2026-03-06T10:57:17Zhttps://escholarship.org/oaioai:escholarship.org:ark:/13030/qt57p6w6s32025-12-29T00:56:31Zqt57p6w6s3Pathways to Modern Family Planning: A Longitudinal Study on Social Influence among Men and Women in BeninIgras, SusanBurgess, SarahChantelois‐Kashal, HeatherDiakité, MariamGiuffrida, MonicaLundgren, Rebecka2021-03-01Despite improvements in family planning (FP) knowledge and services in West Africa, unmet need for FP continues to grow. Many programs apply a demographically and biologically driven definition of unmet need, overlooking the complex social environment in which fertility and FP decisions are made. This longitudinal, qualitative cohort study captures the changing nature of FP need, attitudes and behaviors, taking into account life context to inform understanding of the complex behavior change process. Purposively sampled, 25 women and 25 men participated in three rounds of in-depth interviews over 18 months. Analyses used a social network influence lens. Findings suggest alignment of six foundational building blocks operating at individual, couple, services, and social levels is essential to meet FP need. If one block is weak, a person may not achieve met need. Women and men commonly follow five pathways as they seek to fulfill their FP need. Some pathways achieve met need (determined users, quick converters), some do not (side effect avoiders), and some do not lead to consistent FP outcomes (male-priority decision makers, gender-egalitarian decision makers). Findings clarify the role of social determinants of FP and offer insight into program approaches informed by user typologies and return on program investments.4206 Public Health (for-2020)42 Health Sciences (for-2020)Clinical Research (rcdc)Contraception/Reproduction (rcdc)Behavioral and Social Science (rcdc)Basic Behavioral and Social Science (rcdc)3 Good Health and Well Being (sdg)Benin (mesh)Cohort Studies (mesh)Contraception Behavior (mesh)Family Planning Services (mesh)Female (mesh)Humans (mesh)Longitudinal Studies (mesh)Male (mesh)Humans (mesh)Cohort Studies (mesh)Longitudinal Studies (mesh)Contraception Behavior (mesh)Family Planning Services (mesh)Benin (mesh)Female (mesh)Male (mesh)Benin (mesh)Cohort Studies (mesh)Contraception Behavior (mesh)Family Planning Services (mesh)Female (mesh)Humans (mesh)Longitudinal Studies (mesh)Male (mesh)1117 Public Health and Health Services (for)1603 Demography (for)Demography (science-metrix)4206 Public health (for-2020)application/pdfpubliceScholarship, University of Californiahttps://escholarship.org/uc/item/57p6w6s3https://escholarship.org/content/qt57p6w6s3/qt57p6w6s3.pdfinfo:doi/10.1111/sifp.12145articleStudies in Family Planning, vol 52, iss 159 - 76