Nega Gali, Abera Muluemebet, Tadele Afework
College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia.
Population and Family Health, Jimma University, Oromia, Jimma, Ethiopia.
Arch Public Health. 2021 May 13;79(1):75. doi: 10.1186/s13690-021-00603-6.
Subdermal contraceptive implant is the most widely used method of long-acting reversible contraception among Ethiopian women. Many, however, discontinue use early, which results in unwanted pregnancies and induced abortions and their associated complications. The aim of this study is to determine the rate of and reasons for discontinuation of the contraceptive implant among users in the Kersa district of southwestern Ethiopia.
A mixed-method study was carried out between March and April 2019 among 475 women who had been using the contraceptive implant between January 2015 and August 2016 in the Kersa district. Systematic random sampling was used for quantitative data collection and purposive sampling was used for qualitative data collection using 8 focus group discussion and 56 In-depth interviews. A binary logistic regression was carried out for bivariate and multivariable analyses.
One hundred and ten (23.2 %) contraceptive implant users requested removal before 2.5 years of use. The main reasons for the discontinuation were side effects, followed by a desire for pregnancy or to switch to another contraceptive method and misconceptions. Implant discontinuation was associated with a lack of information prior to insertion on the effectiveness of modern contraception (adjusted odds ratio [OR] 2.0; 95 % confidence interval [CI] 1.13, 3.55), being served by a midwife or nurse (adjusted OR 1.8; 95 % CI 1.04, 3.23), and not being told to return to the health facility if any side effects were experienced (adjusted OR 1.8; 95 % CI 1.01, 3.19) (all p < 0.05).
Almost a quarter of the study participants discontinued use of the contraceptive implant before the due date. Public health interventions should focus on providing adequate awareness for family planning users, trainings for the health care workers on effective counselling services, especially on side effect and misconceptions.
皮下避孕植入剂是埃塞俄比亚女性中使用最广泛的长效可逆避孕方法。然而，许多人过早停止使用，这导致意外怀孕、人工流产及其相关并发症。本研究的目的是确定埃塞俄比亚西南部克萨地区皮下避孕植入剂使用者的停用率及原因。
2019年3月至4月，对克萨地区2015年1月至2016年8月期间使用皮下避孕植入剂的475名女性进行了一项混合方法研究。定量数据收集采用系统随机抽样，定性数据收集采用目的抽样，进行了8次焦点小组讨论和56次深入访谈。采用二元逻辑回归进行双变量和多变量分析。
110名（23.2%）皮下避孕植入剂使用者在使用2.5年之前要求取出。停用的主要原因是副作用，其次是想要怀孕或改用其他避孕方法以及误解。植入剂停用与植入前缺乏现代避孕有效性的信息（调整后的优势比[OR]为2.0；95%置信区间[CI]为1.13，3.55）、由助产士或护士提供服务（调整后的OR为1.8；95%CI为1.04，3.23）以及未被告知如果出现任何副作用要返回医疗机构（调整后的OR为1.8；95%CI为1.01，3.19）有关（所有p<0.05）。
近四分之一的研究参与者在到期前停止使用皮下避孕植入剂。公共卫生干预应侧重于为计划生育使用者提供充分的认识，对医护人员进行有效咨询服务的培训，特别是关于副作用和误解方面的培训。
