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Reporting sterilization as a current contraceptive method among sterilized women: lessons learned from a population with high sterilization rates, Rajasthan, India
Authors: Yoonjoung Choi, Anoop Khanna, Linnea Zimmerman, Scott Radloff, Blake Zachary, and Danish Ahmad
Source: Contraception, Online First; DOI: 10.1016/j.contraception.2018.10.006
Topic(s): Contraception
Family planning
Country: Asia
Published: OCT 2018
Abstract: Objective Measuring current use of contraception relies on self-reported responses from survey respondents. Reporting validity may be affected by women's interpretation of the question and may vary by background characteristics of women. The study aims to understand levels and patterns of under-reporting of female sterilization in a population with high sterilization rates. Study design Data came from the Performance Monitoring and Accountability 2020 survey conducted in Rajasthan, India, in early 2017. In addition to a conventional question to ascertain current contraceptive use, the survey included a probing question; women who did not report sterilization as a current method were asked if they were ever sterilized. Women were defined as sterilization users based on either question. Among sterilized women, we estimated the percent who reported sterilization as a current method. Multivariable logistic regression analysis was conducted to assess differential reporting across background characteristics. Results Among women who were ever sterilized, 78% reported currently using any contraceptive method(s), and 77% reported sterilization as the current method. Women in the lowest household wealth quintile or in general caste were less likely to report sterilization as a current method. Time since sterilization was not associated with correct reporting of sterilization. Conclusion This study demonstrates in a population with high sterilization, sterilization as a current contraceptive method would be substantially underestimated using conventional survey questions. It highlights the importance of context-specific questionnaire adaptation to measure and monitor contraceptive use and provides implications in measuring current use of contraception in populations with high rates of sterilization.