Early contraceptive implants removal and its associated factors among women using implants at a National Referral Hospital, Kampala Uganda

Ssebatta, Gerald; Kaye, Dan K.; Mbalinda, Scovia Nalugo

doi:10.1186/s12905-021-01541-9

Cited by 13 publications

(9 citation statements)

References 22 publications

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“…Women who experienced etonogestrel sub-dermal implant side effects were at high risk of early etonogestrel sub-dermal implant discontinuation. The finding was in agreement with other studies conducted in Ethiopia, 46,50 Uganda, 51 Egypt, 52 Kinshasa, 53 Turkey, 54 Jos Nigeria, 55 and Jordan. 56 The possible reason might be inadequate pre-insertion counseling about the possible side effects.…”

Section: Discussionsupporting

confidence: 93%

“…This finding is witnessed by other studies conducted in Debre Markose, 35 Mekelle, 44 and Uganda. 51 The possible reason for this might be women who did not get effective pre-insertion counseling may not accept and tolerate minor side effects, and possibly they may seek early removal of the method. On the other hand, the information provided during counseling can clear their concerns or misconceptions related to the method causing early discontinuation.…”

Section: Discussionmentioning

confidence: 99%

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Determinants of early discontinuation of etonogestrel sub-dermal implant among reproductive-age women in Legambo district, Northeast Ethiopia: An unmatched case–control study

2022

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Objective: Etonogestrel sub-dermal implant discontinuation is very common in the study area. But evidence on the determinants was limited. So, this study aimed to identify determinants of early discontinuation of etonogestrel sub-dermal implant among reproductive-age women in Legambo district, Northeast Ethiopia. Methods: An institution-based unmatched case–control study was conducted on 252 reproductive-age women (84 cases and 168 controls) from 1 February up to 30 April 2020. Systematic random sampling was used to select women, and the data were collected by face-to-face interview using a structured, pretested, and interviewer-administered questionnaire. The collected data were entered into Epi Data version 3.1 and analyzed by SPSS version 23. A binary logistic regression model was used to identify determinants of early discontinuation of etonogestrel sub-dermal implant. Statistical significance was declared at a p value of less than 0.05, and adjusted odds ratio with a 95% confidence interval was used to identify determinants of early discontinuation of etonogestrel sub-dermal implant in the final model. Result: In this study, not receiving pre-insertion counseling (adjusted odds ratio = 3.19, 95% confidence interval: (1.61, 6.30)), having a history of abortion (adjusted odds ratio = 2.89, 95% confidence interval: (1.50, 5.54)), contraceptive side effects (adjusted odds ratio = 2.45, 95% confidence interval: (1.99, 3.91)), and not receiving an appointment for a follow-up visit at the time of insertion (adjusted odds ratio = 3.45, 95% confidence interval: (1.89, 5.99)) were determinants of early discontinuation of etonogestrel sub-dermal implant. Conclusion: Not receiving pre-insertion counseling, having a history of abortion, contraceptive side effects, and not receiving an appointment for a follow-up visit at the time of insertion were predictors of early discontinuation of etonogestrel sub-dermal implant. Thus, healthcare professionals should give an appointment for a follow-up visit at the time of insertion and provide detailed counseling for all women, not only for those who had had an abortion and contraceptive side effects.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Determinants of early discontinuation of etonogestrel sub-dermal implant among reproductive-age women in Legambo district, Northeast Ethiopia: An unmatched case–control study

2022

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“…The ndings are consistent with ndings conducted in Myanmar 48 , Ethiopia 49 and Uganda 50 which reported discontinuation rates that were generally ranging from 32-42% although those studies were conducted among the general population, considered all women who had ever used contraception and those studies had a very short time scope for discontinuation assessment.…”

Section: Discussionsupporting

confidence: 87%

Factors associated with unindicated discontinuation of long-acting reversible contraceptives among refugee women in Rhino Camp and Kyangwali refugee settlements, Uganda

