Determinants of implanon discontinuation among women who ever used implanon in Shashamane district, West Arsi zone, Southern Ethiopia: Case-control study

Abstract

Background: Despite tremendous work has been done on demand creation, capacity building and ensuring the logistics of Implanon; Implanon discontinuation rate remained high in Ethiopia. Risk factor of implanon discontinuation varies across different settings according to sociodemographic variations. However, there is a dearth of stronger evidences on those factors in the country and the study area in particular. Therefore, this study was designed to identify the determinants of Implanon discontinuation in Shashamane District, West Arsi Zone, Southern Ethiopia.Methods: A Community based unmatched case-control study was carried out in Shashamane district from April 12 to May 18, 2021 among 88 cases and 176 controls selected using systematic random sampling technique. A pretested, structured questionnaire with face to face interview was used. The collected data were entered using the EPI-INFO7.2.2 and analysed using Statistical Package for the Social Science (SPSS) version 25.0. Bi-variable and multivariable logistic regression analysis was performed and P-value of less than 0.05 was used to declare significance. Crude and adjusted odds ratio with respective confidence interval of 95% was used to show strength of association between variables.Result: The odds of Implanon discontinuation were more among women who can`t read and write [AOR:3.09(1.20- 8.00)], had < 4 living children [AOR:2.47(1.20-5.08)], no history of abortion [AOR:2.84(1.25-6.46)], not ever used contraceptive before Implanon [AOR:2.14(1.02-4.49)], counselled for <15 minutes [AOR:2.47(1.29-4.70)], had no discussion with her partner [AOR:2.88(1.42-5.84)], experiencing side effects after insertion [AOR:0.35(0.17-0.71)] as compared to their counterparts. Conclusion: This study found out that women educational status, number of living children, history of abortion, ever use of any contraceptive, duration of counselling, discussion with partner, and side effects were determinants of Implanon discontinuation. Thus, ensuring counselling before insertion of implanon, managing side effects would improve retention of implanon use. In addition, implanon discontinuation intervention should target partners, new acceptors and those with no formal education.