Nageso Abreham, Gebretsadik Achamyelesh
School of Public and Environmental Health, Hawassa University, Hawassa, Ethiopia.
BMC Womens Health. 2018 Nov 20;18(1):189. doi: 10.1186/s12905-018-0678-x.
Early discontinuation of the Implanon contraceptive method and reasons for such discontinuation remains a major concern for family planning programs. In less developed countries, contraceptive discontinuation due to health concerns is generally higher, these complaints are often related to service quality. Significant numbers of women become exposed to conception after discontinuation and accidental pregnancies that end up with abortion & stillbirth. The aim of this study was to assess the early discontinuation rate of Implanon and identify its associated factors among women who ever used Implanon in 2016 in Dale district, Southern Ethiopia.
Community based cross-sectional study design was conducted from January to February, 2017. A total number of 711 women who ever used Implanon in 2016 were selected using multistage sampling. The data were entered and cleaned in Epi Info and analyzed using SPSS. Multivariate logistic regression analysis was used to determine the effect of factors on the outcome variables. Finally, the results were presented using adjusted odds ratio (AOR) & confidence interval of 95%.
Early Implanon discontinuation rate in this study was 160 (23.4%) with a mean duration of Implanon use of 9.6 ± 2.5 months. The main reasons for discontinuation of Implanon were 55 (34.4%) the facing of side effects. Factors for discontinuation of Implanon were women age 20-24 years (AOR =. 44 (95% CI: 23-. 85), 25-29 years (AOR =. 52 (95% CI: 27-. 96), 35+ years, (AOR =. 08 (95% CI: 02-. 41), less likely to discontinue. Women who weren't counseled about the side effects during Implanon insertion were 1.93 times (AOR = 1.93 (95% CI: 1.27-2.93), women who didn't satisfied by the service (AOR = 2.55(CI: 95%: 1.63-3.97), women who didn't appointed for follow up (AOR = 3.13 (CI: 95%: 2.0-4.95), women who didn't choose the method by themselves (AOR = 1.83 (CI: 95%: 1.18-2.83) and women who didn't have information on family planning before Implanon insertion (AOR = 1.52 (CI: 95%: 1.1-2.28) were the predictors of Implanon discontinuation.
Implanon discontinuation rate in this study area was high. Appropriate counseling prior to insertion and proper follow up, autonomous choice will improve the continuation rate of Implanon.
依伴侬避孕法的早期停用及其停用原因仍是计划生育项目的主要关注点。在欠发达国家,因健康问题导致的避孕药具停用率通常较高,这些投诉往往与服务质量有关。大量女性在停用避孕药具后面临受孕风险,意外怀孕最终导致流产和死产。本研究的目的是评估依伴侬的早期停用率,并确定2016年在埃塞俄比亚南部戴尔地区使用过依伴侬的女性中其相关因素。
于2017年1月至2月进行了基于社区的横断面研究设计。采用多阶段抽样选取了2016年曾使用过依伴侬的711名女性。数据录入Epi Info并进行清理,然后使用SPSS进行分析。采用多变量逻辑回归分析来确定各因素对结果变量的影响。最后,结果以调整后的优势比(AOR)和95%置信区间呈现。
本研究中依伴侬的早期停用率为160例(23.4%),依伴侬的平均使用时长为9.6±2.5个月。依伴侬停用的主要原因是55例(34.4%)出现副作用。依伴侬停用的因素包括年龄在20 - 24岁的女性(AOR = 0.44(95%CI:0.23 - 0.85))、25 - 29岁的女性(AOR = 0.52(95%CI:0.27 - 0.96))、35岁及以上的女性(AOR = 0.08(95%CI:0.02 - 0.41)),停用可能性较小。在依伴侬植入过程中未得到副作用咨询的女性停用的可能性是1.93倍(AOR = 1.93(95%CI:1.27 - 2.93)),对服务不满意的女性(AOR = 2.55(95%CI:1.63 - 3.97))、未被安排随访的女性(AOR = 3.13(95%CI:2.0 - 4.95))、未自行选择该方法的女性(AOR = 1.83(95%CI:1.18 - 2.83))以及在依伴侬植入前没有计划生育信息的女性(AOR = 1.52(95%CI:1.1 - 2.28))是依伴侬停用的预测因素。
本研究区域内依伴侬的停用率较高。植入前进行适当咨询、进行妥善随访以及自主选择将提高依伴侬的续用率。