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Record W4416204655 · doi:10.1186/s12978-025-02146-3

Does family planning use empower women? A systematic review of the evidence

2025· article· en· W4416204655 on OpenAlex
Nadia Diamond‐Smith, Lakshmi Gopalakrishnan, Salome Wawire, Jacqueline Kunesh, Jennifer Choi, Moazzam Ali, Alison M. El Ayadi

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueReproductive Health · 2025
Typearticle
Languageen
FieldMedicine
TopicGlobal Maternal and Child Health
Canadian institutionsnot available
FundersUNICEFWorld Health OrganizationUnited States Agency for International Development
KeywordsEmpowermentFamily planningLatin AmericansWomen's empowermentVariety (cybernetics)Diversity (politics)

Abstract

fetched live from OpenAlex

INTRODUCTION: Extensive evidence suggests that family planning programs are second only to education in providing returns on dollars spent with improvements in long-term maternal and child health outcomes. However, no current research synthesis to date has robustly examined whether use of family planning results in increased empowerment and greater agency of women, despite theoretical, but not empirical, support that family planning influences this outcome as well. Our objective was to conduct a systematic review of the evidence on how women's access to and/or use of family planning methods impacts their agency and empowerment, including mechanisms and effect modifiers important to this relationship. METHODS: We searched 20 global and regional databases for interventional and observational research published from January 2000 through January 2022 which reviewed the relationship between family planning use and subsequent women's empowerment. Titles/abstracts and full-text articles were screened in duplicate, and key data were extracted using a standardized form. We evaluated risk of bias using the Newcastle-Ottawa Scale and rated the certainty of evidence for four outcomes (decision-making, labor force participation, wages, and schooling) using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Findings were analyzed and summarized in both tabular and narrative format. RESULTS: We identified 3,170 articles after de-duplication, of which 14 quantitative and three qualitative studies met inclusion criteria. Studies were in both high income and low- and middle-income countries, with the largest proportion being from South Asia. Studies ranged from randomized controlled trials of programs at the community level to quasi-experimental studies of policies. The GRADE framework yielded low and very low confidence in the findings. Outcomes were categorized into domains using Kabeer's framework of Resources, agency and achievements. Most studies measured the impact of family planning on resources or agency. Combining measures across all domains of empowerment, 47% had positive, 39% null, and 14% negative results. DISCUSSION: Overall, this systematic review suggests that family planning access has a positive impact on a variety of empowerment measures across different domains of empowerment. However, the quality ratings indicate that while our synthesis suggests potential benefits of family planning for women's empowerment, the current evidence base provides limited confidence for definitive conclusions. One of the main challenges in understanding the impact of family planning on empowerment is the diversity of conceptualizations and measures of empowerment used. In addition, the geographic coverage of studies was limited to few countries, with only one study from Latin America. Further research using a process-oriented measure of empowerment comparable across contexts could add to our understanding. In addition to being a fundamental human right, investing in family planning likely contributes to women's empowerment in multiple domains.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.180
Threshold uncertainty score0.276

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.039
GPT teacher head0.374
Teacher spread0.335 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it