Many program implementers have difficulty collecting and analyzing data on program beneficiaries’ wealth because a large number of survey questions are required to construct the standard wealth index. We created country-specific measures of household wealth with as few as 6 questions that are highly reliable and valid in both urban and rural contexts.
Objective
To develop a shortened, valid and reliable scale applicable across multiple settings for routine monitoring of person‐centered maternity care (PCMC).
Methods
Exploratory analysis was used to generate parsimonious versions of a 30‐item PCMC scale in four datasets from cross‐sectional surveys conducted between August 2016 and October 2017, involving women aged 15–49 years in Kenya, Ghana and India who had recently given birth. Analysis was informed by expert opinion via a separate online survey of global maternal and child health experts. Items retained in each dataset were compared, and those unique to a single setting removed. The remaining items were pooled and assessed for construct and criterion validity and reliability in each setting.
Results
Thirteen items were retained for a potential multi‐setting short PCMC scale, incorporating the domains of dignity and respect, communication and autonomy, and supportive care. Cronbach's alpha for the scale was >0.7 in each setting. Scores on the 13‐item scale were correlated with the 30‐item scale scores, and with global measures of care satisfaction in Kenya and India.
Conclusion
Analysis yielded a 47% shorter PCMC scale, that showed promise for routine assessment of women's experience of care during childbirth across multiple settings. However, further validation is needed.
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.
Overall, expulsion rates were lower than previously reported, particularly for immediate post-partum insertions. Attention to high fundal placement at insertion is a likely explanation for the low expulsion rates. Contrary to conventional wisdom, these low expulsion rates indicate that previous notions regarding insertion timing may not be accurate. Satisfaction levels were also favourable. PPIUD can be safe, acceptable and feasible in an African setting.
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