Characteristics Associated with Reliability in Reporting of Contraceptive Use: Assessing the Reliability of the Contraceptive Calendar in Seven Countries

Abstract

Although the reproductive calendar is the primary tool for measuring contraceptive dynamics in low‐income settings, the reliability of calendar data has seldom been evaluated, primarily due to the lack of longitudinal panel data. In this research, we evaluated the reproductive calendar using data from the Performance Monitoring for Action Project. We used population‐based longitudinal data from nine settings in seven countries: Burkina Faso, Nigeria (Kano and Lagos States), Democratic Republic of Congo (Kinshasa and Kongo Central Provinces), Kenya, Uganda, Cote d'Ivoire, and India. To evaluate reliability, we compared the baseline cross‐sectional report of contraceptive use (overall and by contraceptive method), nonuse, or pregnancy with the retrospective reproductive calendar entry for the corresponding month, measured at follow‐up. We use multivariable regressions to identify characteristics associated with reliability or reporting. Overall, we find that the reliability of the calendar is in the “moderate/substantial” range for nearly all geographies and tests (Kappa statistics between 0.58 and 0.81). Measures of the complexity of the calendar (number of contraceptive use episodes, using the long‐acting method at baseline) are associated with reliability. We also find that women who were using contraception without their partners/husband's knowledge (i.e., covertly) were less likely to report reliably in several countries.

Differential discontinuation by covert use status in Kenya

“…Fourth, there is a growing body of work on the overall limitations of the contraceptive calendar due to recall bias [32] , [33] , [34] , [35] . Recent evidence has shed light on inconsistencies in calendar reporting among covert users specifically [36] . We acknowledge that this is an unavoidable limitation of the data.…”

Contraceptive use and discontinuation among women aged 15–24 years in Kenya

“…Also, Demographic and Health Survey (DHS) contraceptive calendar data is retrospective (involves a woman's recollection of past contraceptive use), but with recent data, recall bias is reduced and quality is enhanced. The reliability and quality of calendar data have been recently evaluated using longitudinal panel data from the Performance Monitoring for Action Project and found satisfactory ( 26 ).…”

Fertility Responses to the COVID‐19 Pandemic: A Perspective of Reproductive Process

“…The reliability of contraceptive calendar data can decrease when faced with larger recall periods or increasing complexity (Anglewicz et al 2023;Bradley et al 2019;Callahan and Becker 2012;Strickler et al 1997;Tumlinson and Curtis 2021). To increase the data reliability and accuracy, I employed the following steps.…”