MII (METHOD INFORMATION INDEX)
Quality family planning counseling is crucial for sustained voluntary contraception use. Metrics for Management introduces the Method Information Index (MII) to assess and improve counseling quality efficiently.
Filling the Quality Gap:
Assessing Family Planning Counseling
The Method Information Index (MII) is a widely available measure of contraceptive counseling quality, but little was known about its association with rates of method continuation. Using data from studies in Kenya, Pakistan, and Uganda, Metrics for Management and partners investigated the relationship between the 3-question MII and method continuation. Metrics for Management found that higher scores on the MII were associated with continued use of family planning. This was the first study of its kind to demonstrate the clinic-level association between MII and family planning outcomes. The MII can be easily embedded into existing surveys, for example, into exit interviews or post-visit surveys for family planning clients, and enables providers and other evaluators to easily assess counseling quality and completeness. MII analysis reported at the provider or facility level can also support quality improvement efforts.
Road to Sustainability
The MII consists of 3 yes/no questions. It is an easy-to-use, adaptable tool that only requires minimal training. Ongoing implementation and analysis are owned by the user – local, regional, national, and/or non-governmental actors – and application of the methodology can be done without technical assistance, supporting sustainable use throughout communities. Tested across multiple countries and in both public and private service provision settings, the MII demonstrates usability and effectiveness in assessing counseling quality, strengthening contraceptive counseling and supporting chosen method continuation.
Impact: Method Information Index in Action
- Association between the quality of contraceptive counseling and method continuation: Findings from a prospective cohort study in social franchise clinics in Pakistan and Uganda Assesses the association between MII responses and method continuation over 12 months for women in need of contraception, finding that higher scores on the 3-question MII were associated with continued use of contraception over 12 months.
- Evaluating quality of contraceptive counseling: An analysis of the MII assesses the consistency between MII responses and follow-up questions on the content of the information received, by contraceptive method received, in a prospective study in Uganda and Pakistan. We found high consistency in MII responses among women receiving the implant, injectable, or pill.
- Measures of family planning service quality associated with contraceptive discontinuation: An analysis of measurement, evaluation and learning project data from urban Kenya assesses the association between family planning quality and discontinuation-while-in-need without switching in five cities. The work demonstrates that the MII has the potential to be used at the facility level as an actionable family planning quality metric.
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