Avenir Health, Glastonbury, CN, USA.
Independent consultant, New Paltz, NY, USA.
Glob Health Sci Pract. 2018 Mar 30;6(1):93-102. doi: 10.9745/GHSP-D-17-00341. Print 2018 Mar 21.
The need for annual family planning program tracking data under the Family Planning 2020 (FP2020) initiative has contributed to renewed interest in family planning service statistics as a potential data source for annual estimates of the modern contraceptive prevalence rate (mCPR). We sought to assess (1) how well a set of commonly recorded data elements in routine service statistics systems could, with some fairly simple adjustments, track key population-level outcome indicators, and (2) whether some data elements performed better than others. We used data from 22 countries in Africa and Asia to analyze 3 data elements collected from service statistics: (1) number of contraceptive commodities distributed to clients, (2) number of family planning service visits, and (3) number of current contraceptive users. Data quality was assessed via analysis of mean square errors, using the United Nations Population Division World Contraceptive Use annual mCPR estimates as the "gold standard." We also examined the magnitude of several components of measurement error: (1) variance, (2) level bias, and (3) slope (or trend) bias. Our results indicate modest levels of tracking error for data on commodities to clients (7%) and service visits (10%), and somewhat higher error rates for data on current users (19%). Variance and slope bias were relatively small for all data elements. Level bias was by far the largest contributor to tracking error. Paired comparisons of data elements in countries that collected at least 2 of the 3 data elements indicated a modest advantage of data on commodities to clients. None of the data elements considered was sufficiently accurate to be used to produce reliable stand-alone annual estimates of mCPR. However, the relatively low levels of variance and slope bias indicate that trends calculated from these 3 data elements can be productively used in conjunction with the Family Planning Estimation Tool (FPET) currently used to produce annual mCPR tracking estimates for FP2020.
计划生育 2020 倡议（FP2020）需要年度计划生育方案跟踪数据，这促使人们重新关注计划生育服务统计数据，将其作为年度现代避孕普及率（mCPR）估算的潜在数据来源。我们试图评估：（1）常规服务统计系统中一组常用数据元素经过一些相当简单的调整，是否能很好地跟踪关键人群水平的结果指标；（2）是否某些数据元素比其他数据元素表现更好。我们使用来自非洲和亚洲 22 个国家的数据，分析了从服务统计中收集的 3 个数据元素：（1）向客户分发的避孕药具数量；（2）计划生育服务访问次数；（3）当前使用避孕方法的人数。我们使用联合国人口司的世界避孕使用年度 mCPR 估算值作为“黄金标准”，通过分析均方误差评估数据质量。我们还检查了几种测量误差的大小：（1）方差；（2）水平偏差；（3）斜率（或趋势）偏差。我们的结果表明，向客户分发避孕药具和服务访问次数的数据跟踪误差适中（分别为 7%和 10%），而当前用户数据的误差率略高（19%）。所有数据元素的方差和斜率偏差都相对较小。水平偏差是跟踪误差的最大因素。对至少收集了 3 个数据元素中的 2 个国家的数据元素进行的配对比较表明，向客户分发避孕药具的数据具有适度优势。考虑到的所有数据元素都不够准确，无法单独用来生成可靠的 mCPR 年度估算值。但是，方差和斜率偏差水平较低，这表明可以有效地将从这 3 个数据元素计算得出的趋势与计划生育估计工具（FPET）结合使用，FPET 目前用于生成 FP2020 的年度 mCPR 跟踪估算值。
