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  • Title: Continuation rate surveys in Thailand: results and policy implications 1971-1981.
    Journal: J Thai Assoc Volunt Steriliz; 1982 Dec; ():37-58. PubMed ID: 12265676.
    Abstract:
    Continuation rate (CR) surveys have been an integral part of the Thai National Family Planning Program (NFFP) since its beginning in 1970. CR data for Thailand have 4 special features: in most cases, they are derived from nationally representative samples; because of the popularity of family planning, there is a large sample universe for CR studies which currently increases by 1 million new acceptors/year; there are CR data for IUD, pills, injectables, and now subdermal implants; and the frequency of CR studies provides an excellent time series of trends. CR surveys provide information on continuing use, demographic targets, commodity requirements and logistics, the trends in use patterns, comparative length of protection between methods, areal comparisons, and effects of policy changes. Since 1977 the package computer program LIFETAB has been used in CR studies, and since 1981, multiple classification analysis has been the major means of secondary analysis of results. The rates of greatest significance to NFFP program managers are the net cumulative 1st segment continuation and termination rates, avoidance of pregnancy rates, method failure rates, and gross termination rates. The procedure for data collection has almost always been personal interview of a random sample of method acceptors. The average 1-year pill continuation rates are approximately 68%, ranging from 64-72%. The 12-month rate for the Lippes loop was 75% in both 1971 and 1977. Much greater diversity was found in CRs for the injectable contraceptives. In a pilot trial, Norplant had a 1-year CR of 79%, but acceptors were screened for motivation, possibly biasing the CR upward. Reasons for termination differed by method. 1/2 of terminations of injectables were due to side effects, compared to about 1/3 for the other 3 methods. 45% of pill terminations in the 1st year were for desire for pregnancy and no need, including marital dissolution. 44% of IUD terminations were due to expulsion. Service problems caused more terminations for the injectables than for other methods. Although injectables had the lowest continuation rate, they had the highest avoidance of pregnancy rate. The IUD had the highest 1 year accidental pregnancy rate, 1.2%, compared to .9% for Norplant, .6% for the pill, and .3% for injectables. Gross cumulative termination rates allow program managers to determine method acceptability for various target subgroups. Examples of experiences with pills, injectables, and pill pricing demonstrate the influence of policy decisions on CRs and termination rates.
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