Inequities in Effective Coverage of Family Planning Services in Low-and Middle-Income Countries: Linking Households and Facility Surveys

Abstract Background Despite decades of family planning (FP) program successes in low-and middle-income countries (LIMCs), unmet need for contraceptives persists with inequalities in coverage. Including elements of service readiness in family planning intervention coverage measures will better inform population-level program performance. Methods Five LMICs countries were identified with a health facility and household survey conducted within five years of one another within the last 10 years: Bangladesh, Haiti, Malawi, Nepal and Tanzania, with time trend data available for Nepal. We used ecological linking methods to develop quality readiness adjusted FP coverage measures by linking health facility assessments (readiness) and household surveys (intervention coverage). Linking units were defined by facility type, managing authority and geographic location using women’s reported source of…