Do users of long-acting reversible contraceptives receive the same counseling content as other modern method users? A cross-sectional, multi-country analysis of women's experiences with the Method Information Index in six sub-Saharan African countries

Bullington, Brooke W.; Tumlinson, Katherine; Karp, Celia; Senderowicz, Leigh; Zimmerman, Linnea; Akilimali, Pierre; Zakirai, Musa Sani; OlaOlorun, Funmilola; Kibira, Simon P. S.; Makumbi, Frederick; Shiferaw, Solomon

doi:10.1016/j.conx.2022.100088

Cited by 7 publications

(5 citation statements)

References 35 publications

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“…Thus, the role of the health care provider is to ensure contraceptive counseling and delivery of CM during timely, quality care with an intercultural approach. 22,23 Although access to the safest and most effective CM is free and all women have the possibility of using them, our findings show that women with a higher wealth index have a higher frequency of LARC use, which is consistent with the findings of Bolarinwa et al 24 and Gashaye et al 25 but not with Aychew et al 14 who reported that the use of these methods is more likely in women with lower income. This evidence could reflect that better paid employment, and as a consequence, greater autonomy and empowerment of women, favors the use of these methods.…”

Section: Discussionsupporting

confidence: 90%

Profile of Users of Short- and Long-acting Contraceptive Methods: A Cross-sectional National Study of 12,973 Women

Mayta-Tovalino,

Barja-Ore,

Valverde-Espinoza

et al. 2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim: To compare the profile of users of short-and long-acting contraceptive methods (CM). Materials and methods: Cross-sectional study that analyzed population-based databases in Peru. A total of 12,973 users of short-and longacting CM were included. Social, demographic, and reproductive characteristics were studied, as well as the type of contraceptive method. Descriptive statistics were calculated; and the Chi-square test was applied with 95% confidence. Results: Short-acting contraceptives (87.7%) are more used than long-acting contraceptives (LARCs) (12.3%). Among users of LARCs, the proportion of women with higher education (47.7%) was significantly higher. Women from the highlands (21.9%) used mostly short-acting methods; and those residing in urban areas (85.5%) and with a high wealth index (23.7%) used long-acting methods. Childlessness (18.8%) and non-desire for parity (62.5%) were higher in users of short-and LARCs, respectively. The initiation of sexual intercourse was not different in both groups of users. Conclusion: Social, demographic, and reproductive characteristics are different in women users of short-and long-acting methods, except for age at sexual debut. Clinical significance: The wide range of CM currently available allows women and their partners to satisfy their reproductive demands, although their choice depends on various conditions internal or external to the woman.

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Section: Discussionsupporting

confidence: 90%

Profile of Users of Short- and Long-acting Contraceptive Methods: A Cross-sectional National Study of 12,973 Women

Mayta-Tovalino,

Barja-Ore,

Valverde-Espinoza

et al. 2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…Table 1 indicates how side effects were grouped. For regression analyses, described further below, we included socio-demographic characteristics identified from previous literature related to receiving more comprehensive counseling [19][20][21] , specifically age (categorical in five year age groups), parity (categorized as 0, 1-2, 3+ births), highest level of . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Section: Methodsmentioning

confidence: 99%

“…Such efforts can be further improved by identifying whether the comprehensiveness of side effect counseling varies across women. Recent evidence suggests that women who use long-acting methods are more likely to receive all components of the MII 19,20 , indicating that method choice may influence the comprehensiveness of counseling services (or vice versa). Similarly, evidence across 25 countries found that the MII was generally positively associated with wealth and education and was higher in urban relative to rural areas and among women who received services from public, relative to private, providers 20 .…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…Higher scores on the MII have been shown to be associated with contraceptive behavior; women who reported being informed about all aspects of the MII were 80% less likely to discontinue, while those informed about any one aspect of the MII were 68% less likely to discontinue contraceptive use 16 . Given its ease in measurement and interpretation, in addition to its association with key contraceptive behaviors 17 , the MII has been widely used as a proxy to monitor, evaluate, and improve the quality of contraceptive services [18][19][20][21] .…”

