A qualitative study on reasons for early removal of Implanon among users in Arba Minch town, Gamo Goffa zone, South Ethiopia: a phenomenological approach

Abstract

BackgroundImplanon is one of the cost - effective long acting reversible contraceptive methods used for spacing and limiting births in Ethiopia. Despite the scaling up initiative undertaken by the Ethiopian Government, Implanon uptake is very low compared to short acting contraceptive methods. There is low utilization of Implanon with high level of discontinuation in Ethiopia. Therefore, this study was conducted to explore the reasons for early removal of Implanon among users in Arba Minch town, South Ethiopia.MethodsA community-based qualitative exploratory study using phenomenological approach was conducted. In-depth and key informant interviews were used to collect data from April 20–27, 2018 in Arba Minch town. Convenient sampling was employed to recruit participants from the households of targeted villages. A total of 10 in-depth interviews with women who recently removed Implanon and 5 key informant interviews with health extension workers were conducted. The sample size was determined based on the concept of saturation. The collected data were analyzed using thematic content analysis technique. Data coding and analysis were facilitated by using Open code version 4.0 software.ResultsThis study revealed that majority of participants were able to mention at least three types of contraceptive methods available in the nearby health facilities. The study underlined that side effect of the method, husband opposition, seeking more children, and method failure were the common reasons for early removal of Implanon, in which side effect of the method was the main reason. Among various forms of side effects of Implanon identified by users, heavy and irregular bleeding was mentioned as the most frequently occurring side effect.ConclusionOur result indicated that heavy and irregular bleeding was the main reason for early removal of Implanon. Therefore it suggests improvement in the service delivery system. Improving client’s education and counseling service program could contribute much to avoid unreasonable and untimely removal of Implanon.

Lived experience of women who underwent early removal of long-acting Contraceptive Methods in Bedesa town, Wolaita Zone, Southern Ethiopia: A phenomenological study

“…This study identi ed side effects as the main reason for the early removal of LAFP which is consistent with other studies [8,10,[16][17][18][19][20][21][22]. The most frequently mentioned side effects were heavy and irregular menses, weight change, and dizziness.…”

“…This study found that most of the participants had information about family planning methods which is consistent with a similar research conducted in Arba Minch town [6]. However, the ndings of demographic and health surveys of Ethiopia showed that women in reproductive age know lesser information on family planning methods [11,12].…”

“…Such imbalance between population size and economic growth will certainly have a negative impact on the wellbeing of the nation. Family planning is considered as the key strategy used to improve the imbalance mentioned above and tackle existing problems [6].…”

“…Another mixed method study conducted by FMOH showed that 17% of the women removed their Implanon before the recommended removal date [7]. A similar study conducted in the Tigray region showed that the Implanon discontinuation rate in 1 year was 16% [8,9]. The most common reason for discontinuation are the desire to become pregnant, side effects, wanting a more effective method, infrequent sex or husband away, and inconvenience of use [10].…”

“…Wolaita Zone is characterized by a crude population density of 385 people/square kilometer [6]. Since providing the most effective contraceptive methods is a vital strategy for the improvement of balancing population growth with the economic growth of the locality.…”