The Evidence Project, USAID’s flagship FP implementation science project led by the Population Council, validated two measures of QoC using data from a longitudinal study of reversible contraceptive users in Odisha and Haryana, India. Clients were interviewed about the QoC they received and we assessed the QoC measures’ ability to predict contraceptive continuation three months later. The QoC was measured using 22 items, which was reduced to a 10-item proxy measure through exploratory factor analysis. While the full 22-item measure more comprehensively captures clients’ experiences, a 10-item version adequately measures QoC and also predicts contraceptive continuation, making it ideal for routine data collection and monitoring of programs. We are currently working to confirm the same measures in an additional study in Burkina Faso, in order to routinely monitor QoC for FP services in the public sector and through performance-based financing programs.
We also validated a second way to measure QoC from clients’ perspectives, the MIIplus. The Method Information Index (MII), a three-item measure, has been used to assess QoC based on the information a client receives about a selected contraceptive method. As part of the above-mentioned study in India, we explored the value of adding a fourth, which asks whether the client was told about the possibility of switching to another method if the one she selected was not suitable. The addition of the fourth item, forming the MIIplus, was found to be a better predictor of contraceptive continuation than the MII alone. This short measure can be used to track progress in QoC at national and subnational levels.