Contribution of Contraceptive Discontinuation to Unintended Births in 36 Developing Countries

Jain, Anrudh K.; Winfrey, William

doi:10.1111/sifp.12023

Cited by 90 publications

(89 citation statements)

References 9 publications

(15 reference statements)

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“…Access to effective and affordable prevention technologies, both those currently available and those being developed, may facilitate protection; however, access is not enough. For example, many unintended pregnancies can be attributed to incorrect use, inconsistent use or nonuse of available contraceptives, or to interruptions in contraceptive coverage during periods of discontinuation or method switching . Whether an individual uses contraceptives is related to a constellation of individual and social factors, such as desire to avoid pregnancy, demographic characteristics (e.g., education, race, age), frequency of sexual intercourse, relationship status and interactions with health care providers .…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

Vargas

Midoun

Guillen

et al. 2019

Perspect Sexual Reproductive

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CONTEXT Vaginal rings are available for contraception and hormone replacement, and are being developed as HIV/STD or multipurpose prevention technologies. A comprehensive understanding of women's expectations of and experiences with rings is urgently needed to inform product development and to optimize ring use. METHODS Three databases (PubMed, Global Health and CINAHL) were searched for English‐language, peer‐reviewed articles published between January 1996 and November 2017 that reported qualitative data on barriers to and facilitators of use of female‐controlled contraceptive methods. Data on study methods, findings and conclusions pertaining to contraceptive rings were extracted, organized and analyzed. RESULTS Twenty‐six articles, all published since 2008, met the inclusion criteria. Seven studies focused largely or entirely on rings (and involved current, former or potential users), while the others focused on other contraceptive methods but included ring‐specific data. Familiarity with the ring was low, and women commonly had initial concerns about the method—often related to insertion and removal, cleanliness and discomfort with touching their vagina—that were typically overcome over time. Other major themes were issues related to ring use and discontinuation, the importance of ring‐related properties and characteristics, and considerations related to sexual partners and health care providers. CONCLUSIONS Qualitative data have the potential to inform ring design and promotion. Future research should further explore women's expectations and experiences with the ring, the value of involving male partners in ring evaluation, and evaluation of interventions to improve patient–provider communication concerning ring choice and use.

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Section: Discussionmentioning

confidence: 99%

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

Vargas

Midoun

Guillen

et al. 2019

Perspect Sexual Reproductive

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show abstract

“…Contraceptive users and family planning providers alike noted how helpful providers can be in warning new users about the likely experience of side effects -as well as with switching if side effects became unbearable. Many researchers have concluded the importance of quality family planning services -in particular, family planning provider counseling on the anticipated side effects and switching as one deterrent to contraceptive discontinuation (2)(3)(4)6,7,10,11,14,(22)(23)(24)(25)(26)(27)(28); while others suggest that programs and providers have little impact on continuation (13,17). One study analyzed the correlation between discontinuation rates and family planning program effort scores, and found a negative relationship, albeit weak, and concluded that family planning programs can impact discontinuation, particularly in terms of training and supervision of providers (5).…”

Section: Resultsmentioning

confidence: 99%

“…Researchers examining data from 36 developing countries estimated that approximately a third of unintended births are due to contraceptive discontinuation. Globally, that could mean that 25 million of the 75 million unintended births are due to contraceptive discontinuation (2). Studies report discontinuation rates at 6-56% after just 12 months of contraceptive use (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13).…”

mentioning

confidence: 99%

“Due to the side effects she has when using the method it will be difficult for nurses to convince her to continue with that method. That’s why I said she will leave with another method.”: Family planning providers and contraceptive users in Rwanda do not consider discontinuation an option

Schwandt

Boulware

Corey

et al. 2019

Preprint

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Background Contraceptive discontinuation is a common event. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users is imperative for long-term family planning program success. Methods This qualitative study in Rwanda in 2018 included eight focus group discussions with family planning providers and 32 in-depth interviews with contraceptive users. The data were collected in the two districts with the highest and lowest rates of contraceptive use, Musanze and Nyamasheke, respectively. The aim of this study is to better understand contraceptive use dynamics in Rwanda. Results Family planning providers and current users in Rwanda do not consider method discontinuation an option. Providers give support and medicine for side effects for continuers and counseling for those opting to switch. Current users are willing to try many methods until they find the right one for them – and once they find the right method, they plan to, or use the method, for long durations. Conclusions The Rwandan family planning program is primed to meet the needs of users in their sustained use of contraceptives through empathetic and responsive counseling. Concurrently, family planning users are determined to use family planning to meet their desired family size goals. The matching goals of both providers and clients indicates that contraceptive use will likely continue to increase in the future in Rwanda; however, due to long periods of pregnancy prevention desired – increased use of long acting methods should be encouraged.

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“…The 'how' or mechanisms through which payments for specific services are made can be an important determinant of whether and how well services are provided (McLoughlin and Leatherman, 2003). In the case of FP, research shows that contraceptive discontinuation decreases, and contraceptive use increases with improved quality of care (Jain et al, 2017;Jain and Winfrey, 2017). 'Who' these payments are made to equally matters.…”

Section: Section 3 Fp and Strategic Purchasingmentioning

confidence: 99%

“…The private sector may also be excluded. Considerations such as these are critical to FP given that contraceptive discontinuation accounted for about 38% of women with unmet need and accounted for about 35% of unintended pregnancies (Jain et al, 2017;Jain and Winfrey, 2017).…”

Section: Section 3 Fp and Strategic Purchasingmentioning

confidence: 99%

Health financing and family planning in the context of Universal Health Care: Connecting the discourse

Appleford¹,

RamaRao²

2019

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Section one outlines salient features of health financing and UHC as well as related trends • Section two outlines health financing for FP, current emphasis of financing efforts and the evidence base• Section three outlines strategic purchasing and FP and its relationship with quality FP services • Section four proposes an organizing framework for strategic purchasing for FP, outlining purchasing elements and FP considerations MARCH 2019The Population Council conducts research and delivers solutions that improve lives around the world. Big ideas supported by evidence: It's our model for global change. popcouncil.org

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Contribution of Contraceptive Discontinuation to Unintended Births in 36 Developing Countries

Abstract: High contraceptive discontinuation results in millions of

Cited by 90 publications

References 9 publications

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

A Qualitative Systematic Review of Women's Experiences Using Contraceptive Vaginal Rings: Implications for New Technologies

“Due to the side effects she has when using the method it will be difficult for nurses to convince her to continue with that method. That’s why I said she will leave with another method.”: Family planning providers and contraceptive users in Rwanda do not consider discontinuation an option

Health financing and family planning in the context of Universal Health Care: Connecting the discourse

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