Early Discontinuation of Contraceptive Use In Niger and The Gambia

Cotten, Niki U.; Stanback, John; Maidouka, Halima; Taylor-Thomas, Joseph T.; Turk, Tom

doi:10.2307/2133542

Cited by 50 publications

(41 citation statements)

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“…The findings that receiving family planning advice and higher quality of care predicts contraceptive use are consistent with those of previous studies that show relationships between maternal and child health services and contraceptive use, [8][9][10] or between technical quality and contraceptive use [19][20][21] or prevalence. 22 Previous studies in Mexico also illustrate the importance of family planning advice and counseling.…”

Section: Discussionsupporting

confidence: 90%

Family Planning Advice and Postpartum Contraceptive Use Among Low-Income Women in Mexico

Barber¹

2007

IFPP

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Quality family planning services are an important means of increasing knowledge about contraception and acceptance of effective methods, as well as influencing method choice. 1 In the 1970s, low contraceptive prevalence and poorly functioning health systems existed in many developing countries; in such settings, vertical delivery systems and community-based health workers were essential to the rapid increase of contraceptive knowledge and prevalence. Over time, however, the mode of family planning service delivery has evolved. Today, many family planning programs have been integrated into formal health delivery structures for a number of reasons. These include the success of earlier programs in sustaining contraceptive demand, the relatively high cost of community-based delivery, declining budgets for family planning and the need to increase efficiency in supervision and management. [2][3][4] A review of trials on integrated service delivery, however, found no consistent benefit of integration on patient outcomes, costs or health system performance in less developed settings, although the number of studies was small and their designs limited comparisons. 4 Nonetheless, two of the trials demonstrated that integration of family planning service delivery results in increased contraceptive use or uptake. 5,6 Because the demand for contraception fluctuates over the course of a woman's reproductive life, the timing of service delivery must be considered as part of any integration effort. The postpartum period is particularly important because appropriate birthspacing can improve maternal and infant health. 7 Moreover, the demand for effective contraception may be high immediately after delivery. Previous cross-sectional studies report positive associations between maternal and child health service use [8][9][10] and subsequent contraceptive use. In addition, prenatal services offer the opportunity to reach women who would be the primary target of family planning services. Because of this, global strategies have used prenatal care as an entry point in the delivery of core reproductive health services, including family planning. 11 The site of the present study is Mexico, a middle-income country of 106 million people, more than three-quarters of whom reside in urban areas. 12 During the 1980s, the Mexican government established community-based distribution programs to help reduce population growth rates through the rapid introduction of modern contraceptives. 13 These programs were integral to a doubling of the contraceptive prevalence rate from 30% in 1976 to 60% in 2005. 14,15 Although community-based health workers were essential to delivering family planning services to remote and rural populations in the 1970s, their role has diminished with urbanization and increased access to primary health facilities. Taking an integrated approach to service delivery, the Ministry of Health has incorporated family planning counseling into the national clinical guidelines for prenatal care. 16 The relationship between wome...

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Section: Discussionsupporting

confidence: 90%

Family Planning Advice and Postpartum Contraceptive Use Among Low-Income Women in Mexico

Barber¹

2007

IFPP

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“…11,18 Contraceptives play an important role in improving women's health by avoiding unwanted or mistimed pregnancies, reducing the risks of unsafe abortion, increasing birth intervals, and allowing women to recover from the strain of pregnancy. 5,6,12,19 It is argued that use of family planning also decreases women's exposure to the risk of maternal mortality and is unique in providing a range of non-contraceptive health benefits including protection against endometrial and ovarian cancers. 20 During the mid 1970s and early 1980s, the FP program was dominated by semipermanent and permanent methods such as intrauterine devices (IUD), tubectomy and vasectomy.…”

Section: Introductionmentioning

confidence: 99%

“…23 Comparable evidence from developing countries also suggests higher discontinuation rates. 19,24,25 Moreover, one-third of the unwanted pregnancies in south Asian countries are because of OCP misuse, failure or discontinuation. Thus, discontinuation of OCP use has been considered as a main factor hindering further decline in fertility.…”

