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Measuring Informed Choice for Contraception in Burkina Faso: Comparing Self-Rated and Researcher-Ascribed Measures

Author

Listed:
  • Brooke W. Bullington

    (University of North Carolina Gillings School of Global Public Health
    University of North Carolina at Chapel Hill
    University of Utah)

  • Katherine Tumlinson

    (University of North Carolina at Chapel Hill
    University of North Carolina Gillings School of Global Public Health)

  • Nathalie Sawadogo

    (Université Joseph Ki-ZERBO)

  • Claire W. Rothschild

    (Population Services International)

  • Leigh Senderowicz

    (Harvard T.H. Chan School of Public Health
    University of Wisconsin-Madison
    University of Wisconsin-Madison)

Abstract

While self-rated measures that rely on participant’s perceptions of themselves are common in public health, they remain underused in contraceptive research. Family planning scholars often rely on researcher-ascribed measures of success that capture whether people have the criteria researchers deem necessary for a given outcome. As family planning researchers shift toward rights-based outcomes, understanding women’s perceptions of their contraceptive knowledge is imperative. We sought to determine whether researcher-ascribed measures of contraceptive knowledge or information provided during contraceptive counseling and self-rated measures of informed choice for contraception align. Informed choice captures whether people have sufficient, unbiased information about their contraceptive options. Using data from a population-based sample of 3,929 reproductive-aged women in Burkina Faso, we compared researcher-ascribed measures, including the informed choice subdomain of the contraceptive autonomy indicator (CAIC) and the Method Information Index (MII), with novel self-rated measures of informed choice developed based on formative research, including in-depth interviews and focus group discussions, that capture people’s perceptions of their contraceptive knowledge (self-rated overall informed choice and self-rated method-specific informed choice) using Cohen’s Kappa Statistic. We find that researcher-ascribed measures of contraceptive knowledge and counseling content diverge substantially from self-rated measures of informed choice. CAIC and self-rated overall informed choice had no agreement (Kappa: -0.03); the MII and self-rated method-specific informed choice had no to slight agreement (Kappa = 0.05). These findings reveal that the information researchers consider important for informed choice may not align with women’s perceptions of their informed choice. Both researcher-ascribed and self-rated measures provide uniquely important information needed to inform family planning programs and should be measured on population-based surveys. This study demonstrates the differences between researcher-ascribed and self-rated measures in family planning research, highlighting the importance of both types of measures.

Suggested Citation

  • Brooke W. Bullington & Katherine Tumlinson & Nathalie Sawadogo & Claire W. Rothschild & Leigh Senderowicz, 2025. "Measuring Informed Choice for Contraception in Burkina Faso: Comparing Self-Rated and Researcher-Ascribed Measures," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 179(2), pages 1119-1141, September.
    • Handle: RePEc:spr:soinre:v:179:y:2025:i:2:d:10.1007_s11205-025-03650-6
    DOI: 10.1007/s11205-025-03650-6
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    References listed on IDEAS

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    1. Senderowicz, Leigh, 2019. "“I was obligated to accept”: A qualitative exploration of contraceptive coercion," Social Science & Medicine, Elsevier, vol. 239(C).
    2. Pritchett, Lant H. & DEC, 1994. "Desired fertility and the impact of population policies," Policy Research Working Paper Series 1273, The World Bank.
    3. Manzer, Jamie L. & Bell, Ann V., 2022. "The limitations of patient-centered care: The case of early long-acting reversible contraception (LARC) removal," Social Science & Medicine, Elsevier, vol. 292(C).
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