Oral contraceptive pills and male condoms are 2 of the predominant methods globally, according to an international cross-sectional survey on women’s attitudes regarding hormonal contraception [47]. Oral contraceptive pills accounted for around half of all contraceptive users and were typically the first mode of contraception ever used by women. Condoms and withdrawal (coitus interruptus) were often used alongside or as backup for other contraceptive methods at various times throughout the life course, especially for those who had had bad experiences with other contraceptive methods. Use of these methods was frequently dependent on perceived relationship commitment and stability. Use of emergency contraception correlated strongly with the individual user's (or health worker's) view of when life begins.

Study participants often contrasted modern (hormonal) with traditional (“natural,” often barrier) contraceptive methods. Women in some studies described distrust in hormonal contraception and wanting to “take a break” or “detox” [48] from their contraceptive method. When considering intrauterine contraception or vaginal rings, many expressed negative feelings, concerns, fears, or discomfort with having “something in [my] body” [49], the notion or sensation of a “foreign body” or “foreign object” [50], or having something potentially “get lost inside of me” [51]. Among quantitative studies, between 22% [50] and 53% [52] of participants reported these types of IUD-related concerns.

Most contraceptive users wanted a contraceptive method that fit into their lifestyle, and that was supported by their culture, religious beliefs, government, and community norms. Many people used familiarity to choose a contraceptive method, asking questions like, “Do I know anyone else who uses it?” [27]. In choosing a method, people often used the process of elimination, determining what contraceptive methods they did not want to use based on their own past personal experiences or “the stories of close friends or family, whose experiences were often valued as if they were a women's own” [53]. However, once a contraceptive method was chosen, people tended to have high satisfaction with (ranging from 42.5% among women experiencing idiopathic menstrual bleeding after a 3-month trial using combined oral contraceptive pills [54] to 100% among 24–45-year-old women using the implant [55], with a majority of quantitative studies measuring satisfaction, likelihood of recommendation to others, or desire to continue reporting in the 80%–95% range) what they chose.

Role of counseling in contraceptive choice

Counseling plays an important role in the selection of contraceptive method. Seventy-four of the included articles mentioned the impact of counseling or interactions with health workers on contraceptive choice. Several studies showed that counseling can cause a substantial percentage (33%–50%) of women to change their contraceptive method selection and that it can enable undecided women to make a selection. Research has particularly focused on the effect of counseling in moving women from an intention to use oral contraceptive pills to trying another method, such as the patch or ring [20,21,56].

Ten articles came from one large multicountry study: the Contraceptive Health Research Of Informed Choice Experience (CHOICE) study [20-29]. The CHOICE study was conducted between 2009 and 2010 among 18,787 women in 11 countries: Austria, Belgium, the Czech Republic, Slovakia, the Netherlands, Poland, Russia, Sweden, Switzerland, Ukraine, and Israel. Women who expressed an interest in combined hormonal contraceptives were recruited into the study and asked about their contraceptive preferences. Health workers then used standardized approaches to counsel women on the pill, the patch, and the ring. Women's final contraceptive selection was recorded along with their reasons for this preference and their perceptions of the attributes of each method. Participants described a wide range of preferences for contraceptive method and rationale, with the greatest variability explained by country of residence, followed by health workers’ gender, age, and more frequently recommended method [20]. Preference choice was also associated with the woman's age, educational level, prior unintended pregnancy experience, relationship status, and last contraceptive method. Prior to entering the study, women reported using combined oral contraceptive pills (42%), condoms (25%), and natural family planning (6%); 10% were not using any contraceptive measures [21]. At the start of the study, before receiving counseling, women's contraceptive intentions leaned toward the pill (52%), with only 5% intending to use the patch and 8% the ring; 10% wanted to use another method, and 26% were undecided. Nearly half of the counseled women selected a contraceptive choice different from the method they originally intended to use [20]. After counseling, women chose the pill slightly less (51%) and were more likely to select alternative methods like the patch (8%) and the ring (30%), though the distribution varied by country [21].

Among women choosing between the pill, patch, and ring in the European CHOICE study [23,25,26], intensive counseling significantly decreased the proportion of undecided women and significantly increased the proportion of women choosing the ring (from less than 10% pre-counseling to 23.8%–42.6% postcounseling, p < 0.001) though pill and patch intention/usage remained fairly consistent (around 50% and less than 10% respectively). Women who stayed with oral contraceptive pills cited ease of use and familiarity as their primary reasons, while women who switched to the patch and ring cited reasons like ease of use, decreased frequency of use (and thus less opportunity to forget, i.e., lower probability of omission), and effectiveness when experiencing vomiting/diarrhea/illness. Other than the European CHOICE study, several other papers provided information on the value and role of counseling [[56], [57], [58], [59], [60], [61]–62].

Contraceptive users typically felt they should make the final decision about which contraceptive method they should use but appreciated health worker recommendations and assistance in determining the best method. They preferred caring, less formal relationships with their health workers and prioritized access to comprehensive information, including about alternative methods and side effects, presented both verbally (e.g., face-to-face) and in writing (e.g., internet, books, pamphlets). Before counseling, users were often dissatisfied with the information they had received about family planning methods and less than half reported a high level of confidence in their knowledge of the risks, benefits, and side effects, Clients preferred health workers who engaged with them in “an interactive, appropriately targeted manner” [63], taking into account contextual factors that could influence method choice and giving messages that included personal decision-making language (informative but not commanding). Younger women were more accepting of medical opinion, while older women rejected medical interference in contraceptive decisions and could be quite critical of medical practitioners and their practices. Training and counseling were also important to address users' reservations and concerns. For methods that are new to a user, clients reported that it was helpful to receive practical guidance and support from health workers. For example, adolescents at a family planning clinic in the USA were given demonstrations using sample vaginal rings and diagrams of the vagina; the first time they used the ring, they self-inserted at the clinic, sometimes with the health worker's help, and thereafter at home [64].

Discussion

In this global review, we found a large literature documenting diverse values and preferences about contraceptive methods. Across 423 articles from 93 countries in all regions of the world, we found that values centered on themes of choice, ease of use, side effects, and effectiveness. Many users also considered factors such as cost, availability, interference in sex and partner relations, the effect of hormonal contraceptives on menstruation, and interactions with health workers as aspects they valued in their decisions. Preferences for specific contraceptive methods varied between individual women, as well as across settings, geographic regions, cultures, population subgroups, and which options were considered or available. Users generally reported satisfaction with (and more accurate knowledge about) the methods they were using.

