Association Between the Method Information Index Metric and Choice of Contraceptive Method: Secondary Analysis of Data from the Women’s Integrated Sexual Health (WISH) Programme

Introduction: The quality and comprehensiveness of family planning (FP) counseling has largely remained unaddressed, leaving potential FP users with limited information to make informed contraceptive choice. The method information index (MII) is a metric consisting of a set of questions asked of FP service clients prior to method initiation that serves as a proxy to the quality of FP counseling in determining informed choice. The current study assessed the association between MII scores and choice of a long-acting contraception using data from client exit interview (CEI) surveys conducted during the Women’s Integrated Sexual Health (WISH) programme. Methods Between 2019–2022, 16,525 individuals contributed data across three CEI rounds conducted in 11 countries as part of the WISH programme. Multivariate logistic regression was used to determine the association between MII scores and choice of long-acting contraception. Results Individuals with high MII (aOR = 1.74, 95% CI: 1.46–2.08) and MIIplus (aOR = 1.67, 95% CI: 1.41–1.97) scores were nearly twice as likely to choose long-acting contraceptive method especially if they were single and/or multiparous. Conclusion Under the WISH programme, the MII metric as a proxy for quality of FP counselling, is an important predictor of choice of long-acting contraception. FP programmes should invest in building the capacity of their service providers to offer individuals with quality, comprehensive counselling to increase chances of clients voluntarily selecting a long-acting FP method.