Western Washington University, 516 High Street MS9118, Bellingham, WA, 98225, USA.
Spelman College, Atlanta, USA.
BMC Womens Health. 2021 Oct 11;21(1):361. doi: 10.1186/s12905-021-01503-1.
In Rwanda, nearly a third of contraceptive users discontinue within the first year of use. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users and minimizing discontinuation is imperative for long-term family planning program success. This study explores the efforts providers and contraceptive users in Rwanda employ to prevent one of the greatest challenges to family planning programs: contraceptive discontinuation.
This was a qualitative study conducted in Rwanda between February and July 2018. It included eight focus group discussions with 88 family planning providers and 32 in-depth interviews with experienced modern contraceptive users. Data were collected in two districts with the highest (Musanze) and lowest (Nyamasheke) rates of contraceptive use. Data were analyzed using thematic content approach.
Family planning providers in this study used the following strategies to prevent discontinuation: counseling new users on the potential for side effects and switching, reminding clients about appointments for resupply, as well as supporting dissatisfied users by providing counseling, medicine for side effects, and discussing options for switching methods. Users, on the other hand, employed the following strategies to prevent discontinuation: having an understanding that experiences of side effects vary by individuals, supporting peers to sustain use, persisting with use despite experiences of side effects, and switching methods.
The strategies used by family planning providers and users in Rwanda to prevent discontinuation suggest the possibility of long-term sustained use of contraception in the country. Harnessing and supporting such strategies could contribute to sustaining or improving further contraceptive use in the country.
在卢旺达，近三分之一的避孕药具使用者在使用的第一年就停止使用。计划生育项目通常更侧重于招募新用户，而不是维持现有用户的使用。关注维持用户并最大限度地减少停药对于长期计划生育项目的成功至关重要。本研究探讨了卢旺达的提供者和避孕药具使用者为防止计划生育项目面临的最大挑战之一（避孕药具停用）所做的努力。
这是一项在 2018 年 2 月至 7 月期间在卢旺达进行的定性研究。它包括与 88 名计划生育提供者进行的 8 次焦点小组讨论和与 32 名有经验的现代避孕药具使用者进行的 32 次深入访谈。数据收集在避孕使用率最高（穆桑泽）和最低（尼亚马舍克）的两个地区进行。使用主题内容分析方法对数据进行分析。
本研究中的计划生育提供者使用以下策略来防止停药：向新用户告知潜在的副作用和更换的可能性，提醒客户有关补充供应的预约，以及通过提供咨询、治疗副作用的药物以及讨论更换方法来支持不满的用户。另一方面，用户采取了以下策略来防止停药：理解个人之间的副作用体验不同，支持同龄人维持使用，尽管有副作用仍坚持使用，并更换方法。
卢旺达的计划生育提供者和用户用来防止停药的策略表明，该国可能长期持续使用避孕药具。利用和支持这些策略可以有助于维持或进一步提高该国的避孕使用率。