Family planning counseling can play an important role in clients' choice of contraceptive method. Contraceptive users were generally open to discussion about options, risks and benefits, timing, and side effects, though they usually wanted to personally make their own decision with input from health workers and from their partner(s), family, and community. Health workers require training to be able to provide complete, accurate information and provision of all potential method choices to their clients.

Studies were diverse across populations, geographic settings, contraceptive methods, and study designs. The majority of studies were conducted among adult or adolescent women in the general population. Fewer studies were conducted among women with specific demographic, health, or social considerations. While there were a small number of studies among men, most focused on male-controlled methods of contraception rather than covering contraceptive methods more broadly. This perhaps does not reflect the full potential for male involvement in family planning programs as clients, supportive partners, and agents of change [65]. While studies most commonly came from the USA, Europe, and Australia, there was representation from all regions of the world. However, the diversity of populations and specific contraceptive methods covered prevented us from being able to make definitive comparisons of values and preferences across regions. We identified articles on all 26 contraceptive methods covered by the WHO guidelines, and articles covered a range of appropriate quantitative and qualitative study designs. In these regards, we found few obvious gaps in the literature. We also conducted more focused reviews to delve into the values and preferences of several populations of interest [7-11], using subsets of articles identified in this global review.

Our review has some limitations. While we attempted to conduct a comprehensive search, there was some inherent subjectivity in determining what counted as a study of values and preferences, and we thus may have missed some articles that should have been included. For example, we included only one article on values and preferences of transgender people; however, a recent review also examines perspectives of this population in more detail [66]. We also encountered significant challenges synthesizing such a complex topic at the global level. Regardless of study design, the investigators of specific studies often framed their questions around a limited number of values and preferences, so the themes we discuss in this review (presented by frequency of mention in the 423 included articles) may in part reflect the values and preferences most commonly queried, and some studies explored only a very select set of values/preferences. Our findings are ultimately limited by what was presented in the included articles. Finally, quality of the included studies varied (e.g., some studies had very small sample sizes, and others had nonrepresentative samples, limiting generalizability), and our overall findings are only as strong as the studies on which they are based.

Family planning programs around the world share the goals of improving access to effective contraceptive methods and supporting the reproductive rights of women and men. WHO human rights guidelines recommend ensuring accessibility, acceptability, meaningful participation, and informed decision-making in the provision of contraceptive information and services [67]. Understanding values and preferences that end-users and health workers hold towards different contraceptive methods will help to inform the development of such rights-based, person-centered services that support contraceptive users and their partners in making decisions that are right for them.

In summary, contraceptive users value having a range of contraceptive methods from which to choose and prefer methods that are efficacious, easy to use, and have few side effects. Users desire control over the final choice of which contraceptive method to use, with the guidance of health workers who explore their values and preferences. They want comprehensive information about available methods and side effects. This review uncovered wide variability in values and preferences within and across studies. Context and available options shape people's values and preferences, emphasizing the need for high-quality counseling

Data request

An online repository of data abstracted from included articles is provided in the Appendix. For specific full-text articles or additional information, please contact the corresponding author.

Table 1B

Summary characteristics of articles included in the contraceptive values and preferences global systematic review which were conducted in countries in the WHO Eastern Mediterranean Region 2005-2020

Author year	DOI	Location	Population	Study design
Abu Hashim 2012	10.1016/j.contraception.2011.07.012	Egypt: Mansoura	Menstrual Issues	Quantitative
Jamali 2014	10.4103/2231-4040.143025	Iran	General (female)	Quantitative
Kariman 2014 ARABIC	sid.ir/en/Journal/ViewPaper.aspx?ID=364280	Iran: Zahedan	General (female)	Quantitative
Rahmanpour 2010	PMID: 21381574	Iran: Zanjan	Postpartum	Quantitative
Rahnama 2010	10.1186/1471-2458-10-779	Iran: Tehran	General (female)	Quantitative
Shirvani 2008 FARSI	hayat.tums.ac.ir/browse.php?a_id=169	Iran: Ghaemshahr	General (female)	Quantitative
Baram 2020	10.1080/13625187.2019.1699048	Israel	General (female)	Quantitative
Romer 2009	10.3109/13625180903203154	Multicountry: Austria; Bulgaria; Estonia; France; Germany; Hungary; Ireland; Italy; Jordan; Latvia; Lebanon; Lithuania; Malta; Netherlands; Poland; Russia; Spain; Ukraine	General (female)	Quantitative
Xu 2014	10.1016/j.fertnstert.2011.08.019	Multicountry: China, Taiwan, Hong Kong, Indonesia, Malaysia, Pakistan, South Korea, Thailand	Menstrual Issues	Quantitative
Lendvay 2014	10.1016/j.contraception.2013.11.002	Multicountry: Kenya: Nairobi; Pakistan: Sindh, Punjab	General (female)	Quantitative
Azmat 2012	ecommons.aku.edu/cgi/viewcontent.cgi? article=1895&context=pakistan_fhs_mc_chs_chs	Pakistan: Punjab, Sindh	General (mixed gender)	Qualitative
Naqaish 2012	PMID: 23855088	Pakistan: Islamabad	General (female), Menstrual Issues	Quantitative
Nishtar 2013	10.5539/gjhs.v5n2p84	Pakistan: Kirachi: Nasir Colony and Chakra Goth	Young people (mixed gender), Vasectomies	Qualitative
Karim 2015	10.12669/pjms.316.8127	Saudi Arabia: Riyadh	General (female)	Quantitative

Table 1C

Summary characteristics of articles included in the contraceptive values and preferences global systematic review which were conducted in countries in the WHO European Region 2005-2020

