Measuring Use of the Lactational Amenorrhea Method through the Demographic and Health Surveys: Data Quality and Implications

Madeleine Short Fabic, U.S. Agency for International Development (USAID)
Yoonjoung Choi, U.S. Agency for International Development (USAID)

Our study purpose is to assess data quality of self-reported current use of the Lactational Amenorrhea Method (LAM) in the Demographic and Health Surveys (DHS). LAM, an important contraceptive method during the postpartum period, is a modern contraceptive with an effectiveness rate of 98% when used correctly. Specific objectives are: 1) to examine accuracy of self-reported LAM use compared to the constructed gold standard variable, and 2) to explore differentials in accuracy measures by characteristics at the individual-level and survey-level by analyzing data from 73 DHS conducted in 45 countries since 1998. Findings reveal that accuracy of self-reported LAM use is low, with average sensitivity of 6.8% and average positive predictive value of 25.5% across the surveys, indicating potentially unacceptably low user effectiveness at the population level. We discuss implications for future DHS data collection efforts, and implications for family planning and maternal and child health programming.