Communicating contraceptive effectiveness: A randomized controlled trial to inform a World Health Organization family planning handbook

Am J Obstet Gynecol. 2006 Jul;195(1):85-91. doi: 10.1016/j.ajog.2005.12.053. Epub 2006 Apr 19.


Objective: The objective of the study was to compare 3 different approaches for increasing clients' understanding of contraceptive effectiveness.

Study design: We randomized 900 reproductive-age women in India and Jamaica to 1 of 3 charts presenting pregnancy risk.

Results: The most important reason for choosing a contraceptive was how well it prevents pregnancy (54%) followed by few side effects (17%). At baseline, knowledge about contraceptive effectiveness was poor. About half knew oral contraceptive pills are more effective than condoms (46%) and intrauterine devices are more effective than injectables (50%). All 3 charts improved knowledge significantly (P < .01) for these 2 questions. No chart improved knowledge better than any other (P > .05). The chart ranking contraceptive methods on a continuum was judged slightly easier to understand than the other 2 charts.

Conclusion: Only with accurate understanding of pregnancy risk can clients make informed choices. Our results have already informed a global handbook for family planning providers to use the chart ranking contraceptive methods on a continuum.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Choice Behavior*
  • Communication
  • Contraception Behavior*
  • Counseling
  • Family Planning Services
  • Female
  • Health Education*
  • Humans
  • India
  • Jamaica
  • Risk Assessment
  • Risk Reduction Behavior
  • Teaching Materials*
  • World Health Organization