Determinants of Implant Utilization among Married Women of Childbearing Age in Chencha Town, Southern Ethiopia, 2017: A Case-Control Study

Abstract

Globally, 53% of women in reproductive age group use modern methods of contraception, with less than one percent of which using implants. In Ethiopia and other parts of sub-Saharan Africa, short-term contraceptive methods have been more utilized than long-acting methods like implants. Despite their effectiveness, implants have been underutilized due to various reasons. There is a dearth of stronger evidences on those factors in the country in general and the study area in particular. Therefore, this study aimed to identify determinants of implant utilization among married women of reproductive age at Chencha town, Gamo Gofa Zone, Southern Nations, Nationalities, and Peoples’ Region (SNNPR) of Ethiopia. A community-based case-control study design was conducted among 324 women of reproductive age, 90 cases (users of implants) and 234 controls (users of short-acting contraceptives) from July to August 2017. Data were collected using a pretested, structured questionnaire through face-to-face interview. The data were entered and coded using Epi info 3.5.1 and then exported to Statistical Package for Social Sciences (SPSS) version 20 for cleaning and analysis. Descriptive analysis was done to quantify proportions, means, and standard deviations of variables. Bivariate and multivariable logistic regressions were done to identify the determinants of implant utilization. A total of 324 married women of reproductive age group were interviewed with response rate of 98%. In this study, the major determinants for implant utilization were desire to have 3–4 children {AOR = 0.104, 95% CI (0.03, 0.4)}, husband disproval {AOR = 0.11, 95% CI (0.038, 0.314)}, joint decision {AOR = 3.11, 95% CI (1.02, 9.48)}, and decision by other persons {AOR = 0.065, 95% CI (0.012, 0.352)}. This study found out that desire to have more children, husband disapproval, joint decision making, and decision by other persons were determinants of implant utilization among the target women. Implant utilization would improve through strengthening existing interventions targeting women with high fertility desire, transformation of gender norms in household decisions, and counseling for informed decisions.

Evaluation of Subdermal Birth Control Implants Use among Married Women of Reproductive Age in a Metropolitan City of Bangladesh

“…This finding is consistent with other studies. 3,4,12,[14][15][16] Most of the women (27.5%) had education up to SSC/HSC level and 22% had no formal education. This finding is similar to a study done by Mubarik et al 16 which reflects the education status of women in rural areas of Pakistan.…”

“…17 In this study, we found about 142 (71%) participants had adequate information or idea about subdermal implants which is in concordance with other studies. 3,4,18 But another study done by Mubarik et al in Pakistan showed that implant was used by a very little proportion of women which was only 21%. 16 This probably makes implant the least used contraceptive method in Pakistan.…”

“…1,2 The use of long-acting methods like implants in a country shows that the family planning (FP) program is highly effective in spacing and limiting births similarly to other developing countries of the world. 2,3 These reversible contraceptives have higher continuation rates and higher user satisfaction than short-term methods (such as pills, injectables, and condoms). [4][5][6] Subdermal implants are effective, safe and long-acting reversible hormone-releasing forms of contraception for an extended period after a single administration.…”

“…[4][5][6] Subdermal implants are effective, safe and long-acting reversible hormone-releasing forms of contraception for an extended period after a single administration. 3,4 These consist of small, thin flexible matchstick-sized rods inserted under the skin on the upper arm and release small amounts of progestin hormone to prevent pregnancy for 3 to 5 years. [3][4][5] The primary mode of action of all subdermal implants is to suppress ovulation by altering the hypothalamopituitary-ovarian axis and secondarily thickening of the cervical mucus & preventing implantation by thinning the endometrium.…”

“…3,4 These consist of small, thin flexible matchstick-sized rods inserted under the skin on the upper arm and release small amounts of progestin hormone to prevent pregnancy for 3 to 5 years. [3][4][5] The primary mode of action of all subdermal implants is to suppress ovulation by altering the hypothalamopituitary-ovarian axis and secondarily thickening of the cervical mucus & preventing implantation by thinning the endometrium. [7][8][9] Women with several risk factors like lactation, diabetes, post-abortion state, HIV infection, cigarette smoking, cardiovascular diseases (including those with high blood pressure), and also adolescents can safely use implants.…”