Kirima,

Tuhebwe,

Bukenya

2023

Preprint

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Background: Unindicated discontinuation of long-acting reversible contraceptives (LARCs) poses a growing concern among refugee women residing in Rhino Camp and Kyangwali refugee settlements. This practice is closely linked with unintended pregnancies, short birth intervals, unsafe abortions, and maternal mortality. This study assessed the level and factors associated with the unindicated discontinuation of LARCs among refugee women in these settlements. Methods: A community-based cross-sectional study was conducted from January to March 2022, involving 284 refugee women. Data were collected through structured questionnaires and key informant interviews. Qualitative and quantitative data were analyzed using thematic analysis and STATA 14, respectively. Prevalence ratios and the corresponding 95% confidence intervals were determined. Results: The findings revealed that 90/284 refugee women (32% CI; 22.9%-41.1%) in Rhino camp and Kyangwali refugee settlements had discontinued their LARCs without indication. Notably, users of Implant contraceptives were more prone to discontinuation without a clinical indication. Several factors were associated with unindicated discontinuation, including residing in Rhino camp (adjusted prevalence ratio aPR = = 1.5, 95% confidence interval (CI): 1.01 - 2.30), having an education level up to primary (Upper) level (aPR= 4.9, 95% CI: 2.35 - 10.19), marital status (never married, (aPR = 1.299, 95% CI: 1.088 - 3.001), South Sudanese origin (aPR = 10.2, 95%CI: 1.51 - 68.45), living with all children in one household (aPR= 4.9, 95% CI: 1.26 – 19.16) and having given birth to only one child (aPR = 3.5, 95CI: 1.19 - 10.08). Conversely, women who experienced mild side effects (aPR = 0.24, 95% CI: 0.12 - 0.48), perceived LARC devices as 100% effective in preventing pregnancy (aPR = 0.02, 95%CI: 0.00 - 0.24), lived with their partners (aPR = 0.38, 95% CI: 0.18 - 0.78) and had the support of their spouses in using LARC devices (aPR = 0.42, 95% CI: 0.19 - 0.94) exhibited a lower prevalence of unindicated LARC discontinuation. Additionally, health workers identified domestic violence and fear of side effects as underlying causes of unindicated LARC discontinuation. Conclusions and Recommendations: This study highlights the common occurrence of unindicated LARC discontinuation among refugee women in Rhino camp and Kyangwali refugee settlements, with a higher prevalence in Rhino camp. To address this issue, we recommend implementing comprehensive pre-insertion counselling, particularly for implant users, and launching extensive behavioural change initiatives to combat negative cultural practices, particularly among refugee women from patriarchal communities.

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“…The proportion of participants who discontinued a LARC within the first year in this study is lower than that due to sub-dermal implants alone (42%) in the same setting [ 14 ]. This is can be explained by the high side effect profile of subdermal implants compared to IUDs IUD resulting in less user satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Early discontinuation of long-acting reversible contraceptives and associated factors among women discontinuing long-acting reversible contraceptives at national referral hospital, Kampala-Uganda; a cross-sectional study

Bameka

Kakaire

Kaye

et al. 2023

Contracept Reprod Med

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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.

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Early contraceptive implants removal and its associated factors among women using implants at a National Referral Hospital, Kampala Uganda

Cited by 13 publications

References 22 publications

Determinants of early discontinuation of etonogestrel sub-dermal implant among reproductive-age women in Legambo district, Northeast Ethiopia: An unmatched case–control study

Determinants of early discontinuation of etonogestrel sub-dermal implant among reproductive-age women in Legambo district, Northeast Ethiopia: An unmatched case–control study

Factors associated with unindicated discontinuation of long-acting reversible contraceptives among refugee women in Rhino Camp and Kyangwali refugee settlements, Uganda

Early discontinuation of long-acting reversible contraceptives and associated factors among women discontinuing long-acting reversible contraceptives at national referral hospital, Kampala-Uganda; a cross-sectional study

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