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Developing and testing novel measures of misoprostol use for induced abortion using the list experiment in Pakistan

Erin Pearson, Harvard T.H. Chan School of Public Health

Project abstract

Misoprostol-alone is an increasingly common method of induced abortion in countries such as Pakistan where abortion is legally restricted. The expected failure rate of misoprostol is 10-25% when used correctly, but failure rates are likely higher in settings where women access misoprostol from a variety of sources and receive variable drug quality and regimens. The prevalence of misoprostol use for induced abortion and misoprostol failure in the general population are important for program implementers and policymakers, but measurement poses significant challenges. The proposed study would develop and validate measures of misoprostol use for induced abortion and of misoprostol failure in Pakistan. The list experiment has been shown to result in more reliable estimates of the prevalence of sensitive behaviors such as abortion compared to face-to-face interviews in other settings, but this methodology has not been tested in Pakistan. The measures developed in this study will be piloted in a population with known misoprostol outcomes, and the prevalence resulting from the list experiment and face-to-face interviews will be compared to determine which is closest to the known prevalence of each outcome. Overall, this study is expected to result in 1) validated measures of misoprostol use for induced abortion and misoprostol failure that can be used to measure the prevalence of these outcomes in the general population, 2) validated non-sensitive measures that can be used in list experiments in the Pakistani setting, and 3) evidence of the effectiveness of the list experiment compared to face-to-face interviews for measuring misoprostol outcomes in Pakistan.

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