Contraceptive use dynamics in India: A prospective cohort study of modern reversible contraceptive users

Mozumdar, Arupendra; Tobey, Elizabeth; Aruldas, Kumudha; Acharya, Rajib; Jain, Aparna

doi:10.31899/rh11.1029

Cited by 6 publications

(7 citation statements)

References 3 publications

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“…Their phone numbers were then used to set up a day and time for the follow-up interview. The respondent chose the location of the follow-up interview, which usually occurred at her residence or at the facility (see Mozumdar et al [2020] for study implementation details).…”

Section: Methodsmentioning

confidence: 99%

Not All Women Who Experience Side Effects Discontinue Their Contraceptive Method: Insights from a Longitudinal Study in India

Jain

Dwyer

Mozumdar

et al. 2021

Studies in Family Planning

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Side effects are a primary reason why women stop using contraception, even though they may still want to avoid a pregnancy. The Demographic and Health Surveys (DHS), the largest source of nationally representative data on contraceptive discontinuation, only asks women who discontinued a method their reasons for discontinuation, for which side effects is an option. Yet, side effects are also experienced by continued users. Using longitudinal data collected from a cohort of contraceptive users in Odisha and Haryana, India, this study explores the effect of side effect severity and frequency on six-month discontinuation. Among women who experienced side effects of their enrollment method, . percent continued to use it by the six-month interview. Women who experienced moderate/severe side effects infrequently were  percent (adjusted odds ratio [AOR]: .;  percent confidence interval [CI]: .-.) less likely to discontinue the enrollment method compared to women who experienced moderate/severe side effects always. Women who experienced mild side effects were even less likely to discontinue (AOR: .;  percent CI: .-.). Study results suggest side effect severity and frequency are more important factors than simply the experience of a side effect in understanding contraceptive discontinuation. DHS and other national surveys should expand their exploration of side effects to include questions asked of current users. BACKGROUNDContraceptive discontinuation for reasons other than wanting a child or having no need for contraception (e.g., husband not living at home, not having or infrequent sex, menopausal/hysterectomy, or infertility) can lead to unintended pregnancies. It is estimated that in low-and middle-income countries, approximately one-third of all unintended

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Section: Methodsmentioning

confidence: 99%

Not All Women Who Experience Side Effects Discontinue Their Contraceptive Method: Insights from a Longitudinal Study in India

Jain

Dwyer

Mozumdar

et al. 2021

Studies in Family Planning

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“…Overall, this study found significantly lower continuation rates at six months (15.7%) as compared with other studies, where continuation rates were higher. For example, one study observed injectable continuation rates were much higher at 43.5% after 12 months (Mozumdar et al, 2020). However, this may be attributable to the types of facilities from where the women obtained this method, which included a greater mix of facilities, including NGOs and the private sector.…”

Section: Discussionmentioning

confidence: 99%

“…For example, a study in Uttar Pradesh, India found that only 16.3% of respondents knew about injectables, with awareness only lower for female condoms at (0.8%) (Singh et al, 2016). Data also suggest that injection discontinuation rates were are high, with several studies reporting that less than half on injectable users continue with their method after 12 months (IIPS & ICF, 2017;Mozumdar et al, 2020). Reasons for discontinuation have centered around studies from private-sector clients in India, where barriers not only included side effects related to changes in menstruation such as irregular vaginal spotting, and amenorrhea (Gupta et al, 2020;Mozumdar et al, 2020), as well as spousal opposition, but also private-sector related costs and accessibility (Mozumdar et al, 2020) (Gupta et al, 2020;Mozumdar et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Understanding factors associated with continuation of use of injectable contraceptives in Karnataka and Maharashtra, India: a cross-sectional household study

et al. 2022

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The Government of India has worked to expand access to injectable contraceptives through the introduction of a three-monthly injectable contraceptive MPA under the ‘Antara’ program in 2017. However, the uptake of injectable contraceptives has remained low, and few studies have investigated the experiences of public health facility injectable clients in India. We examined factors associated with continuing, discontinuing, and switching methods among injectable users obtaining services from public health facilities in the Indian states of Karnataka and Maharashtra.The study team recruited respondents (N=1009) that had received their first injectable dose from in public sector facilities between February – May 2019 and conducted a follow-up visit at their residence in December 2020. We used multivariate logistic regression to study the association of the demographic characteristics, service quality, satisfaction with services, follow-up visits, and decision-making on injectable continuation and switching to other family planning methods.Injectable usage rates declined significantly, with 44% of clients receiving a second dose and only 16% receiving a third dose. Over half of women (54%) cited problems related to periods as the reason for discontinuing injectable use after the first dose. Respondents were more likely to continue their method at third dose if they were older (25-35 years) (OR:1.68, p<0.05) and had received a reminder for a follow-up dose (OR: 2.41, pOur results also highlight the importance of addressing side-effects experience by women, which may be better managed by community-based follow-up visits and high-quality counselling services.

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“…8 About 54% married and 44% all women (15-49 years) use any type of contraceptive, and 48% married and 38% all women (15-49 years) use modern contraceptive methods. 9 Among these women, within one year of use, the discontinuation rate of contraceptives was high, 10 which are related to multiple factors. 8 Compared to male sterilisation and temporary modern contraceptives, female sterilisation (accounting to 37% of women between 15 and 49 years of age), is the most preferred approaches of limiting the family size.…”

Section: Introductionmentioning

confidence: 99%

“…5 , 6 , 11 , [13][14][15] Considering this, the government of India is committed to enhancing the demand for modern reversible contraceptives use to 54.3% among married women (15-49 years). 9 , 10 To highlight commonalities (or dissimilarities), it is important to collate and summarise the opinion and perspectives of people belonging to a wider group or context on a complex phenomenon. To the best of our knowledge, there are no qualitative systematic reviews conducted on the resident Indian population that studied perceptions of FP.…”

Section: Introductionmentioning

confidence: 99%

The voice of Indian women on family planning: A qualitative systematic review

Parsekar

Hoogar

Dhyani

et al. 2021

Clinical Epidemiology and Global Health

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Contraceptive use dynamics in India: A prospective cohort study of modern reversible contraceptive users

Cited by 6 publications

References 3 publications

Not All Women Who Experience Side Effects Discontinue Their Contraceptive Method: Insights from a Longitudinal Study in India

Not All Women Who Experience Side Effects Discontinue Their Contraceptive Method: Insights from a Longitudinal Study in India

Understanding factors associated with continuation of use of injectable contraceptives in Karnataka and Maharashtra, India: a cross-sectional household study

The voice of Indian women on family planning: A qualitative systematic review

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