Association Between the Quality of Contraceptive Counseling and Method Continuation: Findings From a Prospective Cohort Study in Social Franchise Clinics in Pakistan and Uganda
| Autor: | Karen A. Grépin, Dominic Montagu, Nirali M. Chakraborty, Xaher Gul, Karen Chang, Waqas Hameed, Benjamin Bellows, Amanda M. Kalamar, Lynn Atuyambe |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Counseling Adolescent Ambulatory Care Facilities 03 medical and health sciences Young Adult 0302 clinical medicine Contraceptive Agents Female Medicine Humans Pakistan Uganda 030212 general & internal medicine Prospective Studies Young adult Prospective cohort study Contraception Behavior Survival analysis reproductive and urinary physiology 030219 obstetrics & reproductive medicine business.industry Contraceptive Devices urogenital system Hazard ratio Contraceptive Devices Female General Medicine Original Articles Patient Acceptance of Health Care Discontinuation Contraception Family planning Family Planning Services Patient Compliance Female business Demography Cohort study |
| Zdroj: | Global Health: Science and Practice |
| ISSN: | 2169-575X |
| Popis: | Higher scores on the 3-question Method Information Index (MII)—measuring client-reported receipt of contraceptive information—was associated with continued use of family planning over 12 months. We recommend incorporating use of the MII in routine assessments of family planning service quality. Quality of family planning counseling is likely associated with whether or not women continue to use the same contraceptive method over time. The Method Information Index (MII) is a widely available measure of contraceptive counseling quality but little is known about its association with rates of method continuation. The index ranges from 0 to 3 based on a client's answer to whether she was told about other methods, potential side effects with her chosen method, and what to do if she experienced side effects. Using data from a prospective cohort study of 1,998 social franchise clients in Pakistan and Uganda, we investigated the relationship between reported baseline MII and the risk of method continuation over 12 months using survival analysis and Cox proportional hazard models. At baseline, about 65% of women in Pakistan and 73% of women in Uganda reported receiving information about all 3 MII aspects. In Pakistan, 59.4% of the 165 women who stopped using their modern method did so while still in need of contraception. In Uganda, of the 77 women who stopped modern method use, 64.9% discontinued while in need. Despite important differences in the demographics and method mix between the 2 countries, we found similar associations between baseline MII and discontinuation: in both countries as the MII score increased, the risk of discontinuation while in need decreased. In Pakistan, the risk of contraceptive discontinuation was 64% lower (crude hazard ratio [HRcrude]=0.36; P=.03), and 72% lower (HRcrude=0.28; P=.007), among women who were told about any 2, or any 3 aspects of MII, respectively. After adjusting for additional covariates, only the difference in the risk of contraceptive discontinuation between MII=3 and MII=0 remained statistically significant (HRadj=0.35; P=0.04). In Uganda, women who reported being informed about all aspects of MII were 80% less likely to discontinue while in need (HRadj=0.20; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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