Keywords: Item Response Theory, Differential Item Functioning, Demographic and Health Survey, Family Planning, Contraception, Malawi
According to the Malawi National Statistical Office (NSO), nearly all women in Malawi have a knowledge of contraceptive methods, defined as knowing at least one method. However, there is still substantial unmet need for family planning and exposure to family planning messages in the media is still limited. While women may know one contraceptive method, greater knowledge of contraception would allow for better health-related choices, alternative choices following discontinuation of a method, and more ability to meet the contraceptive and family planning needs of Malawian women thereby limiting the risks of unintended pregnancies especially when access to adequate medical care is not available. It is quite possible that items intended to measure this family planning method knowledge on the Malawi Demographic and Health Survey (DHS) function differently across space due to regional disparities and inequities. As such, a localized approach to IRT for regional DIF detection is applied to a 13-item instrument extracted from the 2015-16 Malawi DHS data. The study results can benefit health organizations, healthcare professionals, and the women in Malawi regardless of geographic location.