Level and Timing of Implanon Discontinuation and Associated Factors among Women Who Used Implanon in Andabet District, Public Health Facilities, North-West Ethiopia

Abstract

Background. Implanon discontinuation is unacceptably high in developing countries, including Ethiopia. Furthermore, there is an observed problem of high unintended pregnancy after method discontinuation that strides to program failure. Therefore, the purpose of this study was to assess the level and determinants of Implanon discontinuation among women who used Implanon in Andabet district, public health facilities, North-West Ethiopia, 2017. Methods. Facility-based cross-sectional study design was employed among 537 women from Feb. 03 to April 28, 2017. Study participants were selected using a systematic random sampling technique. A face-to-face interview was employed to collect data. Epi-Info version 7 was used for data entry and SPSS version 20 for analysis. Both descriptive and analytical statistical analysis was computed. On multivariable binary logistic regression, a $p$ value of less than 0.05 was used to declare statistical significance. Results. About 37% of Implanon users have discontinued the method before the intended time. About 86% of them discontinued Implanon before two years of insertion. Women who had no live child ( $\text{AOR}=2.17$ , 95% CI: 1.25-3.77), women who did not receive preinsertion counseling ( $\text{AOR}=1.85$ , 95% CI: 1.15-2.97), women who developed Implanon-related side effect ( $\text{AOR}=5.17$ , 95% CI: 3.18-8.40), and women who did not satisfy by the service provided ( $\text{AOR}=5.40$ , 95% CI: 3.04-9.57) had higher odds of Implanon discontinuation. On the other hand, women who received appointment follow-up ( $\text{AOR}=0.23$ , 95% CI: 0.13-0.41) had lower odds of Implanon discontinuation. Conclusions. The level of Implanon discontinuation before its intended time was high in the district. Hence, strengthening preinsertion counseling and appointment follow-up as well as improving the clients’ level of service satisfaction could increase Implanon’s continuation.