Evaluation of the Krio Language Version of the London Measure of Unplanned Pregnancy in Western Area, Sierra Leone

Nataliya Brima, Thomas T. Samba, Anita Yamba, Geraldine Barrett, Judith Stephenson, Jennifer Hall


New ways of measuring pregnancy planning/intention such as the London Measure of Unplanned Pregnancy (LMUP), which recognise the complexity of the construct, are being adopted worldwide. The aim of this study was to evaluate the psychometric properties of the Krio version of the LMUP in Sierra Leone. An interviewer-administered version of the LMUP was translated into Krio and pre-tested with 12 pregnant women. Field testing involved 172 pregnant women aged 15–42, with 87 completing a re-test. Completion rates of LMUP items were 100%. LMUP scores 1-12 were captured. Reliability: the scale was internally consistent (Cronbach‘s alpha 0.84) and stable (weighted Kappa 0.93). Construct validity: all hypotheses were confirmed. Principal components analysis revealed five items (items 2-6) related to one construct. Mokken scaling procedure selected the same five items. Removal of item 1 (which had 97% endorsement of the ‗no contraception‘ response option) brought about only a very slight improvement in LMUP performance, therefore we recommend retaining all six items. The Krio LMUP is reliable, valid and suitable to use in Sierra Leone. (Afr J Reprod Health 2019; 23[4]:81-91).

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Guttmacher Institute. Adding It Up: Investing in Contraception and Maternal and Newborn Health,


Accessed 2 March 2019.

United Nation Population Fund. Universal Access to Reproductive Health. http://www.unfpa.org/sites/default/files/pubpdf/UNFPA_Reproductive_Paper_20160120_onlin

e.pdf. Accessed 2 March 2019.

Ahmed S, Li Q, Liu L and Tsui AO. Maternal deaths averted by contraceptive use: an analysis of 172

countries. Lancet 2012; 380.

United Nations Development Programme. Sustainable Development Goals (see https://sustainabledevelopment.un.org for related resources collated by United Nations SDG

Knowledge Platform, accessed 7th January 2018). Geneva: United Nations, 2015.

Sciarra JJ. Global issues in women's health. International Journal of Gynecology & Obstetrics.

;104(1):77. http://dx.doi.org/10.1016/j.ijgo.2008.09.001. Access ed 2 March 2019.

Hall JA, Benton L, Copas A and Stephenson J. Pregnancy Intention and Pregnancy Outcome:

Systematic Review and Meta-Analysis. Matern Child Health J. 2017;21(3):670-704. . Popul Stud

(Camb). 2003;57(1):7-93

Tsui AO, McDonald-Mosley R and Burke AE. Family Planning and the Burden of Unintended

Pregnancies. Epidemiol Rev. 2010;32(1):152–74.

United Nations Development Programme. Sustainable Development Goals. Knowledge Platform. Geneva:

United Nations, 2015. https://sustainabledevelopment.un.org. Accessed 2

March 2019.

Brown W, Druce N, Bunting J, Radloff S, Koroma D, Gupta S, Siems B, Kerrigan M, Kress D and

Darmstadt GL. Developing the "120 by 20" goal for the Global FP2020 Initiative. Stud Fam Plann 2014;


Singh S, Darroch JE and Ashford LS. Adding It Up: The Costs and Benefits of Investing in Sexual and

Reproductive Health. New York: Guttmacher Institute; UNFPA, 2014.

Bachrach CA and Newcomer S. Intended pregnancies and unintended pregnancies: distinct categories or

opposite ends of a continuum? Fam Plann Perspect 1999, 31(5):251–252.

Barrett G, Smith S and Wellings K. Conceptualisation, development and evaluation of a measure of

unplanned pregnancy. J Epidemiol Community Health 2004, 58:426–433.

Barrett G and Wellings K. What is a 'planned' pregnancy? Empirical data from a British study. Soc

Sci Med 2002, 55:545–557.

Petersen R and Moos M: Defining and measuring unintended pregnancy: Issues and concerns. Women

Health Iss 1997, 7(4):234–240.

Santelli J, Rochat R, Hatfield-Timajchy K, Gilbert B, Curtis KM, Cabral R, Hirsch JS and Schieve L. The

Measurement and Meaning of Unintended Pregnancy. Perspect Sex Reprod Health 2003,


Santelli JS, Lindberg LD, Orr MG, Finer LB and Speizer I. Toward a multidimensional measure of pregnancy

intentions: evidence from the United States. Stud Fam Plann 2009, 40(2):87–100.

Speizer IS, Santelli JS, Afable-Munsuz A and Kendall C. Measuring factors under- lying intendedness of

women's first and later pregnancies. Perspect Sex Reprod Health 2004, 36(5):198–205.