Author year	DOI	Location	Population	Study design
Bodner 2011	10.1007/s00404-010-1368-6	Austria: multiple sites	Young people (female), General (female)	Quantitative
Egarter 2012	10.1016/j.rbmo.2011.12.003	Austria: multiple sites	General (female)	Quantitative
Stoegerer-Hecher 2012	10.3109/09513590.2011.588751	Austria	General (female)	Quantitative
Merckx 2011	10.3109/13625187.2011.625882	Belgium	General (female)	Quantitative
Benčić 2014 CROATIAN	PMID: 26285466	Croatia: Zaprešić	General (female)	Quantitative
Fait 2011a	10.2478/s11536-011-0062-9	Czech Republic	General (female)	Quantitative
Kikalova 2014 CZECH	N/A	Czech Republic: Olomouc, Palacky University	Young people (mixed gender)	Quantitative
Tiihonen 2008	10.2165/1312067-200801030-00004	Finland	General (female)	Quantitative
Amouroux 2018	10.1371/journal.pone.0195824	France	General (male), Providers	Quantitative
Jost 2014 FRENCH	10.1016/j.gyobfe.2014.04.008	France	General (female)	Quantitative
Brucker 2008	10.1080/13625180701577122	Germany	General (female)	Quantitative
Oppelt 2017	10.1007/s00404-017-4373-1	Germany	General (female), Providers	Quantitative
Schramm 2007	10.1016/j.contraception.2007.03.014	Germany	General (female)	Quantitative
Buhling 2014	10.3109/13625187.2014.945164	Germany	Providers	Quantitative
Tsikouras 2014	10.1007/s00404-014-3181-0	Greece	Previously had abortions	Quantitative
Sweeney 2015	10.1371/journal.pone.0144074	Ireland: Galway	General (female), Providers	Qualitative
Shilo 2015	10.1111/jsm.12940	Israel	Young people (mixed gender)	Quantitative
Cagnacci 2018	10.1080/13625187.2018.1541080	Italy	General (female)	Quantitative
Crosignani 2009	10.1186/1472-6874-9-18	Italy: multiple sites	General (female)	Quantitative
Di Giacomo 2013	10.1111/jocn.12432	Italy	Postpartum	Quantitative
Franchini 2017	10.1016/j.jmig.2017.02.004	Italy	Other special medical conditions	Quantitative
Gambera 2015	10.1186/s12905-015-0226-x	Italy	General (female)	Quantitative
Sabatini 2006	10.1016/j.contraception.2006.03.022	Italy: Bari	General (female)	Quantitative
Tafuri 2010	10.3109/13625180903427683	Italy: Apulia	General (mixed gender)	Quantitative
Vercellini 2010	10.1016/j.fertnstert.2009.01.071	Italy: Milan	Other special medical conditions, Menstrual Issues	Quantitative
Zeqiri 2009	PMID: 20380116	Kosovo: Kosova	General (female)	Quantitative
Čepuliene 2012	PMID: 23128463	Lithuania	General (female)	Quantitative
Crosby 2013	10.1258/ijsa.2008.008120	Multicountry (online): mostly USA; Australia; Canada; New Zealand; United Kingdom; Western Europe	General (mixed gender)	Quantitative
Gemzell-Danielsson 2017	10.1111/j.1600-0412.2011.01180.x	Multicountry: Argentina; Canada; Chile; Finland; France; Hungary; Mexico; Netherlands; Norway; Sweden; USA	General (female)	Quantitative
Gemzell-Danielsson 2012	10.1016/j.contraception.2012.06.002	Multicountry: Australia, Brazil, Canada, France, Germany, Korea, Mexico, Spain, Sweden, United Kingdom	Providers	Quantitative
Hooper 2010	10.2165/11538900-000000000-00000	Multicountry: Australia; Brazil; France; Germany; Italy; Russia; Spain; United Kingdom; USA	General (female)	Quantitative
Apter 2016	10.1016/j.fertnstert.2016.02.036	Multicountry: Australia; Finland; France; Norway; Sweden; United Kingdom	General (female)	Quantitative
Schultz-Zehden 2006	10.2165/00024677-200605040-00006	Multicountry: Austria; Belgium; Czech Republic; Denmark; Finland; France; Germany; Hungary; Iceland; Netherlands; Norway; Slovakia; Spain; Sweden; United Kingdom	General (female)	Quantitative
Bitzer 2012	10.1080/13625180902968856	Multicountry: Austria; Belgium; Czech Republic; Israel; Netherlands; Poland; St Petersburg/Moscow in Russia; Slovakia; Sweden; Switzerland; Ukraine	General (female)	Quantitative
Bitzer 2013	10.3109/13625187.2011.637586	Multicountry: Austria; Belgium; Czech Republic; Israel; Netherlands; Poland; St Petersburg/Moscow in Russia; Slovakia; Sweden; Switzerland; Ukraine	General (female)	Quantitative
Egarter 2013	10.1186/1472-6874-13-9	Multicountry: Austria; Belgium; Czech Republic; Israel; Netherlands; Poland; St Petersburg/Moscow in Russia; Slovakia; Sweden; Switzerland; Ukraine	General (female)	Quantitative
Ahrendt 2006	10.1016/j.contraception.2006.07.004	Multicountry: Austria; Belgium; Denmark; France; Germany; Italy; Norway; Spain; Sweden; Switzerland	General (female)	Quantitative
Urdl 2005	10.1016/j.ejogrb.2005.01.021	Multicountry: Austria; Belgium; Finland; France; Germany; Hungary; Netherlands; Poland; South Africa; Switzerland	General (female)	Quantitative
Nappi 2016	10.3109/13625187.2016.1154144	Multicountry: Austria; Belgium; France; Italy; Poland; Spain	General (female)	Quantitative
Borgatta 2016	10.1080/13625187.2016.1212987	Multicountry: Austria; Belgium; Germany; USA	General (female)	Quantitative
Romer 2009	10.3109/13625180903203154	Multicountry: Austria; Bulgaria; Estonia; France; Germany; Hungary; Ireland; Italy; Jordan; Latvia; Lebanon; Lithuania; Malta; Netherlands; Poland; Russia; Spain; Ukraine	General (female)	Quantitative
Jakimiuk 2011	10.3109/09513590.2010.538095	Multicountry: Belgium; Bulgaria; France; Ireland; Italy; Poland; Romania; Russia	General (female)	Quantitative
Short 2009	10.2165/00044011-200929030-00002	Multicountry: Belgium; Czech Republic; Estonia; France; Germany; Hungary; Latvia; Lithuania; Malta; Slovakia; Slovenia; Spain	General (female)	Quantitative
Mansour 2014	10.2147/IJWH.S59059	Multicountry: Brazil; France; Germany; Italy; USA	General (female)	Quantitative
Fait 2018	10.7573/dic.212510	Multicountry: Czech Republic; Poland; Romania; Russia; Slovakia	General (female)	Quantitative
Fait 2011b CZECH	PMID: 21838148	Multicountry: Czech Republic; Slovakia	General (female)	Quantitative
