Author:
Bameka Agery,Kakaire Othman,Kaye Dan Kabonge,Namusoke Fatuma
Abstract
Abstract
Background
High levels of unmet need for contraception and unwanted pregnancies are high in developing countries despite efforts to reduce them. Long-acting reversible contraceptive (LARC) methods are more than 99% effective in preventing pregnancy. Discontinuation of LARC within the first year of initiation contributes to the high levels of unmet need. This study aimed to determine the prevalence and factors associated with the first-year discontinuation of LARC at Kawempe National Referral hospital.
Methods
A facility-based cross-sectional study was conducted from February 2020 to June 2021. We consecutively recruited 354 participants who discontinued a LARC (intrauterine device {IUD} and sub-dermal implant) during the study period after informed written consent. Data on duration of use, reasons for discontinuation, and factors associated were collected using a face-to-face interviewer-administered questionnaire and review of client records. Early LARC discontinuation was defined as the termination of the contraception within the first 12 months of use. Data were entered using SPSS version 14/0 and analyzed in STATA version 15. Prevalence was expressed as a proportion while logistic regression was used to assess factors associated with early LARC discontinuation. Variables with a p-value of < 0.05 were considered statistically significant.
Results
The proportion of first-year discontinuation of LARC was 29%. Women Age less than 25 years (OR = 5.07; 95% CI: 1.1–24.8) and those who desired a family size of fewer than four children (OR = 3.19; 95%CI: 1.2–8.7 ) were more likely to discontinue the LARC within 12 months of initiation after multivariate analysis. Method-related reasons for removal were painful menstrual cramps for implants, recurrent infections for IUDs, and a non-side effect reason was the desire to get pregnant.
Conclusion
A high proportion of women discontinue LARC within 12 months following initiation. Young adults and those who desire small families are more likely to have first-year discontinuation of LARC. We recommend age-specific counseling for patients receiving the LARC and further studies looking at the depth analysis of reasons for the first-year discontinuation.
Publisher
Springer Science and Business Media LLC
Reference29 articles.
1. UNICEF, Surviving birth. Every 11 seconds, a pregnant woman or newborn dies somewhere around the world. https://reliefwebint/report/world/surviving-birth-every-11-seconds-pregnant-woman-or-newborn-dies-somewhere-around-world. 2019.
2. Stover J, Ross J. How increased contraceptive use has reduced maternal mortality. Matern Child Health J. 2010;14(5):687–95.
3. UDHS, Uganda Demographic Health S. 2016, https://dhsprogram.com/pubs/pdf/FR333/FR333.pdf. 2016.
4. Mavranezouli I, Group LGD. The cost-effectiveness of long-acting reversible contraceptive methods in the UK: analysis based on a decision-analytic model developed for a National Institute for Health and Clinical Excellence (NICE) clinical practice guideline. Hum Reprod. 2008;23(6):1338–45.
5. Bradley SEK, Hilary M, Schwandt, Shane Khan. Levels, Trends, and reasons for contraceptive discontinuation. DHS Analytical Studies No. 20. Maryland, USA: Calverton; ICF Macro 2009.
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献