Measuring Women's Covert Use of Modern Contraception in Cross-Sectional Surveys

Studies in Family Planning
Ifta Choiriyyah, S Becker

Abstract

A proportion of women in couples use contraception without their partners' knowledge. There are two principal ways to measure this covert use in cross-sectional surveys like the Demographic and Health Surveys (DHS). First is a direct question, "Does your husband/partner know that you are using a method of family planning?" Second is an indirect method: the reports of both partners to the question on contraceptive use are matched, and if the woman reports a modern contraceptive method and the male partner reports nonuse, her use is considered covert. For 21 DHS surveys for which both estimates could be made, there are large discrepancies between the two. We found that a proxy variable-responses to the question, "Would you say that using contraception is mainly your decision, mainly your husband's/partner's decision, or did you both decide together?"-has high sensitivity and specificity for classifying those in the open category for both methods and those in the covert category for both methods. Recommendations are that the direct question be reinstated in the DHS and that the indirect method not be used by itself but in conjunction with the decision-making variable.

References

Nov 5, 1999·Studies in Family Planning·S CastleS Martin
Jul 14, 2001·Studies in Family Planning·S Becker, E Costenbader
Jul 14, 2001·Studies in Family Planning·J B CasterlineM ul Haque
Sep 20, 2008·Violence Against Women·Lyndsey Wilson-WilliamsKaren Andes
Oct 16, 2008·Studies in Family Planning·Rob StephensonTarun K Roy
Sep 22, 2009·Social Science & Medicine·Nuriye Nalan Sahin-HodoglugilUNKNOWN MIRA Team
Mar 17, 2010·Contraception·Elizabeth MillerJay G Silverman
Jan 27, 2016·Journal of Biosocial Science·Jessica D Gipson, Andrew L Hicks
Jul 2, 2017·Contraception·Madeleine Short Fabic, Stan Becker

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