Fait 2011c CZECH	PMID: 21649999	Multicountry: Czech Republic; Slovakia	General (female)	Quantitative
Heikinheimo 2014	10.1093/humrep/deu063	Multicountry: Finland; France; Ireland; Sweden	General (female)	Quantitative
Wiegratz 2010	10.3109/13625187.2010.518708	Multicountry: Germany; Austria	Providers	Quantitative
Lopez-del Burgo 2013	10.1111/jocn.12180	Multicountry: Germany; France; Sweden; Romania; United Kingdom	General (female)	Quantitative
Haimovich 2009	10.1080/13625180902741436	Multicountry: Germany; France; United Kingdom; Spain; Italy; Russian Federation; Estonia; Latvia; Lithuania; Austria; Czech Republic; Denmark; Norway; Sweden	general (female), Young people (female)	Quantitative
Festin 2016	10.1093/humrep/dev341	Multicountry: Thailand, Brazil, Singapore, Hungary	General (female)	Quantitative
Loeber 2017	10.1080/13625187.2017.1283399	Netherlands	Previously had abortions	Mixed methods
Roumen 2006	10.1080/13625180500389547	Netherlands	General (female)	Quantitative
Banas 2014	10.3109/01443615.2013.817982	Poland	General (female), Other special medical conditions	Quantitative
Zgliczynska 2019	10.3390/ijerph16152723	Poland (online)	General (female)	Quantitative
Bombas 2012	10.3109/13625187.2011.631622	Portugual: multiple sites	Providers	Quantitative
Costa 2011	10.3109/13625187.2011.608441	Portugual: multiple sites	General (female)	Quantitative
Larivaara 2010	10.1080/09581590903436895	Russia: St. Petersburg	Providers	Qualitative
Lete 2007	10.3109/13625187.2016.1174206	Spain: multiple sites	General (female)	Quantitative
Lete 2008	10.1016/j.contraception.2007.11.009	Spain: multiple sites	General (female)	Quantitative
Lete 2016	10.1016/j.contraception.2007.04.014	Spain	General (mixed gender)	Quantitative
Gemzell-Danielsson 2011	10.1016/j.ejogrb.2016.11.022	Sweden: multiple sites	General (female)	Quantitative
Kilander 2017	10.1080/13625187.2016.1238892	Sweden	Providers	Qualitative
Bitzer 2009	10.3109/13625187.2013.819077	Switzerland: Basel, Bern, Zurich	Providers	Quantitative
Merki-Feld 2007	10.3109/13625187.2011.630114	Switzerland	General (female), Young people (female)	Quantitative
Merki-Feld 2010	10.3109/13625187.2010.524717	Switzerland: Zurich	General (female)	Quantitative
Merki-Feld 2012	10.3109/13625187.2014.907398	Switzerland: multiple sites	General (female)	Quantitative
Merki-Feld 2014	10.1080/13625180701440180	Switzerland: Zurich	General (female), Young people (female), Menstrual Issues	Quantitative
Asker 2006	10.1783/147118906776276170	United Kingdom: England: Birmingham	General (female)	Qualitative
Altiparmak 2006 TURKISH	N/A	Turkey: Manisa	General (female)	Quantitative
Ciftcioglu 2009	10.1111/j.1365-2648.2009.05024.x	Turkey	General (female)	Quantitative
Eskicioglu 2017	10.12891/ceog3291.2017	Turkey	Other special medical conditions	Quantitative
Kahramanoglu 2017	10.5603/GP.a2017.0115	Turkey: Istanbul	General (female)	Quantitative
Kursun 2014	10.3109/13625187.2014.890181	Turkey	General (female)	Quantitative
Ortayli 2005	10.1016/s0968-8080(05)25175-3	Turkey	General (male)	Qualitative
Ozturk Inal 2017	10.4274/jtgga.2016.0180	Turkey: Meram	General (female)	Quantitative
Yanikkerem 2006	10.1016/j.midw.2005.04.001	Turkey: Manisa	General (female)	Quantitative
Bracken 2014	10.3109/13625187.2014.917623	United Kingdom	General (female)	Quantitative
Cheung 2005	10.1016/j.contraception.2004.12.010	United Kingdom: England: London	Young people (female), Special social conditions	Qualitative
Free 2005	10.1080/08870440412331337110	United Kingdom	Young people (female)	Qualitative
Glasier 2008	10.1783/147118908786000497	United Kingdom: Scotland: Edinburgh, Glasgow	General (female), Young people (female)	Qualitative
Heller 2017	10.1111/aogs.13178	United Kingdom: Scotland: Edinburgh and surrounding area	Other special medical conditions, Pregnant	Quantitative
Hoggart 2013	10.1016/s0968-8080(13)41688-9	United Kingdom: England: London	Young people (female), Providers	Qualitative
Kane 2009	PMID: 19416603	United Kingdom: England: Lincolnshire	General (female), Young people (female)	Mixed methods
Lakha 2005	10.1016/j.contraception.2004.12.002	United Kingdom: Scotland: Edinburgh	General (female)	Quantitative
Lowe 2019	10.1080/13625187.2019.1675624	United Kingdom: England: Birmingham, Solihull	General (female)	Mixed methods
Moses 2010	10.3109/13625180903414483	United Kingdom: England: Leicestershire and Rutland	Vasectomies	Quantitative
Newton 2014	10.1136/jfprhc-2014-100956	United Kingdom: England: London	Young people (female)	Qualitative
Okpo 2014	10.1016/j.puhe.2014.08.012	United Kingdom: Scotland	Young people (female), Special social conditions	Qualitative
Rosales 2012	10.3109/01443615.2011.638998	United Kingdom	General (female), Previously had abortions	Quantitative
Say 2009	10.1783/147118909787931780	United Kingdom: England: Newcastle upon Tyne	Young people (female)	Mixed methods
Seston 2007	10.1007/s11096-006-9068-9	United Kingdom: England: North West	General (female)	Quantitative
Stephenson 2013	10.1016/j.contraception.2013.03.014	United Kingdom	General (female)	Quantitative
Umranikar 2008	ijsw.tiss.edu/greenstone/collect/ijsw/index/assoc/HASH0182/026f5b23.dir/doc.pdf	United Kingdom: England: Southamptom	General (female)	Quantitative
Verran 2015	10.1136/jfprhc-2013-100764	United Kingdom: England: West Midlands	General (female), Special social conditions	Qualitative
Walker 2012	10.1016/j.jadohealth.2018.10.291	United Kingdom	General (mixed gender)	qualitative
Wellings 2007	10.1016/j.contraception.2007.05.085	United Kingdom	Providers, General (mixed gender)	quantitative
Williamson 2009	10.1783/147118909788708174	United Kingdom: Scotland	Young people (female)	qualitative

