Although client and method-related biases can be defined as discrete experiences on paper, in reality they are inherently interconnected. For example, biases against providing a certain type of method, such as the IUD or implants, are typically directed toward certain types of clients, such as young, unmarried women who have not yet had children. These biases are often due to cultural beliefs about the appropriate age to begin sexual relations or about the need to prove fertility before starting contraception.
How is provider bias related to method choice?
Many providers restrict access based on reasons beyond those outlined in guidelines or deemed medically necessary. This can negatively affect a client’s ability to make an informed choice and can lead to the use of less effective methods and higher risk of pregnancy. While it’s difficult to measure informed choice, there are proxies, such as the Method Information Index, to assess whether clients received complete information about their options when they selected a contraceptive method.
How can you identify provider bias?
Provider bias has mainly been identified and measured through either in-depth interviews with providers who self-report on their behaviors or through mystery clients seeking services. However, in some instances, method mix may be able to help identify potential provider bias issues that warrant further investigation. For example, provider bias may be playing a role if over 50% of contraceptive users in a country are all using the same method. However, method skew may also be the cause of other issues such as deeply rooted cultural preferences or supply chain issues.