FPsim: An agent-based model of family planning

Abstract

AbstractThe biological and behavioral underpinnings of family planning (FP) unfold on an individual level, across a full reproductive life course, and within a complex system of social and structural constraints. Yet, much of the existing FP modeling landscape has focused solely on macro- or population-level dynamics of family planning. There is a need for an individual-based approach to provide a deeper understanding of how family planning is intertwined with individuals’ lives and health at the micro-level, which can contribute to more effective, person-centered design of both contraceptive technologies and programmatic interventions. This article introduces the Family Planning Simulator (FPsim), a data-driven, agent-based model of family planning, which explicitly models individual heterogeneity in biology and behavior over the life course. Agents in FPsim can experience a wide range of life-course events, such as increases in fecundability (and primary infertility), sexual debut, contraceptive choice, postpartum family planning, abortion, miscarriage, stillbirth, infant mortality, and maternal mortality. The core components of the model – fecundability and contraceptive choice, are represented individually and probabilistically, following age-specific patterns observed in demographic data and prospective cohort studies. Once calibrated to a setting leveraging multiple sources of data, FPsim can be used to build hypothetical scenarios and interrogate counterfactual research questions about the use, non-use, and/or efficacy of family planning programs and contraceptive methods. To our knowledge, FPsim is the first open-source, individual-level, woman-centered model of family planning.Author SummaryAlthough the causes and consequences of family planning unfold on an individual level, few models of family planning consider individual heterogeneity over the life course. To that end, we introduce the methodology, parameters, and use-case(s) of the family planning simulator (FPsim). FPsim is a data-driven agent-based model of family planning, which explicitly models individual heterogeneity in biology and behaviors over a woman’s full life course to better understand the micro-level dynamics leading to more or less successful family planning programs and policies. FPsim is a data-driven model that leverages multiple sources of data to simulate realistic populations in settings that reflect real-life contexts. It is designed to be flexible and user-friendly, allowing for custom calibrations and providing integrated functions for straightforward use. This manuscript describes the model design, including its parameters, potential data sources, and limitations. We illustrate the functionality of FPsim using hypothetical scenarios that improve upon existing injectable contraceptives and introduce new injectable contraceptives into a Senegal-like setting.