title: Using patient-held records to evaluate contraceptive use in Malawi.
abstract: OBJECTIVE
  To investigate a method of using patient-held records to collect contraception data in Malawi, that could be used to explore contraceptive discontinuation and method switching.
  
  
  METHODS
  In 2012, all 7393 women aged 15 to 49 years living in the area covered by the Karonga demographic surveillance site were offered a family planning card, which was attached to the woman's health passport - a patient-held medical record. Health-care providers were trained to use the cards to record details of contraception given to women. During the study, providers underwent refresher training sessions and received motivational text messages to improve data completeness. After one year, the family planning cards were collected for analysis.
  
  
  RESULTS
  Of the 7393 eligible women, 6861 (92.8%) received a family planning card and 4678 (63.3%) returned it after one year. Details of 87.3% (2725/3122) of contacts between health-care providers and the women had been recorded by health-care providers on either family planning cards or health passports. Lower-level health-care providers were more diligent at recording data on the family planning cards than higher-level providers.
  
  
  CONCLUSIONS
  The use of family planning cards was an effective way of recording details of contraception provided by family planning providers. The involvement of health-care providers was key to the success of this approach. Data collected in this way should prove helpful in producing accurate estimates of method switching and the continuity of contraceptive use by women.
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, England .
authors.forename: Aisha Nz
authors.initials: AN
authors.lastname: Dasgupta
authors.affiliation: District Health Office, Karonga, Malawi .
authors.forename: Ruth
authors.initials: R
authors.lastname: Ngwalo
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, England .
authors.forename: Keith
authors.initials: K
authors.lastname: Branson
authors.affiliation: Karonga Prevention Study, Chilumba, Malawi .
authors.forename: Levie
authors.initials: L
authors.lastname: Gondwe
authors.affiliation: College of Medicine, University of Malawi, Blantyre, Malawi .
authors.forename: Frank
authors.initials: F
authors.lastname: Taulo
authors.affiliation: College of Medicine, University of Malawi, Blantyre, Malawi .
authors.forename: Bagrey
authors.initials: B
authors.lastname: Ngwira
authors.affiliation: London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, England .
authors.forename: Basia
authors.initials: B
authors.lastname: Zaba
authors.affiliation: Karonga Prevention Study, Chilumba, Malawi .
authors.forename: Amelia C
authors.initials: AC
authors.lastname: Crampin
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data; D003268:Contraception Behavior / Q000706:statistics & numerical data; D016208:Databases, Factual; D003906:Developing Countries; D005193:Family Planning Services; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D007407:Interviews as Topic; D008295:Malawi; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D055815:Young Adult