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Appropriate methods for analyzing the effect of method choice on contraceptive discontinuation
1Institute of Education, University of London, 20 Bedford Way, London WC1H 0AL, United Kingdom. F.Steele@ioe.ac.uk
Demography
|March 22, 2003
Summary
Contraceptive method choice significantly impacts discontinuation, but choice is also influenced by discontinuation. This study confirms this endogeneity for abandonment and switching, not failure.
Area of Science:
- Reproductive Health
- Demography
- Sociology
Background:
- Contraceptive discontinuation is a major challenge in family planning programs.
- Understanding the factors influencing discontinuation is crucial for improving contraceptive use and outcomes.
Purpose of the Study:
- To examine the impact of contraceptive method choice on three types of discontinuation: abandonment, switching, and failure.
- To investigate the endogeneity of contraceptive method choice in relation to these discontinuation processes.
Main Methods:
- Utilized data from the 1997 Indonesia Demographic and Health Survey.
- Applied a multilevel multi-process model to analyze the relationships between method choice and discontinuation.
- Assessed the endogeneity of method choice using statistical modeling.
Main Results:
- Contraceptive method choice was found to be endogenous to contraceptive abandonment and method switching.
- Method choice was not endogenous to contraceptive failure.
- Ignoring the endogeneity of method choice introduced biases in estimating its effects on abandonment and switching.
Conclusions:
- Contraceptive method choice is intrinsically linked to discontinuation, particularly abandonment and switching.
- Accurate analysis of contraceptive discontinuation requires accounting for the endogeneity of method choice.
- While biases exist when endogeneity is ignored, the overall conclusions regarding method choice and discontinuation remain robust.