Level and Timing of Implanon Discontinuation and Associated Factors among Women Who Used Implanon in Andabet District, Public Health Facilities, North-West Ethiopia

Abstract

Background. Implanon discontinuation is unacceptably high in developing countries, including Ethiopia. Furthermore, there is an observed problem of high unintended pregnancy after method discontinuation that strides to program failure. Therefore, the purpose of this study was to assess the level and determinants of Implanon discontinuation among women who used Implanon in Andabet district, public health facilities, North-West Ethiopia, 2017. Methods. Facility-based cross-sectional study design was employed among 537 women from Feb. 03 to April 28, 2017. Study participants were selected using a systematic random sampling technique. A face-to-face interview was employed to collect data. Epi-Info version 7 was used for data entry and SPSS version 20 for analysis. Both descriptive and analytical statistical analysis was computed. On multivariable binary logistic regression, a p value of less than 0.05 was used to declare statistical significance. Results. About 37% of Implanon users have discontinued the method before the intended time. About 86% of them discontinued Implanon before two years of insertion. Women who had no live child ( AOR = 2.17 , 95% CI: 1.25-3.77), women who did not receive preinsertion counseling ( AOR = 1.85 , 95% CI: 1.15-2.97), women who developed Implanon-related side effect ( AOR = 5.17 , 95% CI: 3.18-8.40), and women who did not satisfy by the service provided ( AOR = 5.40 , 95% CI: 3.04-9.57) had higher odds of Implanon discontinuation. On the other hand, women who received appointment follow-up ( AOR = 0.23 , 95% CI: 0.13-0.41) had lower odds of Implanon discontinuation. Conclusions. The level of Implanon discontinuation before its intended time was high in the district. Hence, strengthening preinsertion counseling and appointment follow-up as well as improving the clients’ level of service satisfaction could increase Implanon’s continuation.

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

“…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.…”

Factors Associated with Implanon Discontinuation among Women of Reproductive Age in Ethiopia: A Systematic Review and Meta-Analysis

“…The 10 included studies were conducted between 2014 and 2021. Concerning their study, there are three in the Southern nation, nationalities, and Peoples (SNNP) region [ 15 , 16 , 20 ], four in the Amhara region [ 13 , 18 , 19 , 25 ], two in Oromia [ 17 , 26 ], and one in the Tigray region [ 14 ]. The sample size ranges from a minimum of 264 from the Tigray region [ 14 ] to a maximum of 711 from the Southern nation, nationalities, and Peoples (SNNP) region [ 15 ].…”

“…This meta-analysis also examines the association between preinsertion counselling and Implanon discontinuation using six studies [ 13 , 15 , 18 , 19 , 25 , 26 ]. A fixed effects model was used to estimate the pooled association between receiving preinsertion counselling and Implanon discontinuation ( I 2 = 0.0%, p value = 0.749).…”

“…We have examined the association between service satisfaction and Implanon discontinuation using six articles [ 14 – 16 , 19 , 20 , 25 ]. A random effects model was used to estimate the pooled association between service satisfaction and Implanon discontinuation ( I 2 = 55%, p value = 0.049).…”

“…The discontinuation rate varies from study to study, but there is no estimate made based on reviewing available research in Ethiopia that could estimate the overall rate of Implanon discontinuation. Therefore, this study evaluated 10 studies [ 13 – 20 , 25 , 26 ] and estimated the pooled discontinuation rate of Implanon. In this study, we have conducted a meta-analysis of eight cross-sectional and two case-control studies, including 4403 reproductive age women, derived from 32.89%, 95% CI = 24.11%, and 41.66%, a national pooled estimate of Implanon discontinuation.…”