Contraceptive Discontinuation and Method Switching Among Registered Modern Family Planning Acceptors in Bahir Dar
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Date
1998-06
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Addis Ababa University
Abstract
The major objec ti ve of
discontin uation, reasons for
ABSTRACT
this study was
discontinuation
to
and
examine contraceptive
me thad swi tching among
registered modern family planning acceptors in one of the major urban center
of Ethiopia, Bahir-Dar . Using systematic sampling technique a total of 1000
women were selected from 14245 women who for the first time visited one of the
family planning providing center in the town and a total of 907 respondents
tvere interviewed for the present study. Three and halt years retrospective
contraceptive histories were collected for these women i n a monthly calendar
of events. Single and multiple decrement life table technique are used to
analyze the dynamics of contraceptives practice in the study population.
The finding shows that method specific 12- month discontinuation rates range
from 43 . 8 percent for pill to 24.4 percent for injectable and IUD . For all
methods combined, 39 percent of users were likely to terminate within the
first year of use.
Side eff eccs are the main reasons tor first year discont inuation of the pill,
IUD, and injectable. Method change, on the other hand, i s the main rea son for
disconti nua tion of ' other modern methods I such as condom and vaginal methods .
For all methods together side effects and the desire to get pregnane are the
two main reasons for discontinua tion of can tracepti ve use. pri thin the first
year of use about 13 percent and 9 percent of users, respectively, were likely
to t erminate use of a method as a resul t of these reasons. The 12-month
contraceptive failure rate is comparatively higher for the p il l (2 . 8 percent )
than ' other modern methods I (3 . 6 percent) and it ranges from 0 percent for
in jectable and IUD to 3.6 percent for rather modern methods'. For all methods
combined the 12-month probability of discontinuation due to method failure is
2. 0 percent, indicating that method failure is not a significant problem as
compared to other categories of reasons in the populati on under study.
The likelihood of method change is highest among users of IUD and the lowest
is observed among users of injectable . About 27 percent of IUD users and 19percent of inj ectable users were likely to switch methods within the second
year of use . Switchers as a whole we r e most likely to switch their first
method to injectable.
Contraceptive discontinuation rates we r e also significantly different among
women wi th various socio-demographic characteristics . Discontinuation of a
given contraceptive method is significantly influenced by age of acceptors,
number of living children, additional children desired, contraceptive goal,
and marital sta tus. However, educational level and type of occupation were not
found to have a signifi cant effect on the disc ontinuati on rate .
Based on the major findings of the study, the paper indicates major ar eas of
policy and program interventions to improve the quality of family planning
services. Among others, a need to address the issue of contraceptive related
side effects, maximize t he method mix, informing users about the proper usage
of oral c ontraceptive, Specialized training for all tJ'J.ose in the field
particularly to c ommunity agents and further study in tlJe area are suggested.
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Keywords
Development