Understanding the Predictive Utility of Intention to Use Modern Family Planning Methods: A Comprehensive Theoretical and Empirical Review

According to the Pakistan Demographic and Health Survey (2017-18), there is universal awareness of family planning amongst married women of reproductive age, however, use of modern contraception remains low in Pakistan at 25 percent. This review aims to highlight the value of intention to use modern family planning methods as a critical measure for bridging the awareness-behavior gap. This study conducted a narrative review using systematic searches in PubMed, PsycINFO, Web of Sciences, and Google Scholar for articles published between January 2010 and May 2015. Articles providing theoretical grounding for intention before January 2010 were also included. Search terms included “family planning intention”, “contraceptive adoption”, “theory of reasoned action”, “theory of planned behavior”, “integrated behavioral model”, and “Pakistan family planning intention”. This review discussed the reasoned-action theories which posit intention as the primary predictor of behavior while also underpinning its psychosocial determinants. Moreover, the review also discussed studies that underpin the predictive utility of intention to use over unmet need, traditionally used to inform family planning programs, and how intention captured through demographic surveys can be used to inform program design. Intention alongside its determinants can play a pivotal role in program monitoring and evaluation as well highlighting critical individual and community-level factors that influence modern contraceptive uptake.