Section: Introductionmentioning

confidence: 99%

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What contraceptive side effects are women told about during counseling? Evidence from PMA Ethiopia 2019 cross-sectional survey

Zimmerman

Sarria

Kassa

et al. 2023

Preprint

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Background Despite widespread concerns about contraceptive side effects, few studies explore the specific side effects women are told about during contraceptive counseling. This study explored patterns of counseling on specific side effects by user characteristics in Ethiopia. Methods Data were collected from a nationally representative sample of women between October and December 2019. Analyses were restricted to 2,039 current users of hormonal contraception or the non-hormonal IUD. Descriptive analyses identified the types and number of side effects, across all methods and by the injectable, implant, and pill. Multinomial regression identified factors associated with receipt of counseling on bleeding changes only, non-bleeding changes only, or both, relative to no counseling on side effects, adjusting for method type, source, and socio-economic characteristics. Results Less than 10% of users were told of at least one bleeding and non-bleeding side effect. Relative to implant users, injectable and other method users were less likely to be told about bleeding changes only (aRRR: 0.65, 95% CI: 0.46-0.93 and aRRR: 0.31, 95% CI: 0.16-0.61, respectively) and users of other methods were less likely to be told about both a bleeding and non-bleeding change (aRRR: 0.43, 95% CI: 0.19-0.93). Users who received their method from a non-public source were less likely to receive counseling on any kind of side effect and nulliparous women were less likely to be told about both kinds of side effects. Conclusion There is need to improve counseling in the private sector. Research to understand provider barriers to counseling on side effects is needed.

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“…To measure information provision, the MII+ uses a predefined list of topics the provider is expected to cover. Notably lacking are items related to interpersonal treatment and respect for informed choice ( Senderowicz 2020 ; Bullington et al 2022 ), thereby excluding assessment of the degree to which individuals, themselves, deemed their informational needs were met. The measurement of this alignment between services and individuals’ preferences is critical given the wide range of possible needs during contraceptive counseling ( Kennedy, Yeh, and Gaffield 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Validation and Predictive Utility of a Person‐Centered Quality of Contraceptive Counseling (QCC‐10) Scale in Sub‐Saharan Africa: A Multicountry Study of Family Planning Clients and a New Indicator for Measuring High‐Quality, Rights‐Based Care

Karp

OlaOlorun

Guiella

et al. 2023

Studies in Family Planning

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The lack of validated, cross‐cultural measures for examining quality of contraceptive counseling compromises progress toward improved services. We tested the validity and reliability of the 10‐item Quality of Contraceptive Counseling scale (QCC‐10) and its association with continued protection from unintended pregnancy and person‐centered outcomes using longitudinal data from women aged 15–49 in Burkina Faso, Kenya, and Nigeria. Psychometric analysis showed moderate‐to‐strong reliability (alphas: 0.73–0.91) and high convergent validity with greatest service satisfaction. At follow‐up, QCC‐10 scores were not associated with continued pregnancy protection but were linked to contraceptive informational needs being met among Burkinabe and Kenyan women; the reverse was true in Kano. Higher QCC‐10 scores were also associated with care‐seeking among Kenyan women experiencing side effects. The QCC‐10 is a validated scale for assessing quality of contraceptive counseling across diverse contexts. Future work is needed to improve understanding of how the QCC‐10 relates to person‐centered measures of reproductive health.

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Do users of long-acting reversible contraceptives receive the same counseling content as other modern method users? A cross-sectional, multi-country analysis of women's experiences with the Method Information Index in six sub-Saharan African countries

Cited by 7 publications

References 35 publications

Profile of Users of Short- and Long-acting Contraceptive Methods: A Cross-sectional National Study of 12,973 Women

Profile of Users of Short- and Long-acting Contraceptive Methods: A Cross-sectional National Study of 12,973 Women

What contraceptive side effects are women told about during counseling? Evidence from PMA Ethiopia 2019 cross-sectional survey

Validation and Predictive Utility of a Person‐Centered Quality of Contraceptive Counseling (QCC‐10) Scale in Sub‐Saharan Africa: A Multicountry Study of Family Planning Clients and a New Indicator for Measuring High‐Quality, Rights‐Based Care

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