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  • Title: Continuation and effectiveness of contraceptive practice: a cross-sectional approach.
    Author: Laing JE.
    Journal: Stud Fam Plann; 1985; 16(3):138-53. PubMed ID: 3874451.
    Abstract:
    This paper proposes a cross-sectional approach to the study of contraceptive continuation and use-effectiveness, based on data from surveys of married women of reproductive age rather than the more conventional follow-up surveys of family planning acceptors. Such an approach has the advantages of indicating the fertility effects of contraceptive practice during a particular period of time and providing information on the experience of users who obtain contraceptive information or supplies from nonprogram sources. An application of the approach in the context of a nationwide survey of wives living in areas covered by the Outreach Project of the Philippine Commission on Population is presented and the findings are discussed in relation both to program management and to the validity of the methodology. Conventional methods for the study of fertility effects of contraceptive practice include direct or retrospective analyses of records from family planning centers. The authors suggest an alternative method, a cross-sectional approach based on data from surveys of married reproductive age women. The advantage is the ability to follow methods and efficacy of fertility regulation control for those contraceptive users not affiliated with a family planning program. In short, this offers an approach to study contraceptive continuation and effectiveness. The result is information on average continuation rates and effectiveness levels which can be more helpful in planning future programs. Data was collected from 1320 interviews conducted during the 1980 Community Outreach Survey. Those interviewed were married and lived in areas serviced by volunteer workers of the National Family Planning Outreach Project of the Philippine Commission on Population (POPCOM), thus presenting a rural representation of the Philippines. Analyzing reversible contraceptive methods showed the IUD in 1st place for continuation rates and effectiveness while the condom was in last place. Failure rates were unusually high for pills and condoms, suggesting a decline in effectiveness for nonprogram users. Nonprogram users preferred the natural methods of abstinence, withdrawal, and the rhythym method. All of these were used more extensively and successfully than were condoms, suggesting a benefit in promoting these methods for women resistant to contraception. Further analysis revealed positive correlations between continuation and desire to avoid childbearing, socioeconomic status, urbanization of place of residence, exposure to clinics and contraceptive information, family planning knowledge and experience, and spousal support. Contraceptive effectiveness was most strongly linked to exposure to family planning information. The authors conclude that contraceptive effectiveness is more reliable as an indicator of relative effectiveness than the conventional Pearl Pregnancy rates.
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