Evaluating contraceptive choice through the method-mix approach - An Indian Council of Medical Research (ICMR) Task Force Study

The method-mix approach was used to evaluate informed contraceptive choices in the present study. A total of 8,077 potential clients were given a bala nced presentation of all available contraceptive methods in the national pr ogram, ie, the CuT 200 intrauterine device (IUD), low-dose combined oral pi lls (OC), condom, and sterilization (female/male) along with a new method, Norplant(R). The majority of women opted for spacing methods; among them, t he IUD was preferred by about 60% of clients, followed by condoms (9%), OC (6%), and Norplant (5%). Sterilization, mainly female, was accepted by abou t 17% of the women making an informed choice. The economic status of couples did nor influence the contraceptive choices, as all the methods were offered free of cost in the present study, which i s the current practice in the national program. Illiterate women more often accepted sterilization (abour 25%) than did Literate women (15%). This is because illiterate women had more children; about 30% of illiterate women h ad three or more children, as opposed to 16.2% of literate women. However, literacy status did not influence the choice of any specific spacing method . The study also revealed that, by encouraging potential clients to make an informed choice, they could override the provider's bias while accepting a particular type of spacing method. This is evident from the observation th at Norplant was the first choice of the provider for 35% of the women, wher eas only 5% of women preferred and accepted Norplant. The present study str esses an urgent need to promote the practice of informed choices in the nat ional program with a variety of contraceptive options-especially, spacing m ethods for improving contraceptive prevalence and reproductive health in th e country. (C) 2000 Elsevier Science Inc. All rights reserved.