Table 1D

Summary characteristics of articles included in the contraceptive values and preferences global systematic review which were conducted in countries in the WHO Region of the Americas 2005-2020

Author year	DOI	Location	Population	Study design
Alves 2008 Portuguese	10.1590/s0034-71672008000100002	Brazil: Sao Paulo	Young people (mixed gender)	Quantitative
Fernandes 2006 Portuguese	old.scielo.br/scielo.php?pid=S0104-42302006000500019&script=sci_abstract&tlng=en	Brazil: Sao Paulo: Campinas	Other special medical conditions	Quantitative
Ferreira 2014	10.1016/j.contraception.2013.09.012	Brazil: Sao Paulo: Campinas	General (female)	Quantitative
Gurgel Cosme de Nascimento 2017 Portuguese	10.15446/rsap.v19n1.44544	Brazil: Caraubas: West Potiguar	General (mixed gender)	Quantitative
Heilborn 2009	10.1590/S0102-311X2009001400009	Brazil: Rio de Janeiro State	General (female)	Qualitative
Hoga 2013	10.1016/j.srhc.2013.04.001	Brazil: Sao Paolo	General (male), Special social conditions	Qualitative
Machado 2013	10.3109/09513590.2013.808325	Brazil	General (female)	Quantitative
Marchi 2008	10.1111/j.1466-7657.2007.00572.x	Brazil: Sao Paulo: Campinas	Vasectomies	Qualitative
Scavuzzi 2016	10.1055/s-0036-1580709	Brazil: Pernambuco	General (female), Nulliparous	Quantitative
Telles Dias 2006	10.1007/s10461-006-9139-x	Brazil: Belem, Salvador, Sao Jose do Rio Preto, Rio de Janeiro, Porto Alegre, Itajai	General (mixed gender), Special social conditions, PLHIV	Mixed methods
Choi 2010	10.1016/s1701-2163(16)34571-6	Canada: British Columbia	Providers	Quantitative
Nguyen 2011	10.1016/j.contraception.2017.01.002	Canada: Ontario: Kingston (online)	General (mixed gender)	Quantitative
Skakoon-Sparling 2019	10.1080/00224499.2019.1579888	Canada: Ontario	General (mixed gender)	Quantitative
Toma 2012	10.1016/j.jpag.2006.05.005	Canada	Young people (female)	Quantitative
Wiebe 2006	10.1016/j.contraception.2006.02.001	Canada: Vancouver	General (female)	Qualitative
Wiebe 2010	10.1016/S1701-2163(16)34477-2	Canada: British Columbia	Nulliparous	Mixed methods
Wiebe 2012	PMID: 23152475	Canada: British Columbia	Providers	Mixed methods
Weisberg 2005b	10.3109/13625187.2013.853034	Canada	General (female)	Quantitative
Gomez Sanchez 2015 Spanish	10.1007/s10995-017-2297-9	Colombia	General (female)	Quantitative
Pomales 2013	10.1111/maq.12014	Costa Rica: San Jose	General (male), Vasectomies	Qualitative
van Dijk 2013	10.1016/j.jana.2012.10.007	Dominican Republic: Santiago, Puerto Plata	Special social conditions, General (mixed gender)	Qualitative
Cremer 2011	10.1089/jwh.2010.2264	El Salvador: La Paz, San Vicente, Cuscatlan, Cabanas	General (female), Special social conditions	Quantitative
Cravioto 2014	10.1016/j.contraception.2014.04.001	Mexico	Other special medical conditions	Quantitative
Juarez 2011	10.1080/17441692.2011.581674	Mexico: Mexico City: Gustavo A. Madera, Iztapalapa	General (mixed gender)	Qualitative
Crosby 2013	10.1258/ijsa.2008.008120	Multicountry (online): mostly USA; Australia; Canada; New Zealand; United Kingdom; Western Europe	General (mixed gender)	Quantitative
Crosby 2008	10.1007/s10935-013-0294-3	Multicountry (online): mostly USA; Canada	General (mixed gender)	Quantitative
Gemzell-Danielsson 2017	10.1111/j.1600-0412.2011.01180.x	Multicountry: Argentina; Canada; Chile; Finland; France; Hungary; Mexico; Netherlands; Norway; Sweden; USA	General (female)	Quantitative
Gemzell-Danielsson 2012	10.1016/j.contraception.2012.06.002	Multicountry: Australia, Brazil, Canada, France, Germany, Korea, Mexico, Spain, Sweden, United Kingdom	Providers	Quantitative
Hooper 2010	10.2165/11538900-000000000-00000	Multicountry: Australia; Brazil; France; Germany; Italy; Russia; Spain; United Kingdom; USA	General (female)	Quantitative
Borgatta 2016	10.1080/13625187.2016.1212987	Multicountry: Austria; Belgium; Germany; USA	General (female)	Quantitative
Yam 2007	10.1363/ifpp.33.160.07	Multicountry: Barbados; Jamaica: Kingston metro area	Providers	Quantitative
Todd 2011	10.1007/s10461-010-9848-z	Multicountry: Brazil: Rio de Janiero; Kenya: Kericho; South Africa: Soweto	PLHIV	Qualitative
Mansour 2014	10.2147/IJWH.S59059	Multicountry: Brazil; France; Germany; Italy; USA	General (female)	Quantitative
Coffey 2006	10.1016/j.contraception.2005.10.017	Multicountry: Mexico: Cuernavaca; South Africa: Durban; Thailand: Khon Kaen	General (mixed gender)	Quantitative
Mack 2010	10.1363/3614910	Multicountry: Nicaragua: Managua; El Salvador: San Salvador and San Miguel	Special social conditions, Providers	Mixed methods
Festin 2016	10.1093/humrep/dev341	Multicountry: Thailand, Brazil, Singapore, Hungary	General (female)	Quantitative
Cartwright 2020	10.12688/gatesopenres.13045.2	Multicountry: unspecified	Young people (mixed gender), Special social conditions	Mixed methods
Yarris 2016	10.1080/17441692.2016.1168468	Nicaragua: Matagalpa	General (female)	Qualitative
Jennings 2011	10.1016/j.contraception.2010.11.011	Peru: Lima, Piura	General (female), Providers	Quantitative
Ortiz-Gonzalez 2014	PMID: 25244880	Puerto Rico: San Juan	Young people (female), Pregnant	Quantitative
Agénor 2020	10.1363/psrh.12128	USA: MA: Boston	Young people (male), Special social conditions	Qualitative
Akers 2010	10.1089/jwh.2009.1735	USA: PA: Pittsburgh	Providers	Qualitative
Amico 2016	10.1016/j.contraception.2016.04.012	USA: NY: NYC: Bronx	General (female)	Qualitative
Anderson 2014	10.1363/46e1814	USA: CA: San Francisco	General (female)	Qualitative
Arteaga 2016	10.1080/00224499.2015.1079296	USA: CA: San Francisco Bay Area	Young people (female)	Qualitative
Bachorik 2015	10.1016/j.jpag.2014.08.002	USA: NY: New York City	Young people (female)	Quantitative
Baldwin 2016	10.1016/j.contraception.2015.12.006	USA: OR	Postpartum	Quantitative
Benfield 2018	10.1016/j.contraception.2018.01.017	USA: NY	Providers	Quantitative
Best 2014	10.1363/46E0114	USA: IN: Indianapolis	Young people (female)	Quantitative
Borrero 2009	10.1007/s11606-008-0887-3	USA: PA: Pittsburgh	General (female), Other special medical conditions	Qualitative
