Contraceptive Use Measured in a National Population-Based Approach: Cross-Sectional Study of Administrative Versus Survey Data

• Published in: JMIR public health and surveillance 2024-07, Vol.10, p.e45030
• Main Authors: Congy, Juliette, Rahib, Delphine, Leroy, Céline, Bouyer, Jean, de La Rochebrochard, Elise
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Birth control; Contraception - methods; Contraception - statistics & numerical data; Contraception Behavior - statistics & numerical data; Contraceptives; Cross-Sectional Studies; Female; France - epidemiology; Gynecology and obstetrics; Health insurance; Human health and pathology; Humans; Intrauterine devices; IUD; Life Sciences; Middle Aged; Oral administration; Original Paper; Polls & surveys; Public health; Public policy; Reproductive health; Santé publique et épidémiologie; Sexual health; Teenagers; Womens health; Young Adult
• ISSN: 2369-2960; 2369-2960
• DOI: 10.2196/45030

Prescribed contraception is used worldwide by over 400 million women of reproductive age. Monitoring contraceptive use is a major public health issue that usually relies on population-based surveys. However, these surveys are conducted on average every 6 years and do not allow close follow-up of contraceptive use. Moreover, their sample size is often too limited for the study of specific population subgroups such as people with low income. Health administrative data could be an innovative and less costly source to study contraceptive use. We aimed to explore the potential of health administrative data to study prescribed contraceptive use and compare these data with observations based on survey data. We selected all women aged 15-49 years, covered by French health insurance and living in France, in the health administrative database, which covers 98% of the resident population (n=14,788,124), and in the last French population-based representative survey, the Health Barometer Survey, conducted in 2016 (n=4285). In health administrative data, contraceptive use was recorded with detailed information on the product delivered, whereas in the survey, it was self-declared by the women. In both sources, the prevalence of contraceptive use was estimated globally for all prescribed contraceptives and by type of contraceptive: oral contraceptives, intrauterine devices (IUDs), and implants. Prevalences were analyzed by age. There were more low-income women in health administrative data than in the population-based survey (1,576,066/14,770,256, 11% vs 188/4285, 7%, respectively; P