Early discontinuation of Implanon and associated factors among women in public health facilities of the Hawassa administration, south Ethiopia

Abstract

Background/Aims Despite improving availability and use of the contraceptive Implanon, early discontinuation is a public health concern. A significant proportion of women discontinue using Implanon before it is due to be removed, which poses a health concern and may lead to contraceptive failure. Only 8% of married women in Ethiopia use contraceptive implants. There is a paucity of information on factors associated with early discontinuation of Implanon. This study's aims were to assess early discontinuation of Implanon and associated factors among women using public health facilities of Hawassa, south Ethiopia. Methods An institution-based cross-sectional study was conducted in six randomly selected public health facilities in Hawassa. All women using Implanon who visited the selected institutions during the data collection period were invited to participate in the study. Data were collected through face-to-face interviews using a pretested questionnaire. A multivariate logistic regression model was used to identify predictors of early Implanon removal. Results Of the 250 study participants, 54.0% discontinued using Implanon early. A woman having primary level education (adjusted odds ratio=2.332, P=0.048), lack of counselling about the possible benefits of Implanon (adjusted odds ratio=2.496, P=0.019), side effects (adjusted odds ratio=2.092, P=0.002) and the desire to be pregnant in the near future (adjusted odds ratio=2.222, P<0.0001) were associated with early discontinuation. Conclusions Over half of women using Implanon discontinued early, which was related to lower education, a lack of counselling, side effects of the implant and the desire to become pregnant. Pre-insertion counselling for women should include information on the possible side effects and benefits of Implanon, to decrease the proportion of women who discontinue its use early.

Early contraceptive implant removal and associated factors among women attending public family planning clinics, Mbarara City, Southwestern Uganda: a cross-sectional study

“…This nding is consistent with the nding in the study conducted in public health facilities in Ethiopia where women were more likely to have early implant removal if they desired to conceive in the near future (< 2 years) as compared to one who desired to conceive later. (24) This might be due to women who, at the time of implant insertion, may have experienced a pregnancy loss, or were anticipating completing their career obligations soon but still desired to have children in the near future (24,25). While no studies directly link career obligations to early implant removal, women may choose implants either to limit family size after reaching their desired number of children or to space pregnancies.…”

Early Implanon Discontinuation and Associated Factors among Woman's of Implanon Users in Ethiopia: A Systematic Review and Meta-Analysis

“…Addressing the factors that contribute to early Implanon discontinuation is essential to ensure safe and reliable services to women in the reproductive age group through appropriate use of contraceptive methods and method switching. In Ethiopia, studies assessing early implanon discontinuation and associated factors among implanon user have contributed a range of findings [7,8,[13][14][15][16][17]. These small and fragmented studies revealed that early discontinuation of implanon ranged from 16% in Ofla District, Tigray, Northern Ethiopia [18], to 65% in Debre-tabor town, Amhara regional state [13].…”

“…Such discrepancy has not been yet investigated. Regarding associated factors, previous studies have cited mothers' experienced side effect [7,[13][14][15][16][17][18], services dissatisfaction [13][14][15]18], lack of appointment after insertion [13][14][15][16]18], and in adequate pre-insertion counselling [7,8,[14][15][16][17] as the common factors contributing to early implanon discontinuation among women's of implanon users in Ethiopia.…”