Inequities in effective coverage of family planning services in low- and middle-income countries: linking household and facility surveys

Background: Despite decades of family planning (FP) programme successes in low- and middle-income countries (LMICs), women still face an unmet need for contraceptives, as well as inequalities in coverage. Including elements of service readiness in FP intervention coverage measures will better inform population-level programme performance. Methods: We identified five LMICs that had health facility and household surveys conducted <5 years apart within the past ten years: Bangladesh, Haiti, Malawi, Nepal, and Tanzania; only Nepal had time-trend data available. We developed quality readiness-adjusted FP coverage measures by linking health facility assessments (i.e. readiness) and household surveys (i.e. intervention coverage) according to ecological linking methods. We defined linking units by facility type, managing authority, and geographic location using women's reported source of…