Estimated use of emergency contraception (EC) remains low, and one reason is measurement challenges. The study aims to compare EC use estimates using five approaches. Data come from Performance Monitoring and Accountability 2020 surveys from ten countries, representative sample surveys of women ages 15-49 years. We explore EC use employing the five definitions and calculate absolute differences between a reference definition (percent of women currently using EC as the most effective method) and each of the subsequent four, including the most inclusive (percent of women having used EC in the past year). Across the 17 geographies, estimated use varies greatly by definition and EC use employing the most inclusive definition is statistically significantly higher than the reference estimate. Impact of using various definitions is most pronounced among unmarried sexually active women. The conventional definition of EC use likely underestimates the magnitude of EC use, which has unique programmatic implications.
Published in a peer-reviewed journal of the Population Council.