Stanford JB, Hobbs R, Jameson P, DeWitt MJ and Fischer RC. Defining dimensions of pregnancy

intendedness. Matern Child Health J 2000, 4(3):183–189.

Rocca CH, Krishnan S, Barrett G and Wilson M. Measuring pregnancy planning: an assessment of

the London measure of unplanned pregnancy among urban, South Indian women. Demogr Res.

; 23:293.

Morof D, Steinauer J, Haider S, Liu S, Darney P and Barrett G. Evaluation of the London Measure of

Unplanned Pregnancy in the United States population of women. PloS One. 2012;7(4):e35381.

Hall J, Barrett G, Mbwana N, Copas A and Stephenson J. Understanding pregnancy planning in a low-income

country setting: validation of the London measure of unplanned pregnancy in Malawi. BMC

Pregnancy Childbirth. 2013;13(1):200.

Roshanaei S, Shaghaghi A, Jafarabadi MA and Kousha A. Measuring unintended pregnancies in postpartum

Iranian women: validation of the London Measure of Unplanned Pregnancy. EMHJ. 2015;21:8.

Borges ALV, Barrett G, dos Santos OA, Nascimento NC, Cavalhieri FB and Fujimori E. Evaluation of

the psychometric properties of the London measure of unplanned pregnancy in Brazilian

Portuguese. BMC Pregnancy Childbirth. 2016;16:244.

Habib MA, Raynes-Greenow C, Nausheen S, Soofi SB, Sajid M, Bhutta ZA and Black K. Prevalence and

determinants of unintended pregnancies amongst women attending antenatal clinics in Pakistan. BMC

Pregnancy Childbirth. 2017;17:156.

Almaghaslah E, Rochat R and Farhat G. Validation of a pregnancy planning measure for Arabic-speaking

women. PLoS One. 2017;12(10)

Goossens J, Verhaeghe S, Van Hecke A, Barrett G, Delbaere I and Beeckman D. Psychometric

properties of the Dutch version of the London Measure of Unplanned Pregnancy in women with

pregnancies ending in birth. PLoS One. 2018; 13(4)

Lang AY, Hall JA, Boyle YA, Harrison CL, Teede H, Moran LJ, Barrett G. Validation of the London

Measure of Unplanned Pregnancy among pregnant Australian women. 2019 https://doi.org/10.1371/journal.pone.0220774

Bukenya JN, Nalwadda CK, Neema S, Kyambadde P, Wanyenze RK, Barrett G. Pregnancy Planning

among Female Sex Workers in Uganda: Evaluation of the Psychometric Properties of the London

Measure of Unplanned Pregnancy. AJRH. 2019; 23(3)

UNDP. Human Development Report 2016. http://hdr.undp.org/sites/default/files/2016_human_

development_report.pdf. Accessed 2 March 2019.

Statistics Sierra Leone (SSL) and ICF International. Sierra Leone Demographic and Health Survey 2013.

SSL and ICF International. 2014. https://dhsprogram.com/pubs/pdf/FR297/FR297.pdf

. Accessed 2 March 2019.

Statistics Sierra Leone (SSL). 2015 Population and Housing Census. SSL.


_population_and_housing_census.pdf. Accessed 2 March 2019.

London Measure of Unplanned Pregnancy: Krio version. 2019. Available from:

www.lmup.org.uk/docs/LMUP_Krio.pdf (Accessed 10.11.2019

Roscoe J. Fundamental Research Statistics for the Behavioural Sciences. 2nd edition. New York: Holt

Rinehart & Winston; 1975.

Loewenthal K. An introduction to psychological tests and scales. 2nd edition. London: Psychology Press;

Streiner D and Norman G. Health Measurement Scales: a practical guide to their development and use. 4th

edition. Oxford: Oxford University Press; 2008.

Cronbach LJ. Essentials of psychologic testing. 5th edition. New York: Harper & Row; 1990.

Landis J and Koch G. Measurement of observer agreement for categorical data. Biometrics 1977,


Kline P. The new psychometrics: science, psychology and measurement. London: Routledge; 1998.

Mokken RJ, editor. A theory and procedure of scale analysis. Berlin, Germany: De Gruyter. RJ

Mokken1971A theory and procedure of scale analysisBerlin, GermanyDe Gruyter 1971

UNFPA Sierra Leone. Investing in family planning is key to saving women‘s lives in Sierra Leone. 2017.


leone. Accessed 2 March 2019.

UNAIDS. Uptake and discontinuation of long-acting reversible contraceptives (LARC) in Low-income.

https://dhsprogram.com/pubs/pdf/AS54/AS54.pdf. Accessed 2 March 2019.

Gipson JD, Koenig MA, Hindin MJ. The Effects of Unintended Pregnancy on Infant, Child, and

Parental Health: A Review of the Literature. Studies in Family Planning 2008;39(1):18-38.


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