Service vs Survey Statistics: An Evaluation of Contraceptive Use in Pakistant

Contraceptive use rates estimated from service statistics and contraceptive prevalence surveys often disagree particularly in larger populations. This disagreement is more pronounced in traditional societies where under~reporting of contraceptive use is a common feature not only because of methodological problems in sample surveys and deficient reporting and recording systems of family planning programmes but also because of socio-psychological reasons including social taboos, personal inhibition, shyness, lack of education and lack of openness to foreign ideas and mass disapproVal by the society for cultural and religious reasons. The disparity in contraceptive use rates based on these two sources of information is also acknowledged in countries with strong family planning programmes and efficient reporting and recording systems. Indonesia, which is often cited as a prime example of operating a successful family planning programme and is also quoted to be the one with “very strong reporting, recording and research component” [ESCAP (1989), p. 4] is not an exception. Comparative studies undertaken there reveal that service statistics estimates exceed that of surveys by 24 percent for IUD, 28 percent for pill and 110 percent for Condom [Streatfield (1985), p. 45]. Similar inconsistencies were found in India and Bangladesh [Koening et al. (1984) and Ahmed et al. (1987)] . In Pakistan wide differences have been observed in contraceptive use rates based on service statistics and those revealed by surveys [Syed (1981); Rukanuddin et al. (1985) and Sultan (1987)]. The deficient recording and reporting system of contraceptive use, the inappropriateness of the usage assumptions, continuation rates of different methods and the lack of necessary information on method effectiveness and use effectiveness cast doubt on the estimates of service statistics. Table 1 shows reported contraceptive use rates in the 1975 Pakistan Fertility Survey (PFS) and 1984-85 Pakistan Contraceptive Prevalence Survey (PCPS) together with estimated use rates based on serivce statistics for the corresponding reference periods. (See Table 1).