The recent increase in contraceptive discontinuation in Egypt

Khalifa, Mona; Abdelaziz, Wafaa; Metwally, Soha; Sakr, Ehab

doi:10.1017/s0021932019000269

Cited by 11 publications

(9 citation statements)

References 2 publications

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“…The nding was in line with the study conducted in Egypt 46% [20]. This nding was lower as compared with those studies conducted in Vietnam 80 % [21] Malawian 58% [9], Zambia 89% [10], and Vietnam 66.7% [22].…”

Section: Discussionsupporting

confidence: 85%

Method Shifting from Long to Short Term Contraceptives and its Associated Factors among Reproductive Age Women, Northwest Ethiopia, 2018

Desalegn¹,

Habitu

Yenit

2019

Preprint

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Objective: Even if long term contraceptives are more effective, cost efficient and tolerable choices, method shifting from long to short term contraceptives continued as a global issue. Therefore this study assessed the proportion and associated factors of method shifting from long term to short term contraceptives in Gondar city administration, northwest Ethiopia. Result: A total of 390 women participated in the study that made the response rate of the current study as 96%. The overall proportion of method shifting from long to short term contraceptives was 48.5% with (95% CI: 43.8, 53.3). Had secondary level educational status (AOR=0.18, 95%CI 0.07, 0.51), had information about long acting contraceptives from friends (AOR=6.67, 95%CI 1.89, 23.52), use of long acting contraceptives for limiting purposes (AOR=0.26, 95%CI 0.11, 0.60), and had enough counseling on long acting contraceptives during ANC visits (AOR=0.20, 95% CI 0.08, 0.50) were found to have statistically significant association with method shifting.

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Section: Discussionsupporting

confidence: 85%

Method Shifting from Long to Short Term Contraceptives and its Associated Factors among Reproductive Age Women, Northwest Ethiopia, 2018

Desalegn¹,

Habitu

Yenit

2019

Preprint

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“…The use of hormonal methods increased from 19.7% to 27.4% for pills and from 12.3% to 14.5% for injectables, and the share of IUD use dropped from 59.9% to 51.5%. An alarming increase in the total fertility rate (TFR) from 3.0 to 3.5 children per woman was documented over the period 2008-2014(Ministry of Health and Population et al, 2015a. Three national strategic objectives have been defined: to increase the contraceptive prevalence to 72%, reduce the discontinuation rate (within 12 months of use) to 18% and reduce the proportion of unmet need for family planning from 13% to 6% (National Population Council, 2015).…”

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confidence: 99%

The recent increase in contraceptive discontinuation in Egypt

et al. 2019

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This study sought to establish whether recent changes in discontinuation of contractive use and switching in Egypt can be considered an important cause of the unexpected increase in overall fertility and slight fall in contraceptive prevalence in the country. The analysis was based on calendar data from the 2008 and 2014 Egyptian DHS. Single/multiple decrement life tables were built to calculate contraceptive discontinuation rates and examine these by reasons for discontinuation focusing on three methods: IUDs, pills and injectables. The unit of the analysis was ‘segment of use’, defined as a continuous period of use/non-use of a contraceptive method (in months). It was found that over the period 2008–2014 the rise in the ‘all method’ discontinuation rate was mainly due to the shift away from IUDs to hormonal methods, which have higher discontinuation rates. Segments of use were more likely to be discontinued for ‘method/service-related’ reasons than for ‘reduced need’ reasons. This was due to an increase in contraceptive failure and side-effect/health concerns. Also, ‘the desire to get pregnant’ increased to become the second highest reason-specific discontinuation rate. This has coincided with a recent increase in ideal family size in Egypt. About half of the women who reported discontinuing for reasons related to method/services switched to another method, while the rest became subject to the risk of an unintended pregnancy. The rate of switching, rather than stopping use, increased for IUDs, remained the same for pills and increased slightly for injectables, indicating an improvement in switching behaviour. However, a marked high percentage of switchers moved to less-effective methods. If these issues are not addressed, many women in Egypt have an unmet need for contraception, leading to an increase in unintended pregnancies. Specific interventions that would greatly benefit the family planning programme in Egypt include improvement in counselling at the time of IUD insertion and removal and the reduction in failure rates for hormonal methods.

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“…However, in EDHS2014 the reason "desire to become pregnant" emerges as the second highest reason for discontinuation (20.8 per cent). The increase in the share of "desire to become pregnant" among reasons for discontinuation is a recent trend and was observed in EDHS2008 (Khalifa et al, 2019).…”

Section: All Methods Discontinuation By Socio-economic Characteristicsmentioning

confidence: 99%

Contraceptive discontinuation in Egypt as fertility returns to its 2000 level

Khalifa

Hussein

Metwally

2020

JHASS

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Purpose The similarity of family planning (FP) indicators from EDHS2014 to that of EDHS2000 is alarming for policymakers and researchers who consider it as an echo of the past and a threat, which the FP programme has to face to prevent its progression. In 2000, the total fertility rate (TFR) was 3.5, the contraceptive prevalence rate was 56.1% and the discontinuation rate was 29.5%. In 2014, these indicators were 3.5, 58.5 and 30.1%, respectively. Although the change in the all method discontinuation rate is not large, it is a result of great changes in the method specific discontinuation rates, which was masked by changes in the contraceptive method mix. This study aims to present a comparison between contraceptive discontinuation rates in 2000, 2008 and 2014, discuss the reasons for discontinuation by methods and background characteristics of women and calculate the impact of eliminating discontinuation for reasons related to method and service provision on fertility. Design/methodology/approach Single/multiple decrement life tables were applied to the calendar data of the EDHS2008 and EDHS2014, to examine various net rates of contraceptive discontinuation by reasons and the status after discontinuation. The TFR estimated in the absence of method failure and abandonment while in need of births occurred within 24 months after discontinuation using installed Stata command tfr2. Findings The study estimates the impact of discontinuation on the TFR in 2014 to be an increase of about 20%. The TFR of 3.5 would have been only 2.8 if discontinuation due to method failure and method/service-related reasons were eliminated. Improvement regarding discontinuation behaviour is evident by increased switching, from 43.6 to 54.3% and the drop in the proportion of abandoning use while in need from 56.4 to 45.7%. Differentials suggest that discontinuation is expected to increase among vulnerable groups as desired fertility continues to rise. The increase in the share of “desire to become pregnant” – as a reason for discontinuation is a recent trend observed during the period between EDHS2008 and EDHS2014 and is recognised as a challenge by the national population strategy. Originality/value This study confirms that contraceptive discontinuation is an important part of the overall fertility increase observed by EDHS2014. The rising trend of increased desired family size and the shift away from using the intra uterine device may be considered as major challenges facing the FP programme in Egypt.

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The recent increase in contraceptive discontinuation in Egypt

Cited by 11 publications

References 2 publications

Method Shifting from Long to Short Term Contraceptives and its Associated Factors among Reproductive Age Women, Northwest Ethiopia, 2018

Method Shifting from Long to Short Term Contraceptives and its Associated Factors among Reproductive Age Women, Northwest Ethiopia, 2018

The recent increase in contraceptive discontinuation in Egypt

Contraceptive discontinuation in Egypt as fertility returns to its 2000 level

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