Measuring dynamic contraceptive use: The quality and consistency of DHS calendar data

Sarah E. K. Bradley, Abt Associates
Dana Sarnak, Johns Hopkins Bloomberg School of Public Health
Eve Brecker, Population Reference Bureau (PRB)
Kaitlyn Patierno, Population Reference Bureau

Contraceptive use dynamics—including method switching and discontinuation—are important determinants of contraceptive prevalence rates (CPR) and demographic outcomes like unintended pregnancy. Yet data on contraceptive use dynamics can be challenging to analyze and interpret. The primary source of these data in low- and middle-income countries are retrospective surveys, most notably through the Demographic and Health Survey (DHS) Program which collects month-by-month calendar histories of reproductive events dating back seven years. Studies of the quality and consistency of such retrospective calendar data are limited. Early studies found the DHS calendar produced consistent estimates of CPR, reduced heaping, and demonstrated moderate to high reliability of calendar data. More recent studies suggest moderate to substantial underreporting of contraceptive use and other quality issues, both in the DHS and other retrospective calendars. To enhance understanding and use of DHS calendar data to analyze contraceptive use dynamics, we undertook a comprehensive review of DHS calendar data quality. Our assessment explored but was not limited to measuring overlap of CPR estimates, heaping, and displacement of births or women out of the calendar or interview, respectively. Preliminary findings suggest potential biases exist in data quality the further back in time women are asked to recall.

Keywords: Family planning and contraception, Life event calendar analysis, Demographic and social surveys, Sexual and Reproductive Health and Rights

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  Presented in Session 131. Fertility, Fertility Preferences and Contraception: Data and Methods