Predictors of contraceptive discontinuation among postpartum women in Arusha region, Tanzania

Abstract

Background Postpartum contraceptive discontinuation refers to cessation of use following initiation after delivery within 1 year postpartum. Discontinuation of use has been associated with an increased unmet need for family planning that leads to high numbers of unwanted pregnancies, unsafe abortion or mistimed births. There is scant information about contraceptive discontinuation and its predictors among postpartum women in Tanzania. This study aimed to determine predictors of contraception discontinuation at 3, 6, 12 months postpartum among women of reproductive age in Arusha city and Meru district, Tanzania. Methods This was an analytical cross-sectional study which was conducted in two district of Arusha region (Arusha city and Meru district respectively). A multistage sampling technique was used to select 13 streets of the 3 wards in Arusha City and 2 wards in Meru District. A total of 474 women of reproductive age (WRAs) aged 16–44 years residing in the study areas were included in this analysis. Data analysis was performed using STATA version 15. Odds ratios (ORs) with 95% confidence interval (CI) for the factors associated with contraceptives discontinuation (at 3, 6 and 12 moths) were estimated in a multivariable logistic regression model. Results Overall, discontinuation rate for all methods at 3, 6, and 12 months postpartum was 11, 19 and 29% respectively. It was higher at 12 months for Lactational amenorrhea, male condoms and injectables (76, 50.5 and 36%, respectively). Women aged 40–44 years had lower odds of contraceptive discontinuation at 3 months as compare to those aged 16 to 19 years. Implants and pills users had also lower odds of contraceptive discontinuation compared to injectable users at 3, 6 and 12 months respectively. Conclusion Lactational amenorrhea, male condoms and injectables users had the highest rates of discontinuation. Women’s age and type of method discontinued were independently associated with postpartum contraceptive discontinuation. Addressing barriers to continue contraceptive use amongst younger women and knowledge on method attributes, including possible side-effects and how to manage complications is warranted.

Prediction of contraceptive discontinuation among reproductive-age women in Ethiopia using Ethiopian Demographic and Health Survey 2016 Dataset: A Machine Learning Approach

“…The independent variables were adopted from previous studies [ 12 , 14 , 27 , 33 – 35 ] and includes age of women, residence, marital status, religion, women occupation, sex of household head, region, employment, women education, husband education, internet usage, mobile ownership, wealth index, owning TV, owning radio, khat chewing, alcohol drinking, smoking cigarette, fertility preference, parity, family size, husband’s desire for a child and woman’s abortion history.…”

“…Various research studies have been conducted to study the potential factors associated with contraceptive discontinuation by applying classical statistical analysis techniques [ 20 , 27 – 30 ]. However, no previous studies have tried to predict contraceptive discontinuation and identify predictor factors with the application of machine learning.…”

Determinants of early discontinuation of long-acting and reversible contraceptive methods among women within childbearing age attending health facilities in Ethiopia, 2019

“…[13][14][15] Studies conducted in Southern Ethiopia, Tanzania, and West Africa have also shown that poor decision-making about the method, occupation, parity, marital status, and desire to have another child were all the associated factors of contraceptive method discontinuation. [16][17][18] In order to successfully reduce unplanned early withdrawal of LARCs and their related consequences, it is necessary to identify their determinants. However, most studies in Ethiopia have focused on determining the influencing factors and prevalence of a single contraceptive method (implants or IUCD) and have not been studied in the study area.…”

“…Studies conducted in Southern Ethiopia, Tanzania, and West Africa have also shown that poor decision-making about the method, occupation, parity, marital status, and desire to have another child were all the associated factors of contraceptive method discontinuation. 16 – 18 …”