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An application of Systematic Anomalous Case Analysis to improve models predicting contraceptive use in the Philippines

Published online by Cambridge University Press:  05 April 2021

Subasri Narasimhan Open the ORCID record for Subasri Narasimhan [Opens in a new window]  and
Jessica D. Gipson Open the ORCID record for Jessica D. Gipson [Opens in a new window]
Subasri Narasimhan*
Affiliation:
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA Center for Reproductive Health Research in the Southeast, Emory University, Atlanta, GA, USA
Jessica D. Gipson
Affiliation:
Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
*
*Corresponding author. Email: [email protected]
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Abstract

Amidst persistently high unintended pregnancy rates and lags in contraceptive use, novel methodological approaches may prove useful in investigating sexual and reproductive health outcomes in the Philippines. Systematic Anomalous Case Analysis (SACA) – a mixed-methods technique – was employed to examine predictors of women’s lifetime contraceptive use. First, multivariable, longitudinal Poisson regression models predicted fertility and sexual debut using the 1998–2009 Cebu Longitudinal Health and Nutrition Surveys (CLHNS), then regression outliers and normative cases were used to identify 48 participants for in-depth interviews (2013–2014) for further examination. Qualitative findings from 24 women highlighted ‘control over life circumstances’ was critical, prompting the addition of two items to the original quantitative models predicting any contraceptive use (n=532). Each of the items, ‘what happens to [them] is their own doing’ and ‘[I] do not [have] enough control over direction life is taking [me]’, significantly and independently predicted any contraceptive use (aOR: 2.37 (CI: 1.24–4.55) and aOR: 0.46 (CI: 0.28–0.77), respectively). The findings demonstrate the utility of SACA to improve the understanding and measurement of sexual and reproductive health outcomes and underscore the importance of integrating psychosocial constructs into existing models of fertility and reproductive behaviour in the Philippines to improve sexual and reproductive health outcomes.

Keywords

PhilippinesContraceptionMixed methods
Type
Research Article
Information
Journal of Biosocial Science , Volume 54 , Issue 3 , May 2022 , pp. 384 - 397
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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