Interviewer effects on abortion reporting: a multilevel analysis of household survey responses in Côte d’Ivoire, Nigeria and Rajasthan, India

Katy Footman, LSE

Abortion is often excluded from household surveys because the presence of an interviewer can exacerbate under-reporting. This analysis is the first to assess interviewer effects on abortion survey responses in the 2018 Performance Monitoring for Action (PMA) nationally-representative household surveys. Responses to three questions about abortion were compared with each other, and with less sensitive topics, using survey data from Côte d’Ivoire, Nigeria and Rajasthan, India. Data were analysed using multi-level logistic regression models with an interviewer random intercept. Substantial interviewer effects were observed, ranging from 7% in Côte d’Ivoire to 24% in Nigeria for pregnancy removal. Interviewer effects for survey questions that were designed to ask about abortion in a less stigmatising way were either similar to (9-26% for confidante-reporting) or higher than (17-32% for a question about period regulation) the pregnancy removal question. Factors associated with abortion reporting included respondent-interviewer familiarity, the language of interview, and the interviewer’s comfort asking questions about abortion. This study highlights that questions designed to be less stigmatising may increase interviewer effects due to lower comprehension among respondents. The findings raise challenges for surveys using ‘insider’ interviewers and indicate the importance of selecting and training interviewers to ensure comfort asking questions about abortion.

Keywords: Demographic and social surveys, Sexual and Reproductive Health and Rights, Methodology

See extended abstract.

  Presented in Session 147. Measurement Issues in Sexual and Reproductive Health Research