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| (22) Percent of clients who believe family and community approve of contraceptive use |
- Definition: This indicator measures the extent to which the family planning user's family and social network have positive attitudes toward contraceptive use (1).
- Relevance to a continuing-client strategy: Contraceptive users who are supported by their family and community are more likely to adopt and continue contraceptive use because they do not have to go against other people's opinions or use contraception clandestinely.
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| (23) All-method continuation rate |
- Definition: The all-method continuation rate is defined as the cumulative probability that acceptors of a contraceptive method will still be using any contraceptive method offered by the program after a specified period of time. An all-method continuation rate measures the change from using any method of contraception (including those who have switched contraceptive methods) to using no contraceptive method (1). (To calculate all-method continuation rates, see "Compendium of Indicators for Evaluating Reproductive Health Programs," http://pdf.usaid.gov/pdf_docs/PNACR080.pdf)
- Relevance to a continuing-client strategy: All-method continuation rates provide a summary of the extent to which the service environment enables clients to maintain contraceptive use, including switching from one contraceptive method to another. Calculation of continuation rates is typically made using population-based data, such as Demographic and Health Surveys. Using these data, researchers can determine reasons for discontinuation. These reasons can be related to reduced need (for example, a woman's desire to become pregnant) or to other reasons such as dissatisfaction with service quality (2). Obtaining accurate continuation rates at the programmatic level can be a challenge because programs typically collect this type of information only on clients who return for follow-up. Consequently, if contraceptive continuation rates dip, managers will not know why—whether clients are seeking services elsewhere, no longer need services, or are discouraged from contraceptive use because of poor quality of care or other reasons that could put them at risk of unintended pregnancy (5). More accurate measurement of all-method continuation rates requires programs to follow-up with new contraceptive users after a specified time period once they have adopted a method. Such follow-up is often expensive and logistically difficult, however (1). Nonetheless, programs should measure contraceptive continuation to the extent possible, and complement their findings with data from population-based surveys or follow-up studies with new acceptors (5).
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| (24) Percent of clients who have an unintended pregnancy |
- Definition: A woman has an unintended pregnancy if it is mistimed (she wanted to be pregnant later) or unwanted (she did not want to become pregnant at any time).
- Relevance to a continuing-client strategy: Focusing on the needs of continuing clients has been proven to reduce unintended pregnancy. Ensuring good-quality care for contraceptive users can reduce their exposure to unintended pregnancy by helping them sustain contraceptive use as long as they do not want to become pregnant.
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