Callegari 2017	10.1016/j.ajog.2016.12.178	USA	General (female), Special social conditions	Quantitative
Campo 2010	10.1080/03630242.2010.480909	USA: (unspecified) rural midwestern state	General (female)	Qualitative
Carr 2018	10.1016/j.contraception.2017.10.008	USA: NM	Pregnant, Postpartum, Special social conditions	Mixed methods
Chapa 2012	10.2147/PPA.S30247	USA: TX: Dallas	General (female), Other special medical conditions	Quantitative
Coleman-Minahan 2019	10.1016/j.contraception.2019.08.011	USA: TX	General (female), Special social conditions, Postpartum	Quantitative
Corbett 2006	10.1111/j.1745-7599.2006.00114.x	USA: (unspecified) southern coastal city	Young people (mixed gender)	Quantitative
Creinin 2008	10.1097/01.AOG.0000298338.58511.d1	USA: multiple sites (Boston, New York, Norfolk, Baltimore, Portland, Los Angeles, Chicago, Philadelphia, Pittsburg, Madison)	General (female)	Quantitative
Dehlendorf 2010	10.1016/j.pec.2010.06.021	USA: CA: San Francisco	Previously had abortions	Quantitative
Dehlendorf 2013	10.1016/j.contraception.2012.10.012	USA: CA: San Francisco	General (female)	Qualitative
DeMaria 2019	10.1186/s12905-019-0827-x	USA: (unspecified) southeastern coastal region	General (female)	Mixed methods
DeSisto 2018	10.1186/s40834-018-0073-x	USA: GA	Postpartum, Special social conditions	Mixed methods
Diedrich 2015	10.1016/j.ajog.2014.07.025	USA: MO: St. Louis	General (female)	Quantitative
Donnelly 2014	10.1016/j.contraception.2014.04.012	USA: ME, NH, VT	General (female), Providers	Quantitative
Downey 2017	10.1016/j.whi.2017.03.004	USA: CA: San Francisco Bay Area	Young people (female)	Qualitative
Edelman 2007	10.1016/j.contraception.2007.02.005	USA: OR: Portland; GA: Atlanta	General (female)	Quantitative
Epstein 2008	10.1016/j.jadohealth.2007.12.007	USA: CA: San Francisco	Young people (female), Special social conditions	Qualitative
Espey 2014	10.1016/j.ajog.2013.11.018	USA: NM: Albuquerque	Nulliparous	Quantitative
Fan 2016	10.1007/s10508-016-0816-1	USA: PA: Pittsburgh	General (female)	Mixed methods
Fennell 2014	10.1016/j.contraception.2013.11.012	USA: CT, MA, NC, NJ, RI, VA	General (female)	Qualitative
Fleming 2010	10.1016/j.contraception.2010.02.020	USA: CA	Young people (female)	Quantitative
Foster 2014	10.1016/j.contraception.2014.01.025	USA: multiple sites (St. Louis, New York, San Francisco, Philadelphia, Salt Lake City)	General (female)	Quantitative
Friedman 2015	10.1016/j.jpag.2014.02.015	USA: NY: New York City	Young people (female)	Quantitative
Frost 2008	10.1363/4009408	USA	General (female)	Quantitative
Galloway 2017	10.1016/j.jadohealth.2016.12.006	USA: SC: Spartanburg, Horry	Young people (mixed gender), Nulliparous	Qualitative
Garbers 2013	10.1089/jwh.2013.4247	USA: NY: New York City	General (female)	Quantitative
Gilliam 2009	10.1016/j.jpag.2008.05.008	USA: IL: Chicago	Young people (female)	Qualitative
Gollub 2015	10.1080/13691058.2015.1005672	USA	General (female)	Mixed methods
Gomez 2014	10.1363/46e2014	USA	General (female)	Quantitative
Gomez 2015	10.1016/j.whi.2015.03.011	USA	General (mixed gender)	Quantitative
Gomez 2017	10.1016/j.whi.2015.03.011	USA	General (female)	Qualitative
Goyal 2017	10.1097/AOG.0000000000001926	USA: TX	Women seeking abortion services	Quantitative
Gubrium 2011	10.1007/s13178-011-0055-0	USA: MA: 3 cities in western region	General (female)	Qualitative
Hall 2016a	10.1016/j.contraception.2016.02.007	USA	General (female), Young people (female)	Quantitative
Hall 2016b	10.1136/jfprhc-2014-101046	USA: NY: Ithaca	General (female), Young people (female)	Quantitative
He 2016	10.1089/jwh.2016.5807	USA	General (female)	Quantitative
Hensel 2012	10.1111/j.1743-6109.2012.02700.x	USA	General (male)	Quantitative
Higgins 2008	10.1363/psrh.12025	USA: GA: Atlanta	General (mixed gender)	Qualitative
Higgins 2015	10.1111/jsm.12375	USA	General (female)	Qualitative
Higgins 2017	10.1363/47e4515	USA: WI: Dane County	General (female)	Qualitative
Hodgson 2013	10.1016/j.contraception.2012.10.011	USA: CT: New Haven	General (female), Special social conditions	Qualitative
Holt 2006	10.1089/jwh.2006.15.281	USA: CA: Northern region	General (mixed gender)	Qualitative
Hoopes 2015	10.1016/j.jpag.2015.09.011	USA: WA	Young people (female)	Qualitative
Hoopes 2018	10.1016/j.jpag.2017.11.008 10.1016/j.jpag.2017.11.008. Epub 2017 Dec 1.	USA: CO	General (female)	Quantitative
Howard 2013	10.1016/j.jpag.2013.07.013	USA: MO: Kansas City	Postpartum, Young people (female)	Quantitative
Hubacher 2015b	10.1016/j.contraception.2014.11.006	USA: NC	General (female)	Quantitative
Hubacher 2017	10.1016/j.ajog.2016.08.033	USA: NC	General (female)	Quantitative
Jackson 2016	10.1016/j.contraception.2015.12.010	USA	General (female), Women seeking abortion services	Quantitative
Kaller 2020	10.1186/s12905-020-0886-z	USA: CA: San Francisco	Women seeking emergency contraception, Young people (female)	Qualitative
Kavanaugh 2013	10.1016/j.jpag.2012.10.006	USA	Young people (female), Providers	Qualitative
Kimport 2017	10.1016/j.contraception.2016.10.009	USA: CA: San Francisco Bay Area	General (female)	Qualitative
Lamvu 2006	10.1016/j.contraception.2005.10.007	USA	General (female)	Quantitative
Latka 2008	10.1521/aeap.2008.20.2.160	USA: NY: New York City	Young people (mixed gender)	Qualitative
Lehan Mackin 2015	10.1177/0193945914551005	USA	General (female)	Quantitative
Lessard 2012	10.1363/4419412	USA: multiple sites (St. Louis, Chicago, Little Rock, Seattle, Philadelphia, Oakland)	Women seeking abortion services	Quantitative
Levy 2014	10.1016/j.whi.2014.10.001	USA: CA: 6 San Francisco Bay Area clinics	General (female), Providers	Qualitative
Lewis 2012	10.1016/j.jpag.2012.08.003	USA: IL: Chicago	postpartum, Young people (female)	Qualitative
Madden 2010	10.1016/j.contraception.2009.08.002	USA: IL	Providers	Quantitative
Madden 2015	10.1016/j.ajog.2015.01.051	USA	General (female)	Quantitative
Mantell 2011	10.1521/aeap.2011.23.1.65	USA: NY: New York City	Providers	Qualitative
Marshall 2016	10.1363/48e10116	USA	General (female)	Quantitative
