Abstract
ObjectiveTo investigate the psychometric properties of the validated Chichewa version of the London Measure of Unplanned Pregnancy in a large representative community-based sample in Malawi, a low-income country. We collected data on pregnancy intention from a cohort of 4244 pregnant women in Malawi using the validated Chichewa version of the London Measure of Unplanned Pregnancy (LMUP). We evaluated the psychometric properties of the Chichewa LMUP using classical test theory and confirmatory factor analysis to re-assess the performance of items one and six, which had weaker performance in the original smaller, facility-based validation sample.ResultsThe Chichewa version of the LMUP met all pre-set criteria for validation. There are now nine validations of the LMUP in different low-and-middle-income countries, confirming the validity and applicability of the LMUP in these settings.
Highlights
The London Measure of Unplanned Pregnancy (LMUP) is a psychometrically validated measure of pregnancy intention that was developed in the United Kingdom in the early 2000s [1, 2]
The original evaluation of the Chichewa LMUP in Malawi in 2013 found the measure to be acceptable to women and psychometrically valid [4]
We evaluated the LMUP using Classical Test Theory, in keeping with its development [2] and the previous Chichewa validation [4]
Summary
The London Measure of Unplanned Pregnancy (LMUP) is a psychometrically validated measure of pregnancy intention that was developed in the United Kingdom in the early 2000s [1, 2]. Using six questions, scored zero, one or two, it produces a score of zero-to-12, with higher scores indicating a more planned/intended pregnancy. Since its publication it has been translated and validated in diverse settings and populations around the world. Hypothesis testing confirmed construct validity and principal component analysis confirmed unidimensionality (the Eigenvalue of the first component was 3.1), albeit with a borderline second compenent (Eigenvalue 1.0) which mostly represented the contraception question (loading 0.99). A sensitivity analysis to assess the effect of the removal of the contraceptive item (item one) showed slightly improved performance of the measure but as the LMUP was not significantly adversely affected by its inclusion, and for the purposes of international comparability, tracking of trends, and future relevance, we recommended retaining it
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