Prevalence of Early Removal of Long-Acting Contraceptive Methods and Its Associated Factors in Sidama Regional State, Ethiopia

Abstract

Background Long-acting reversible contraceptive methods, IUD and sub-dermal implant, offer women the most effective method to control fertility. Yet, reports on high early removal rates were emerged, prompting concern among service providers and highlighting the need to review removal rates and its reasons. Therefore, this study was conducted to assess the prevalence of early removal rates of LARCs and its associated factors in Sidama Regional State, Southern Ethiopia. Methods Community-based cross-sectional study was conducted in Sidama Regional State, Ethiopia from June 1 to June 30, 2019. A multistage sampling technique was used to select 21 administrative units in the first stage. Then, systematic sampling was used to select 475 women who have ever used implants or IUD 3 years preceding the data collection period. Data were entered into Epi Info version 3.4.3 and exported to SPSS version 20 for analysis. Descriptive statistics, bivariate, and multivariate logistic regression were computed. P-value <0.05 was used to declare a significant association. Results The mean (±SD) of the participant’s age was 29.81 (±5.69) years. The prevalence of early removal rate of LARCs was 10.3%, ie, 43 (10.8%) among Implanon/jadelle users and 6 (7.8%) among IUD users. Eleven (22.4%) discontinued within the first six months and 38 (77.6%) utilized for more than six months and discontinued before the 12th month. Women who were not advised about advantage [OR= 2.81 (95% CI: 1.23–6.40)] and effectiveness of contraceptive [OR= 2.70 (95% CI: 1.30–5.60)] and those who were satisfied with the family planning service [OR= 2.24 (95% CI: 1.10–4.57)] were identified as factors. Conclusions The prevalence of early removal rate was considerably high among the study subjects. Providing appropriate counseling about the advantage and effectiveness of family planning and improving client satisfaction need to be considered to reduce the early removal rate.

Factors Influencing Discontinuation of Long-Term Contraceptive Methods

“…This is due to the level of awareness and understanding of contraceptive properties (Abebe et al, 2020). This is in line with the findings by Geja et al, (2021) that women with higher education are less likely to stop longterm contraception before one year of use. The use of long-term contraceptive methods is higher among educated women than among those who are not educated.…”

“…Based on the 8 articles that were the sample of the study, it can be seen that the factors influencing discontinuation of long-term contraceptive methods are marital status (Grunloh et al, 2013), education (Abebe et al, 2020;Abeje et al, 2020;Geja et al, 2021;Isa et al, 2020), counseling (Abebe et al, 2020;Geja et al, 2021;Weldekidan et al, 2022), age (Abeje et al, 2020;Geja et al, 2021;Isa et al, 2020), parity (Abeje et al, 2020;Bereku et al, 2022;Isa et al, 2020), employment (Isa et al, 2020), contraceptive satisfaction (Geja et al, 2021;Mihretie et al, 2022), partner support (Mihretie et al, 2022), duration of visits to health facilities (Weldekidan et al, 2022), desire to become pregnant again (Abebe et al, 2020;Abeje et al, 2020;Weldekidan et al, 2022) and side effects (Weldekidan et al, 2022). Long-term contraceptive discontinuation among women with low education was 2.3 times higher than among those with higher education.…”

“…Women between the ages of 25 and 29 years and those between the ages of 30 and 34 years are 10 and 11 times more likely to stop using a long-term contraceptive method within a one-year period compared to women over 35 years of age (Geja et al, 2021). Women in their 20s are more likely to stop using contraception, because younger women are associated with the highest fertility rates and are more likely to initiate active childbearing (Bawah et al, 2021).…”

“…If women have very clear information about the services provided, they will experience fewer side effects and may have a higher chance of continuing long-term contraceptive methods (Obsu et al, 2022). Women who are dissatisfied with family planning services are 2 times more likely to stop the method earlier than those who are satisfied (Geja et al, 2021). Low levels of satisfaction can result from inadequate information or understanding during counseling at method initiation.…”

Discontinuation of long acting reversible contraceptive use and its determinants among women in Ethiopia: Systematic review and meta-analysis

“…Both community and institutional studies were equally represented (10 studies in each). Nine studies conducted in Southern Nations Nationalists and Peoples Region ( 23 , 27 , 31 , 32 , 34 – 37 , 39 ), five in Amhara ( 26 , 28 – 30 , 41 ), three in Tigray ( 40 , 42 , 43 ), and three in Oromia ( 33 , 38 , 44 ). The sample sizes ranged from 222 to 1050.…”