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埃塞俄比亚南部肯巴塔地区前往公共卫生机构的依伴侬使用者中依伴侬的早期停用情况及相关因素:一项基于机构的横断面研究

Early Implanon discontinuation and associated factors among Implanon women users visiting public health facilities, in Kembata zone of Southern Ethiopia: An institution based cross-sectional study.

作者信息

Beyene Gemechu Nigusie, Assefa Nega, Mokonnon Taklu Marama, Ejigu Habtamu Bekele, Yadeta Tesfaye Assebe

机构信息

Doyogena Primary Hospital, Doyogena, Ethiopia.

School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Harar, Ethiopia.

出版信息

Front Glob Womens Health. 2022 Aug 11;3:909411. doi: 10.3389/fgwh.2022.909411. eCollection 2022.

Abstract

BACKGROUND

Contraceptive practice is the basis of fertility and plays a significant role in minimizing maternal morbidity and mortality. Implanon is one of the most effective long-acting contraceptive methods that prevents pregnancy for 3 years. Early Implanon discontinuation can lead to many negative reproductive health consequences. Therefore, this study assessed the magnitude of early Implanon discontinuation among female Implanon users visiting public health facilities to discontinue Implanon in the Kembata zone of southern Ethiopia.

METHODS

An institution-based cross-sectional study design was carried out from 1 March 2020 to 30 March 2020. Simple random sampling techniques were used to select 454 women who had discontinued Implanon. The data were collected using a pretested and structured questionnaire. The collected data were entered into Epi Data version-3.1 and then exported to STATA version-16 for analysis. A descriptive analysis along with bivariate and multivariate regression was performed to identify factors associated with early Implanon discontinuation. Statistical significance was declared at a < 0.05 along with 95% confidence intervals (CIs).

RESULTS

In the present study, 438 women were interviewed, which corresponds to a response rate of 96.48%. The magnitude of early Implanon discontinuation was 56.4%, 95%CI (51.6, 61.2). Primary educational status [adjusted odds ratio (AOR) = 2.92, 95%CI (1.56, 5.46)], rural residency [AOR = 1.76, 95%CI (1.06, 2.92)], women with no history of modern contraceptive use [(AOR = 2.14, 95%CI (1.14, 4.03)], those who experienced service dissatisfaction [AOR = 3.05, 95%CI (1.52, 6.12)], women who experienced as Implanon side effect [AOR = 3.36, 95%CI (2.09, 5.42)], and women who were not appointed after insertion [(AOR = 2.17, 95%CI (1.18, 4.79)] have shown an association with early Implanon discontinuation.

CONCLUSION

The present study indicated that the magnitude of early Implanon discontinuation was high. Educational level, rural residency, women who experienced side effects, those who experienced service dissatisfaction, women with no history of contraceptive use, and those who missed follow-up appointments were associated with Implanon discontinuation. Family planning service providers should focus on Implanon side effects during pre-insertion counseling. The recommended intervention is to recognize modifiable factors like improving client satisfaction with the service, appointing for follow up after insertion, and providing quality family planning services.

摘要

背景

避孕措施是生育的基础,在降低孕产妇发病率和死亡率方面发挥着重要作用。依伴侬(Implanon)是最有效的长效避孕方法之一,可避孕3年。过早停用依伴侬会导致许多负面的生殖健康后果。因此,本研究评估了在埃塞俄比亚南部肯巴塔地区公共卫生机构停用依伴侬的女性使用者中,依伴侬过早停用的比例。

方法

2020年3月1日至2020年3月30日进行了一项基于机构的横断面研究设计。采用简单随机抽样技术选取454名停用依伴侬的女性。使用预先测试和结构化的问卷收集数据。收集到的数据录入Epi Data 3.1版本,然后导出到STATA 16版本进行分析。进行描述性分析以及双变量和多变量回归,以确定与依伴侬过早停用相关的因素。当P<0.05以及95%置信区间(CI)时宣布具有统计学意义。

结果

在本研究中,对438名女性进行了访谈,对应答复率为96.48%。依伴侬过早停用的比例为56.4%,95%CI(51.6,61.2)。小学教育程度[调整后的优势比(AOR)=2.92,95%CI(1.56,5.46)]、农村居住[ AOR =1.76,95%CI(1.06,2.92)]、无现代避孕使用史的女性[(AOR =2.14,95%CI(1.14,4.03)]、经历服务不满意的女性[AOR =3.05,95%CI(1.52,6.12)]、经历依伴侬副作用的女性[AOR =3.36,95%CI(2.09,5.42)]以及植入后未被预约随访的女性[(AOR =2.17,95%CI(1.18,4.79)]均显示与依伴侬过早停用有关。

结论

本研究表明依伴侬过早停用的比例很高。教育水平、农村居住、经历副作用的女性、经历服务不满意的女性、无避孕使用史的女性以及错过随访预约的女性与依伴侬停用有关。计划生育服务提供者应在植入前咨询期间关注依伴侬的副作用。建议的干预措施是识别可改变的因素,如提高客户对服务的满意度、植入后安排随访以及提供优质的计划生育服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f33/9426357/2c8d87298297/fgwh-03-909411-g0001.jpg

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