Early discontinuation of long-acting reversible contraceptives at four government hospitals, Addis Ababa, Ethiopia

Sisay, Abinet; Teshome, Abel; Bizuneh, Hailemichael; Compton, Sarah D.

doi:10.1186/s40834-023-00238-8

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…Refugee women need to be educated about the different types of LARC to ensure that they are making an informed choice and selecting the method that best meets their personal, reproductive and health needs [ 45 ]. Making an informed choice when selecting one of the LARC methods may address the problem of early discontinuation associated with their use in some low-income settings [ 46 , 47 ]. Using mHealth technology can be used to educate women about the different types of LARC methods and their side effects and to inform them about health facilities that have qualified personnel and which provide such methods for free or for a subsidized fee.…”

Section: Discussionmentioning

confidence: 99%

Syrian refugee women’s access to family planning services and modern contraception during overlapping crises in Bekaa, Lebanon

Mourtada,

Melnikas

2023

BMC Women's Health

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Background Political, financial, and pandemic crises in Lebanon have affected both provision of reproductive health services including family planning and modern contraception methods as well as women’s interest and ability to seek those services. This study aims to explore the impact of the compounding crises on the provision and use of family planning services including modern contraception methods for Syrian refugees in Lebanon focusing on the perspectives of Syrian refugee women. Methods We carried out 12 Focus Group Discussions (FGDs) with 119 Syrian refugee women recruited from two cities in West Bekaa, Lebanon from inside and outside the informal tented settlements. We used Skype video calls to moderate the FGDs due to the limited mobility at the time of the study because of Covid-19. We used thematic analyses to analyse the data. Results The crises seemed to exacerbate supply side barriers, which influenced provision of family planning services and women’s demand for them. These included Covid-19 regulations and maltreatment by staff at public health facilities, disruption of outreach reproductive health services that provide family planning and modern contraception, and reduced supply of modern contraception methods. On the demand side, women reported financial limitations in accessing and paying for services, concern over being infected with Covid-19, and concerns about insecurity. Conclusions We suggest possible interventions to address these challenges and better reach these populations. These include using mobile health technology (mHealth) that may provide contraceptive counselling and/or can inform refugee women about where they may receive family planning and modern contraception. These services may also support Syrian refugees to access care they are entitled to receive and may also address disruptions in service provision due to overlapping crises, including availability and rising costs of contraceptives. These can be coupled with mobile outreach reproductive health services that provide family planning. We also suggest considering the provision of Long Acting Reversible Contraception (LARC) for Syrian refugee women, which would reduce a barrier of needing to revisit health facilities to obtain an additional supply of contraception pills.

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Section: Discussionmentioning

confidence: 99%

Syrian refugee women’s access to family planning services and modern contraception during overlapping crises in Bekaa, Lebanon

Mourtada,

Melnikas

2023

BMC Women's Health

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

Rwebazibwa,

Migisha,

Munaru

et al. 2024

Contracept Reprod Med

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Background Early implant removal not only results in method wastage and strains healthcare resources but also exposes women to the risk of unplanned pregnancies and associated complications if an alternative contraceptive is not promptly adopted. Studies have demonstrated that prevalence and factors associated with contraceptive use vary across different cultures and regions even within Uganda. We determined the prevalence and associated factors of early implant removal, among women attending public family planning clinics in Mbarara City, southwestern Uganda. Methods We conducted a cross-sectional study from April to July 2023 at four public family planning clinics in Mbarara City. We consecutively enrolled women and administered a questionnaire to obtain data on demographic, and medical characteristics. We defined early removal as implant discontinuation within a period < 2 years. We excluded women who did not have a written record of the date of insertion of the contraceptive implants. We used modified Poisson regression analysis to determine factors associated with early implant removal. Results We enrolled 406 women, with a mean age of 29 ± 6 years. The prevalence of early contraceptive implant removal was 53% (n = 210; 95%, CI: 48-58%). Factors associated with early implant removal were experiencing side effects (adjusted prevalence ratio [aPR] = 1.63, 95% CI: 1.20–2.21), inserting an implant to achieve career goals (aPR = 1.88, 95% CI: 1.26–2.81) and intending to use the implant for < 24 months (aPR = 1.36, 95% CI: 1.11–1.66). Conclusion Approximately half of the surveyed women removed their contraceptive implant early. Women who experienced side effects, chose an implant due to career obligations and those whose intended implant use was < 2 years were more likely to have an early contraceptive implant removal compared to their counterparts. We recommend strengthening of pre- and post- insertion counselling to address concerns among those who may experience side-effects. Women who intend to use implants for < 2 years and those who have career obligations should be encouraged to use short-acting methods as an option.

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Early discontinuation of long-acting reversible contraceptives at four government hospitals, Addis Ababa, Ethiopia

Cited by 2 publications

References 19 publications

Syrian refugee women’s access to family planning services and modern contraception during overlapping crises in Bekaa, Lebanon

Syrian refugee women’s access to family planning services and modern contraception during overlapping crises in Bekaa, Lebanon

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

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