Guttmacher Institute, New York, NY, 10038, USA.
Stud Fam Plann. 2021 Dec;52(4):513-538. doi: 10.1111/sifp.12180. Epub 2021 Nov 11.
Indirect estimation techniques are important tools for measuring sensitive and stigmatized behaviors. This includes third-party reporting methods, which have become increasingly common in the field of abortion measurement, where direct survey approaches notoriously lead to underreporting. This paper provides the first in-depth assessment of one of the most widely used of these techniques in the field of abortion measurement: the confidante method. We outline six key assumptions behind the confidante method and describe how violations of these assumptions can bias resulting estimates. Using data from modules added to the performance monitoring for action surveys in Uganda and Ethiopia in 2018, we compute one-year abortion incidence estimates using the confidante method. We also perform a validation check, using the method to estimate intrauterine device /implant use. Our results revealed implementation problems in both settings. Several of the method's foundational assumptions were violated, and efforts to adjust for these violations either failed or only partially addressed the resulting bias. Our validation check also failed, resulting in a gross overestimate of intrauterine device/implant use. These results have implications more broadly for the potential biases that can be introduced in using third-party reporting of close ties to measure other sensitive or stigmatized behaviors.
间接估计技术是测量敏感和污名化行为的重要工具。这包括第三方报告方法,在堕胎测量领域,这些方法越来越常见,因为直接调查方法往往导致报告不足。本文对堕胎测量领域中使用最广泛的技术之一——知己法进行了首次深入评估。我们概述了知己法背后的六个关键假设,并描述了违反这些假设如何导致估计结果产生偏差。我们使用 2018 年在乌干达和埃塞俄比亚进行的行动监测绩效调查中添加的模块的数据,使用知己法计算了一年的堕胎发生率估计。我们还进行了验证检查,使用该方法估计宫内节育器/植入物的使用情况。我们的结果显示在这两个环境中都存在实施问题。该方法的几个基本假设都被违反了,而试图调整这些违规行为的努力要么失败,要么只是部分解决了由此产生的偏差。我们的验证检查也失败了,导致宫内节育器/植入物使用的严重高估。这些结果更广泛地表明,在使用亲密关系的第三方报告来衡量其他敏感或污名化行为时,可能会引入潜在的偏差。
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