DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205746

Modern contraceptives discontinuation, method switching and associated factors among clients at the family planning clinic of a tertiary hospital in Port-Harcourt, Nigeria

Peter A. Awoyesuku, Basil O. Altraide, Simeon C. Amadi

Abstract


Background: Contraceptive discontinuation and switching to less effective methods, often leads to unintended pregnancies and reduces the impact of family planning programs. To understand what drives contraceptive use behavior, it is important to identify factors that influence discontinuation and switching. This study sought to determine the discontinuation rates, reasons for discontinuation or switching, and assess associated factors among women in Port Harcourt.

Methods: A retrospective descriptive study, of women 15-48 years who accepted a modern method, over a five-year period from 1st January 2014 to 31st December 2018 was carried out. Information on age, parity, education, contraceptive use intention, method and duration of use, reason for discontinuation, and method switching, were extracted from their hospital records. Coded data were entered into Excel spreadsheet and exported to SPSS version 20 for statistical analysis at significance level of P<0.05.

Results: There were 349 women with complete data. Their mean age was 32±56 years and median parity was 3. The all-method discontinuation rate was 29.0% at 12 months and 31.5% by 24 months. Method specific discontinuation at 12 months were injectables 53.3%, IUCD 38.2% and implants 23.8%, the difference was significant P=0.018. Reasons for discontinuation were reduced need-64.5%, method problems-26.8% and expiration-7.2%. Majority 79.7% abandoned further use, 6.5% renewed their method and 13.8% switched to other methods.

Conclusions: The discontinuation rate was high, with associated poor switching behaviour. Proper counseling on contraceptive options and reinforcing switching are critical to reduce unwanted pregnancies that might result from poor method use and discontinuation.


Keywords


Associated factors, Contraceptive discontinuation, Family planning, Method switching, Port-Harcourt

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References


World Health Organization (WHO). Sexual and reproductive health: Contraceptive Prevalence, 2013. Available at: http://www.who.int/reproductivehealth/topics/family_planning/contraceptive_prevalence/en/. Accessed Feb 2020.

Statcompiler. The DHS Program. 2016. Available at: http://stacompiler.com/en/index.html. Accessed Feb 2020.

UNDESA. Trends in Contraceptive Use Worldwide, 2015. Available at: http://www.un/org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf. Accessed Feb 2020.

Jain AK, Obare F, RamaRoa S, Askew I. Reducing unmet need by supporting women with met need. Int Perspect Sex R H. 2013;39(3):133-41.

Jain AK, Winfrey W. Contribution of contraceptive discontinuation to unintended births in 36 developing countries. Studies Family Plann. 2017;48(3):269-78.

World Health Organization (WHO), 2012. Family planning factsheets No 351. Geneva, Switzerland.

Awoyesuku PA, Altraide BOA. Contraceptive Choices and Acceptability among New Clients Attending Family Planning Unit of Rivers State University Teaching Hospital, Nigeria. J Advan Med Med Res. 2019;30(3):1-7.

Ali MA, Cleland J, Causes SIH. Consequences of contraceptive discontinuation: evidence from 60 demographic and health surveys. Geneva, Switzerland: World Health Organization, 2012.

Barden-O’Fallon J, Speizer I. What differentiates method stoppers from switchers? Contraceptive discontinuation and switching among Honduran women. Int Perspect Sex R H. 2011;37(1):16-23.

Ravi F, Irfan G. Reasons for discontinuation of contraceptive methods among couples with different family size and educational status. J Ayub Med Abbottabad. 2012;24(1):101-4.

Ali MM, Cleland J. Oral contraceptive discontinuation, and its aftermath in 19 developing countries. Contraception. 2010;81(1):22-9.

Why Do Women and Girls Stop Using Contraceptives?, 2016. Available at: http://globaldaily.com/why-do-women-and-girls-stop-using-contraceptives/.

The Leaking Bucket Phenomenon in Family Planning, 2014. Available at: http://champions4choice.org/2014/09/the-leaking-bucket-phenomenon-in-family-planning/.

Blanc AK, Curtis SL, Croft TN. Monitoring contraceptive continuation: links to fertility outcomes and quality of care. Stud Fam Plan. 2002;33(2):127-40.

Khan MA. Side effects and oral contraceptive discontinuation in rural Bangladesh. Contraception. 2001;64(3):161-7.

World Health Organization, 2012. Contraception discontinuation and switching in developing countries Research policy brief. Available at: https://www.who.int/reproductivehealth/publications/family_planning/rhr_12_15/en/.

Ferguson AG. Fertility and Contraceptive Adoption and Discontinuation in Rural Kenya. Stud Fam Plan. 1992;23(4):257-67.

Barden-O’Fallon J, Speizer IS, Calhoun LM, Corroon M. Women’s contraceptive discontinuation and switching behaviour in urban Senegal, 2010-2015. BMC Women’s Health. 2018;18:35-43.

Modey EJ, Aryeetey R, Adanu R. Contraceptive Discontinuation and Switching Among Ghanaian Women: Evidence from the Ghana Demographic and Health Survey, 2008. African J Reprod Heal. 2014;18(1):84-92.

Yideta ZS, Mekonen L, Seifu W, Shine S. Contraceptive Discontinuation, Method Switching and Associated Factors among Reproductive Age Women in Jimma Town, Southwest Ethiopia, 2013. Fam Med Med Sci Res. 2017;6:213.

Curtis S, Evens E, Sambisa W. Contraceptive Discontinuation and Unintended Pregnancy: An Imperfect Relationship. Intern Perspect Sexual Reproduct Health. 2011;37(2):58-66.

Azmat SK, Hameed W, Mustafa G, Hussain W, Ahmed A, Bilgrami M. IUD discontinuation rates, switching behaviour, and user satisfaction: findings from a retrospective analysis of a mobile outreach service program in Pakistan. Intern J Women’s Health. 2013;5:19-27.

Ali MM, Cleland J. Contraceptive Switching after Method-related Discontinuation: Levels and Differentials. Studies in Family Planning. 2010;41(2):129-33.

World Health Organization. Contraception discontinuation and switching in developing countries. In: Research DoRha, editor. Geneva: WHO, 2012:4.