Section: Introductionmentioning

confidence: 99%

“…6,12,25 Several studies have cited the experience of sideeffects or other health problems as the main reason for early discontinuation of OCP. 12,19,[24][25][26] Half of Bangladeshi women who discontinue pill use attribute their decisions to side-effects. 11,12 In Niger and Gambia, nearly 30% of new FP users discontinued use within the first 8 months of acceptance primarily because of side-effects.…”

Section: Introductionmentioning

confidence: 99%

“…11,12 In Niger and Gambia, nearly 30% of new FP users discontinued use within the first 8 months of acceptance primarily because of side-effects. 19 Others argued that behavioral and cultural factors also influence the contraceptive use dynamics and method choice. 5,18,23,27,28 In Indonesia, women who were given the method they desired had a discontinuation rate of 9%, compared with 72% for women who were not given their chosen method.…”

Section: Introductionmentioning

confidence: 99%

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Determinants of oral contraceptive pill use and its discontinuation among rural women in Bangladesh

Ullah

Humble²

2006

Reprod Med Biol

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Oral contraceptive pills (OCP) contribute a major share in the current method-mix in Bangladesh. However, multiple studies show high discontinuation rates of OCP. The present study examines the behavior and attitude towards OCP use, and investigates the determinants of its discontinuation among the rural married women of Bangladesh.The present study is based on critical analyses of the data from 24 focus group discussions and 135 in-depth-interviews with women, their husbands and key informants conducted over the period of 1 year.The present study shows that more than two-thirds of married women have at one time or another used OCP as a method of family planning. However, many women did not take the pills regularly and about one-quarter of ever users had taken, at one stage or another, a 'short break' from OCP use. Although nearly half of them took a break because of side effects, interestingly, 16% took a break as the result of fear of health problems that were related to 'folk stories' and other misconceptions. The individual assessment by users of the national family planning service delivery, perceived side effects, misconceptions about continuous use of pills, quality of counseling and information, and contraceptive behavior of the OCP users considerably influenced the decisions on contraceptive use or non-use. (Reprod Med Biol 2006; 5: 111-121)

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Contraceptive Implant Discontinuation in Huambo and Luanda, Angola: A Qualitative Exploration of Motives

Qiu

Juarez

Carvalho

et al. 2017

Matern Child Health J

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Introduction The Government of Angola is engaged in ongoing efforts to increase access to contraceptives, in particular contraceptive implants (CIs). Discontinuation of CIs, however, has been identified as being a challenge to this work, hindering the improvement of contraceptive prevalence, and in turn, maternal and child health. The objective of this study was to understand motives for contraceptive implant discontinuation in Luanda and Huambo, Angola. Methods We conducted 45 in-depth interviews and six focus groups amongst former and current contraceptive implant clients and family planning nurses in eight clinics across the provinces of Huambo and Luanda. Data collectors transcribed and translated key information from Portuguese into English. We used a combined deductive/inductive approach to code and analyze data. Results Participants described adverse side effects, desire for pregnancy, partner dissatisfaction, quality of care, alternative or lack of information, and religion as motives for discontinuation. Adverse side effects, including prolonged bleeding, amenorrhea, and headaches were most commonly cited by both clients and providers. Discussion Motives for discontinuation reflect existing findings from other studies in similar settings, in particular the influence of adverse side effects and desire for pregnancy as motivating factors. We contextualize these findings in the Angolan setting to tease out the relationship between cultural norms of ideal family size and the perceived role of women in regards to fertility and child-bearing. We suggest that programs enter into dialog with communities to address these concerns, rather than working exclusively on improving service delivery and quality.

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Early Discontinuation of Contraceptive Use In Niger and The Gambia

Cited by 50 publications

References 2 publications

Family Planning Advice and Postpartum Contraceptive Use Among Low-Income Women in Mexico

Family Planning Advice and Postpartum Contraceptive Use Among Low-Income Women in Mexico

Determinants of oral contraceptive pill use and its discontinuation among rural women in Bangladesh

Contraceptive Implant Discontinuation in Huambo and Luanda, Angola: A Qualitative Exploration of Motives

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