Marshall 2017	10.1016/j.contraception.2017.10.004	USA: CA: Oakland	General (female)	Qualitative
McLean 2017	10.1016/j.contraception.2016.08.010	USA: CA: San Francisco Bay Area	General (female), Providers	Mixed methods
McNicholas 2012	10.1016/j.whi.2012.04.008	USA: (unspecified) urban site	Women seeking abortion services	Quantitative
Melo 2015	10.1016/j.jpag.2014.08.001	USA: CO	Young people (female)	Qualitative
Melton 2012	10.1363/4402212	USA: UT: Salt Lake City	Women seeking emergency contraception	Quantitative
Merkatz 2014	10.1016/j.contraception.2014.05.015	USA: MO: St. Louis	General (female)	Quantitative
Michaels 2018	N/A	USA: IA	Women seeking abortion services	Quantitative
Miller 2011	10.1016/j.contraception.2010.06.005	USA: PA	Young people (mixed gender)	Quantitative
Minnis 2014	10.1363/46e1414	USA: CA: San Francisco	Young people (female)	Mixed methods
Modesto 2014	10.1093/humrep/deu089	USA: CA: San Francisco	General (female)	Quantitative
Munsell 2009	print.ispub.com/api/0/ispub-article/9991	USA: TX: Galveston	Providers	Quantitative
Nelson 2017	10.1016/j.contraception.2017.09.010	USA	General (female)	Quantitative
Nettleman 2007	10.1016/j.jmwh.2006.10.019	USA	General (female), Special social conditions	Qualitative
Nguyen 2017	10.1016/j.jpag.2011.06.002	USA	Providers	Quantitative
Paul 2020	10.1016/j.ajog.2019.11.1266	USA: (unspecified) mid-west region	General (female)	Quantitative
Payne 2016	10.1111/jmwh.12425	USA: (unspecified) southeastern	General (female)	Qualitative
Peipert 2011	10.1097/AOG.0b013e31821188ad	USA: MO: St. Louis	General (female), Special social conditions	Quantitative
Philliber 2014	10.1016/j.whi.2014.06.001	USA: CO, IA	Providers	Quantitative
Potter 2014a	10.1097/aog.0000000000002136	USA: NY: school- based health centers (SBHCs) and community health center	Young people (female)	Qualitative
Potter 2014b	10.1016/j.contraception.2014.06.039	USA: TX: El Paso, Austin	Postpartum	Quantitative
Potter 2017	10.1016/j.contraception.2014.01.011	USA: TX: Odessa, Austin, Edinburg, Dallas, Houston, El Paso	Postpartum	Quantitative
Powell-Dunford 2011	10.1016/j.whi.2010.08.006	USA	General (female), Special social conditions	Quantitative
Raifman 2018	10.1016/j.whi.2017.07.006	USA: MI, MO, NJ, UT	general (female)	Quantitative
Rey 2020	10.1016/j.contraception.2020.01.010	USA: VT	General (female), PWID	Quantitative
Rocca 2007	10.1016/j.ajog.2006.08.024	USA: CA: San Francisco Bay Area	Young people (female)	Quantitative
Roe 2016	10.1016/j.rmed.2016.10.012	USA: PA (online)	Other special medical conditions	Quantitative
Rubin 2010	10.1016/j.jpag.2015.09.001	USA: NY: NYC: Bronx	General (female)	Qualitative
Rubin 2015	10.1089/jwh.2009.1549	USA: NY: NYC: Bronx	Young people (female)	Qualitative
Sanders 2014	10.1371/journal.pone.0199724	USA	Young people (male)	Quantitative
Sanders 2018	10.1007/s10461-013-0422-3	USA: UT: Salt Lake City	General (female)	Quantitative
Sangi-Haghpeykar 2006	10.1016/j.contraception.2006.02.010	USA: TX: Houston	General (female), Previously had abortions	Quantitative
Sangraula 2017	10.1016/j.jpag.2016.11.004	USA: NY: NYC: Uptown Manhattan, Lower Bronx	Young people (female)	Qualitative
Sastre 2015	10.1080/13691058.2014.989266	USA: FL: Miami-Dade County	General (mixed gender), Special social conditions	Qualitative
Shih 2013	10.1177/1557988312465888	USA: CA: San Francisco	General (mixed gender), Vasectomies	Qualitative
Sittig 2020	10.1016/j.whi.2019.11.003	USA: PA (online)	General (female), Special social conditions	Quantitative
Spies 2010	10.1016/j.whi.2010.07.005	USA	Young people (female), General (female)	Qualitative
Stanek 2009	10.1016/j.contraception.2008.09.003	USA: OR	Women seeking abortion services	Quantitative
Stanwood 2009	10.1016/j.contraception.2005.05.020	USA	General (female)	Quantitative
Stein 2020	10.1016/j.jpag.2020.01.004	USA: NY: NYC: Bronx	Young people (female)	Quantitative
Stewart 2007	10.1016/j.jpag.2007.06.001	USA: CA: San Francisco	Young people (female), Special social conditions	Quantitative
Straten 2016	10.1007/s10461-016-1299-8	USA	General (female)	Quantitative
Sulak 2006	10.1016/j.contraception.2005.07.001	USA	Providers	Quantitative
Sundstrom 2015	10.1080/10410236.2016.1172294	USA: SC: Charleston	General (female)	Qualitative
Sundstrom 2016	10.1080/10810730.2015.1018650	USA	Young people (female)	Qualitative
Tanner 2008	10.1016/j.jadohealth.2008.02.017	USA: IN: Indianapolis	Young people (female)	Quantitative
Teal 2012	10.1016/j.contraception.2011.07.001	USA: CO	Young people (female)	Quantitative
Terrell 2011	10.1016/j.jpag.2011.02.003	USA: IN: Indianapolis	Young people (female)	Quantitative
Thorburn 2006	10.1300/J013v44n01_02	USA: CA	Young people (female)	Quantitative
Tung 2012	10.1080/07448481.2012.663839	USA	General (mixed gender)	Quantitative
Turok 2016	10.1016/j.contraception.2016.01.009	USA: UT: Salt Lake City	Women seeking emergency contraception	Quantitative
Tyler 2012	10.1097/AOG.0b013e31824aca39	USA: multiple sites	Providers	Quantitative
Venkat 2008	10.1007/s10900-008-9100-1	USA: NY: NYC	General (female), Special social conditions	Quantitative
von Sadovszky 2008	10.1016/j.whi.2008.01.004	USA	General (female), Special social conditions	Quantitative
Walker 2019	10.1080/03630242.2012.728190	USA: CA: Northern region	Young people (female)	Quantitative
Werth 2015	10.1016/j.ajog.2014.09.003	USA: MO: St. Louis	General (female)	Quantitative
Weston 2012	10.1016/j.ajog.2011.06.094	USA: IL: Chicago	Young people (female), Postpartum	Qualitative
Whitaker 2008	10.1016/j.contraception.2008.04.119	USA: PA: Pittsburgh	Young people (female)	Quantitative
White 2013	10.1016/j.whi.2013.05.001	USA: TX: El Paso	General (female)	Qualitative
Whittaker 2010	10.1363/4210210	USA: PA: Philadelphia	Young people (mixed gender)	Qualitative
Woo 2015	10.1016/j.contraception.2015.09.007	USA: MD: Baltimore	General (female)	Quantitative
Xu 2011	10.2147/ijwh.s57470	USA	General (female)	Quantitative
Yee 2010	10.1016/j.jadohealth.2010.03.014	USA: IL: Chicago	Young people (female), Postpartum	mixed methods

