Contraceptive discontinuation for method-related reasons, while presumably wanting to avoid pregnancy, is a common phenomenon and can contribute to high levels of unmet need and unplanned pregnancies. Some women discontinue contraceptive use and do not quickly resume a method ("stopping"), while others are able to quickly switch to another method to achieve their reproductive goal of avoiding pregnancy ("switching"). We use Demographic and Health Survey data from countries to examine what differentiates women who were able to switch to another method versus those who ultimately stopped entirely, among women who discontinued contraception for method-related reasons. Results show that wanting to limit births, having ever been married, and recent prior use are all associated with switching versus stopping. In addition, we find that women in West and Middle Africa were more likely to stop use compared to women in other regions. Addressing obstacles to contraceptive continuation, including effective method switching, among women who wish to delay or avoid pregnancy should be a priority for global and country initiatives aiming to deliver client-centered care that supports women and couples to make their best family planning choices.
Data on contraceptive use dynamics are difficult to measure, analyze, and present, especially to policy audiences.n Visualization tools, such as Sankey diagrams, are one way to better connect policy audiences with easily understandable contraceptive use dynamics data that will support them in centering women's needs and preferences during program design and implementation.n Users found the Choices and Challenges tool to be an alternative approach for introducing the complex topic of contraceptive adoption, discontinuation, and switching to policy and program decision-makers.nThe Choices and Challenges tool has been effectively used to ensure contraceptive discontinuation and switching are key considerations within national policy documents.nThe Choices and Challenges tool can be an effective, evidence-based resource that enables policy and program decision-makers to deliver high-quality, client-centered care that supports contraceptive autonomy and choice.
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