Quality of Care Matters in Contraceptive Continuation: Results From a Longitudinal Study of Reversible Contraceptive Users in India

Aparna Jain , Population Council
Kumudha Aruldas, Population Council
Arupendra Mozumdar, Population Council
Elizabeth Tobey, Population Council
Rajib Acharya, Population Council

Bruce’s quality of care (QoC) framework brought international attention quality contraceptive services. While methodologies exist to measure quality services, there are no validated QoC measures. We validated the QoC structure, constructed composite measures based on this structure, and tested their predictive validity related to contraceptive continuation among 2,700 married Indian women beginning a reversible contraceptive method. Four QoC framework domains were assessed by 22-questions. A 10-question index was formed using exploratory factor analysis. Quality scores were calculated for 22- and 10-question measures. Adjusted odds of continuing a modern contraceptive at 3-month follow-up was nearly three times greater (AOR:2.98; 95%CI:2.01-4.42) for women who received high quality at method enrollment compared to low quality with the 22-item measure and 2.5 times greater (95%CI:1.66-3.69) with the 10-item measure. Both indices can assess QoC and predict contraceptive continuation. The 22-item index is better suited for special studies while the 10-item index for routine monitoring.

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 Presented in Session 129. Fertility, Family Planning, and Reproductive Health: Programs and Quality of Care