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ORIGINAL ARTICLE
Open Access

Adding a Question About Method Switching to the Method Information Index Is a Better Predictor of Contraceptive Continuation

Aparna Jain, Kumudha Aruldas, Elizabeth Tobey, Arupendra Mozumdar and Rajib Acharya
Global Health: Science and Practice June 2019, 7(2):289-299; https://doi.org/10.9745/GHSP-D-19-00028
Aparna Jain
aPopulation Council, Washington. DC, USA.
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  • For correspondence: apjain@popcouncil.org
Kumudha Aruldas
bPopulation Council, New Delhi, India. Now with Christian Medical College, Vellore, Tamil Nadu, India.
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Elizabeth Tobey
aPopulation Council, Washington. DC, USA.
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Arupendra Mozumdar
cPopulation Council, New Delhi, India.
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Rajib Acharya
cPopulation Council, New Delhi, India.
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  • FIGURE 1
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    FIGURE 1

    Kaplan-Meier Survival Curves of Contraceptive Continuation by MII

    Abbreviation: MII, Method Information Index.

  • FIGURE 2
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    FIGURE 2

    Kaplan-Meier Survival Curves of Contraceptive Continuation by MII With the Added Question About Method Switching (MIIplus)

    Abbreviation: MII, Method Information Index.

  • FIGURE 3
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    FIGURE 3

    Kaplan-Meier Survival Curves of Contraceptive Continuation by MII With the Added Question About Method Switching (MIIplus) Variation

    Abbreviation: MII, Method Information Index.

  • FIGURE 4
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    FIGURE 4

    Kaplan-Meier Survival Curves of Contraceptive Continuation by MII With the Added Question About Method Switching (MIIplus) Among IUD Users at Enrollment

    Abbreviations: IUD, intrauterine device; MII, Method Information Index.

  • FIGURE 5
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    FIGURE 5

    Kaplan-Meier Survival Curves of Contraceptive Continuation by MII With the Added Question About Method Switching (MIIplus) Among Injectable Users at Enrollment

    Abbreviation: MII, Method Information Index.

  • FIGURE 6
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    FIGURE 6

    Kaplan-Meier Survival Curves of Contraceptive Continuation by MII With the Added Question About Method Switching (MIIplus) Among Pill Users at Enrollment

    Abbreviation: MII, Method Information Index.

Tables

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    TABLE 1.

    Respondent Characteristics and Method Information Measures at Enrollment (N=2,699)

    CharacteristicNo. (%)
    Age, years
    ≤241,066 (39.5)
    25–29935 (34.6)
    ≥30698 (25.9)
    Education
    None605 (22.4)
    Primary335 (12.4)
    Middle386 (14.3)
    Secondary798 (29.6)
    Higher secondary575 (21.3)
    Religion
    Hindu2,272 (84.2)
    Muslim418 (15.5)
    Other9 (0.3)
    No. of living children
    023 (0.9)
    11,118 (41.4)
    2891 (33.0)
    3 or more667 (24.7)
    Previous modern method use
    Yes1,037 (38.4)
    No1,662 (61.6)
    Method selected at enrollment
    OCPs1,066 (39.5)
    PPIUD412 (15.3)
    Interval IUD640 (23.7)
    Injectable581 (21.5)
    State
    Haryana908 (33.6)
    Odisha1,791 (66.4)
    MII
    <3 questions1,711 (63.4)
    All 3 questions988 (36.6)
    MIIplus
    <4 questions1,779 (65.9)
    All 4 questions920 (34.1)
    MIIplus variation
    <3 questions of MII1,711 (63.4)
    MII68 (2.5)
    MIIplus920 (34.1)
    • Abbreviations: IUD, intrauterine device; MII, Method Information Index; MIIplus, Method Information Index including the question, “Were you told about the possibility of switching to another method if the method you selected was not suitable?”; OCPs, oral contraceptive pills; PPIUD, postpartum intrauterine device.

    • View popup
    TABLE 2.

    Kaplan-Meier Estimates of 100-Day Continuation of Modern Contraception (n=2,267)

    Method Information Indicators% (95% CI)
    MII
    <3 questions89.3 (87.5, 90.8)
    All 3 questions93.7 (91.7, 95.2)
    MIIplus
    <4 questions89.0 (87.3, 90.5)
    All 4 questions94.7 (92.7, 96.1)
    MIIplus variation
    <3 questions of MII89.3 (87.5, 90.8)
    MII82.3 (70.3, 89.8)
    MIIplus94.7 (92.7, 96.1)
    • Abbreviations: CI, confidence interval; MII, Method Information Index; MIIplus, Method Information Index including the question, “Were you told about the possibility of switching to another method if the method you selected was not suitable?”

    • View popup
    TABLE 3.

    Crude and Adjusted Hazard Ratios of Contraceptive Discontinuation 100 Days Later (n=2,267)

    Models of Method Information IndicatorsHR (95% CI)AHRa (95% CI)
    Model I: MII
    <3 questionsReferenceReference
    All 3 questions0.59*** (0.42, 0.80)0.65* (0.47, 0.91)
    Model II: MIIplus
    <4 questionsReferenceReference
    All 4 questions0.48*** (0.33, 0.68)0.53*** (0.37, 0.76)
    Model III: MIIplus variation
    <3 questions of MII0.57 (0.31, 1.06)0.56 (0.30, 1.04)
    MIIReferenceReference
    MIIplus0.28*** (0.14, 0.55)0.31*** (0.17, 0.61)
    • Abbreviations: AHR, adjusted hazard ratio; CI, confidence interval; HR, hazard ratio; MII, Method Information Index; MIIplus, Method Information Index including the question, “Were you told about the possibility of switching to another method if the method you selected was not suitable?”

    • ↵* P≤.05; **P≤.01; ***P ≤.001.

    • ↵a Adjusted for age, education, religion, number of living children, previous modern method use, method selected at enrollment, and state.

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Global Health: Science and Practice: 7 (2)
Global Health: Science and Practice
Vol. 7, No. 2
June 24, 2019
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Adding a Question About Method Switching to the Method Information Index Is a Better Predictor of Contraceptive Continuation
Aparna Jain, Kumudha Aruldas, Elizabeth Tobey, Arupendra Mozumdar, Rajib Acharya
Global Health: Science and Practice Jun 2019, 7 (2) 289-299; DOI: 10.9745/GHSP-D-19-00028

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Adding a Question About Method Switching to the Method Information Index Is a Better Predictor of Contraceptive Continuation
Aparna Jain, Kumudha Aruldas, Elizabeth Tobey, Arupendra Mozumdar, Rajib Acharya
Global Health: Science and Practice Jun 2019, 7 (2) 289-299; DOI: 10.9745/GHSP-D-19-00028
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