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METHODOLOGY
Open Access

Using a Chord Diagram to Visualize Dynamics in Contraceptive Use: Bringing Data Into Practice

Amy Finnegan, Saumya S. Sao and Megan J. Huchko
Global Health: Science and Practice December 2019, 7(4):598-605; https://doi.org/10.9745/GHSP-D-19-00205
Amy Finnegan
aIntraHealth International, Chapel Hill, NC, USA.
bDuke Center for Global Reproductive Health at the Duke Global Health Institute, Durham, NC, USA.
cEvidence Lab at the Duke Global Health Institute, Durham, NC, USA.
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  • For correspondence: amy.finnegan{at}gmail.com
Saumya S. Sao
bDuke Center for Global Reproductive Health at the Duke Global Health Institute, Durham, NC, USA.
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Megan J. Huchko
bDuke Center for Global Reproductive Health at the Duke Global Health Institute, Durham, NC, USA.
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  • FIGURE 1.
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    FIGURE 1.

    How to Read a Chord Diagram Showing Contraceptive Use

    This figure displays a chord diagram using hypothetical data on contraceptive use at 2 time points: baseline (start) and follow-up (12 months later). The dashed line (Panel a) splits the chord diagram between the 2 time points. The interactive feature of the same chord diagram (Panel b) is shown, with a focus on women reporting injection use at baseline. Arrows and dotted lines are added for demonstration purposes and are not present in the actual chord diagrams.

  • FIGURE 2.
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    FIGURE 2.

    Trajectories of New Contraceptive Users Among Women Sampled in the 2014 Kenya Demographic Health Survey

    The start period (left) begins with a woman’s first reported use after non-use of contraception in the prior month. The right side (12 months later) displays the method she was using, if any, 12 months later. This population of women mostly uses injections between the 2 time periods (Panel a). Most women who quit using injections either switch to less effective methods or stop using contraception altogether. The trajectories of injection users specifically is shown (Panel b). A few women switch to more effective methods, but most stay on injections. Among those who are no longer using injections 12 months later, most have quit using any method of contraception.

  • FIGURE 3.
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    FIGURE 3.

    Reasons for Contraceptive Method Discontinuation Among Women Sampled in the 2014 Kenya Demographic Health Survey

    These chord diagrams display the reasons for switching to another method (Panel a) or discontinuing (Panel b). Colors along the left-hand side encode method effectiveness. The colors along the right-hand side encode reasons for discontinuation into “in need” (dark blue) and not “in need” (light blue). In both cases, the most common reason women quit using injections was because of side effects (both quitting and switching). Comparing Panel (a) to (b), about half of women who quit using any method were still in need while women who switched were still in need.

Tables

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    TABLE.

    Data Matrix of Hypothetical Contraceptive Use Dynamics

    Method Used at BaselineMethod Used 12 Months Later
    ImplantsInjectionsPillCondomRhythmNon-use
    Implants10024
    Injections161100178
    Pill36100
    Condom202158
    Rhythm148
    • Source: Hypothetical data created for tutorial. See Figure 1 for the chord diagram visualization.

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Global Health: Science and Practice: 7 (4)
Global Health: Science and Practice
Vol. 7, No. 4
December 23, 2019
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Using a Chord Diagram to Visualize Dynamics in Contraceptive Use: Bringing Data Into Practice
Amy Finnegan, Saumya S. Sao, Megan J. Huchko
Global Health: Science and Practice Dec 2019, 7 (4) 598-605; DOI: 10.9745/GHSP-D-19-00205

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Using a Chord Diagram to Visualize Dynamics in Contraceptive Use: Bringing Data Into Practice
Amy Finnegan, Saumya S. Sao, Megan J. Huchko
Global Health: Science and Practice Dec 2019, 7 (4) 598-605; DOI: 10.9745/GHSP-D-19-00205
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