The use of Method Information Index (MII) to monitor the amount of information given to women users of modern contraceptives in Indonesia: results from an analysis of the 2007, 2012 and 2017 demographic and health surveys.

BACKGROUND: The use of Method Information Index (MII) indicates whether women contraceptive users receive adequate information about all available contraceptive methods, side effects of the methods, and how to deal with the side effects if experienced-at method initiation. OBJECTIVE: This study aims to investigate the level of MII scores or the amount of information received by married women users of five modern contraceptives at the time of initiation and changes of its determinants based on the Indonesian Demographic and Health data between 2007 and 2017. METHODS: Data of married women who used most common five modern contraceptive methods (the pill, injectables, implants, IUD, and female sterilization), comprised of a total unweighted sample of 35,412 users out of the 32,895; 45,607 and 49,627 women aged 15-49 in the 2007, 2012, and 2017 Indonesian Demographic and Health Survey (IDHS), respectively. The Method Information Index (MII) scores were calculated based on responses to three questions (whether women were told about method-specific side effects, advised what to do if they experienced them, and informed about other available methods). Multivariable logistic regressions with 'time' as an interaction variable were used to assess the influence of time upon the MII scores and its determinants. RESULTS: The MII scores were 23.84% in 2007, 24.60% in 2012 and 28.65% in 2017. Obviously, over 70% of reproductive-age women contraceptive users were not receiving complete information about modern contraceptives at the time of initiation. After 5 years (2012), only living in the Java Bali region (AOR = 1.34, 95% CI 1.09-1.66) compared to living in other islands, and currently using injectables (AOR = 1.43, 95% CI 1.10-1.87) and currently using implants (AOR = 1.68, 95% CI 1.07-2.63) compared to currently using pills had significantly higher odds of receiving MII information. After 10 years (2017), only one variable (the 'richest' in the wealth quintile category (AOR = 0.70, 95% CI 0.50-0.99) compared to the 'poorest') still showed a significant association with receipt of complete MII information. CONCLUSIONS: Despite the fact that the MII scores increased gradually across the years, interaction with 'survey time' showed that the likelihood of receiving complete MII information was not statistically different in the 5 years (2007-2012) and in the 10 years (2007-2017) period from the reference category in 2007. The authors recommend use of the MII score as an objective measure to evaluate access to MII essential information and to monitor an increase in the informed population in Indonesia.

Receiving voluntary family planning services has no relationship with the paradoxical situation of high use of contraceptives and abortion in Vietnam: a cross-sectional study.

BACKGROUND: Vietnam shows a paradoxical situation where high contraceptive prevalence goes together with high abortion rates. This study examined the associations between self-reports of having received voluntary family planning (VFP) services and induced abortions. METHODS: A cross sectional survey was conducted in Thai Nguyen province, covering a total of 1281 women. Data were derived from a sample of 935 married women aged 18-49 years who were ever-users (93.5%) and current users of contraceptives (84%), and had completed birth histories. The dependent variables were the likelihood of having an induced abortion and repeated (two or more) induced abortions. The main independent variable was having received the three VFP dimensions (counselling, broader information, and access to availability). The association was examined using multivariate logistic regressions, taking into account women's socio-demographic characteristics. RESULTS: The overall induced abortion percentage was 19.4 per 100 pregnancies. None of the three VFP dimensions was significantly associated with the odds of having an induced abortion or having repeated induced abortions. Mother's age of 35 or older, having more than three living children, and ever used female contraception methods significantly doubled or more the odds of having an induced abortion and significantly tripled the odds of having repeated abortions. CONCLUSIONS: Results indicate that women receiving VFP services were not less likely to have induced abortions. The provision of family planning counselling, information on contraceptive method mix, and management skills to ensure availability, are in need of reinforcement in a new set of policy and program strategies in the future.