Table 1E

Summary characteristics of articles included in the contraceptive values and preferences global systematic review which were conducted in countries in the WHO South-East Asia Region 2005-2020

Author year	DOI	Location	Population	Study design
Zafar 2006	10.1111/j.1447-0578.2006.00132.x	Bangladesh: Tangail District: Kalihati sub-district	General (female)	Qualitative
Ahuja 2019	10.4103/jfmpc.jfmpc_676_19	India : Patiala, Punjab Province	Young people (female)	Quantitative
Das 2015	10.1071/SH15045	India: Delhi	General (female), Special social conditions	Qualitative
Hall 2008	10.1136/jfprhc-2014-101046	India: Maharashtra	General (female)	Qualitative
Jain 2016	10.7860/JCDR/2016/16545.7516	India: New Delhi	Menstrual Issues	Quantitative
Khokhar 2005	moam.info/determinants-of-acceptance-of-no-scalpel-vasectomy-medind_59d916e41723dd4e6be7785f.html	India: New Delhi	Vasectomies	Quantitative
Meenakshi 2020	10.4103/jfmpc.jfmpc_1012_19	India: Jodhpur, Rajasthan	Providers	Quantitative
Neeti 2010	nihfw.org/Publications/pdf/HPPI_33(1),2010.pdf	India: Delhi: Central district	general (female)	Qualitative
Patra 2015	10.1108/ijhrh-06-2014-0010	India	General (female)	Quantitative
Rizwan 2014	10.7860/jcdr/2014/8278.4714	India: northern	General (male), Special social conditions	Quantitative
Sharma 2018	pesquisa.bvsalud.org/portal/resource/pt/sea-185340	India: east Delhi	General (female)	Quantitative
Sherpa 2013	PMID: 24971113	India: Karnataka: Udupi District: Moodu Alevoor village	General (female)	Quantitative
Sood 2015	ijmch.org/home/indian-journal-of-maternal-and-child-health-volume-17-april—december-2015	India: Punjab, Amritsar	General (female)	Quantitative
Thulaseedharan 2018	10.2147/oajc.s152178	India: Trivandrum district, Kerala	General (female)	Quantitative
Valsangkar 2012	10.4103/0970-1591.102704	India: Karimnagar district, Andhra Pradesh	General (mixed gender)	Quantitative
Spagnoletti 2019	10.1080/17441730.2019.1578532	Indonesia: Yogyakarta	General (female)	Qualitative
Titaley 2017	10.1016/j.midw.2017.07.014	Indonesia: East Java, Nusa Tenggara Barat Provinces	Providers	Qualitative
Brunie 2019	10.1371/journal.pone.0216797	Multicountry: India: New Dehli; Nigeria: Ibadan	General (female), Providers	Qualitative
Cartwright 2020	10.12688/gatesopenres.13045.2	Multicountry: unspecified	Young people (mixed gender), Special social conditions	Mixed methods
Coffey 2006	10.1016/j.contraception.2005.10.017	Multicountry: Mexico: Cuernavaca; South Africa: Durban; Thailand: Khon Kaen	General (mixed gender)	Quantitative
Cover 2013	10.1016/j.contraception.2016.10.007	Multicountry: India: Lucknow, Uttar Pradesh; Uganda: Kampala	General (mixed gender)	Qualitative
Festin 2016	10.1093/humrep/dev341	Multicountry: Thailand, Brazil, Singapore, Hungary	General (female)	Quantitative
Hooper 2010	10.2165/11538900-000000000-00000	Multicountry: Australia; Brazil; France; Germany; Italy; Russia; Spain; United Kingdom; USA	General (female)	Quantitative
Machiyama 2018	10.1186/s12978-018-0514-7	Multicountry: Kenya: Nairobi, Homa Bay; Bangladesh: Matlab	General (female), Special social conditions	Quantitative
Xu 2014	10.1016/j.fertnstert.2011.08.019	Multicountry: China, Taiwan, Hong Kong, Indonesia, Malaysia, Pakistan, South Korea, Thailand	Menstrual Issues	Quantitative
Sapkota 2016	10.3389/fpubh.2016.00122	Nepal: Kapibastu	General (female), General (male)	Mixed methods
Shrestha 2014	10.3126/kumj.v12i3.13718	Nepal: Kathmandu: Dhulikhel	General (mixed gender), Postpartum	Quantitative
Santibenchakul 2016	10.5372/1905-7415.1003.485	Thailand: Bangkok	General (female)	Quantitative