Discontinuation of Long-Acting Reversible Contraceptive methods and associated factors among women in health facilities of Bahir Dar city, Northwest Ethiopia: A Cross-sectional study

Abstract

Background: Long-acting reversible contraceptive discontinuation is the removal or switch to other methods before completion of duration due to any issue. Discontinuation of these methods exposes a woman to unwanted pregnancy, unsafe abortions, and unplanned births that affect millions of women worldwide. Despite the improvement in the availability and utilization of these methods, discontinuation is becoming high. There is no study conducted on discontinuation and associated factors of long-acting reversible contraceptives in Bahir Dar city, Northwest Ethiopia.Objective: This study aimed to assess the proportion and associated factors of discontinuation of Long-Acting Reversible Contraceptives among women in health facilities of Bahir Dar city, Northwest Ethiopia from April 1 to May 30/ 2021. Methods: health facility-based cross-sectional study was conducted on 415 participants from April 1 to May 30/ 2021. Data were collected through a face-to-face interview-guided questionnaire by using a systematic random sampling technique. Epi Data version 3.1 and Statistical Package for Social Sciences version 25 were used for data entry and analysis respectively. Bivariable and multivariable logistic regression analysis were employed; a P-value of less than 0.05 was considered a statistically significant factor for discontinuation Results: The overall proportion of discontinuation of long-acting reversible contraceptives was 66.3% (95% CI: 61.42-69.13). No formal education (AOR=.49; 95% CI:0.30-0.82), primary school education (AOR=.39; 95% CI:0.18-0.81), desire to be pregnant in the near future (AOR=2.57; 95% CI:1.64-4.02), no past history of modern contraceptive utilization (AOR=2.01; 95% CI:1.19-3.38), lack of counseling about benefits (AOR=1.68; 95% CI:1.08-2.62) and side effects (AOR=1.95; 95 CI:1.21-3.16) were the associated factors for discontinuation.Conclusion: The overall discontinuation of long-acting reversible contraceptives among women was low compared to Ethiopian Demographic Health Survey 2016. Education, the desire of pregnancy shortly, no history of contraceptive utilization, lack of counseling about the benefits, and side effects were factors for discontinuation. Therefore, health professionals better give counseling, implement early management of side effects and reassure clients of any concerns.

Discontinuation of long acting reversible contraceptive use and its determinants among women in Ethiopia: Systematic review and meta-analysis

“…Both community and institutional studies were equally represented (10 studies in each). Nine studies conducted in Southern Nations Nationalists and Peoples Region ( 23 , 27 , 31 , 32 , 34 – 37 , 39 ), five in Amhara ( 26 , 28 – 30 , 41 ), three in Tigray ( 40 , 42 , 43 ), and three in Oromia ( 33 , 38 , 44 ). The sample sizes ranged from 222 to 1050.…”

Factors Influencing Discontinuation of Long-Term Contraceptive Methods

“…Long-term methods of contraception including the intrauterine contraceptive (IUD) and implants provide a woman with effective protection against pregnancy (Grunloh et al, 2013). These two contraceptives represent highly effective modern methods of birth control and their duration of action ranges from 3 to 10 years (Melesse et al, 2022). Adolescents and women who use the pill have a 20-fold failure rate compared to women who use long-term contraceptive methods (Grunloh et al, 2013).…”

“…These unplanned pregnancies result in larger family sizes and ultimately contribute to higher overall fertility rates and impact on social, economic and physical health (Amare & Terefe, 2020). Reducing discontinuation of long-term contraceptive methods is an excellent strategy to avoid or at least reduce unwanted pregnancies that affect millions of women worldwide (Melesse et al, 2022).…”