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      Prevalence and factors associated with modern contraceptive discontinuation among reproductive age group women, a community based cross-sectional study in Humera town, northern Ethiopia

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          Abstract

          Background

          Contraceptive prevalence rate (CPR) for married women aged 15–49 in Ethiopia is 36%, with 35% using modern methods and 1% using traditional methods. However, the discontinuation rate is fairly high. Women usually discontinue contraception use for fertility and method related reasons without adopting an alternate method which in turn leads to many health risks such as unwanted pregnancy, unplanned childbearing, miscarriage, abortion, leads to morbidity and mortality among mothers and newborns. The purpose of this study was to determine the prevalence of modern contraceptive discontinuation and to identify predicting factors.

          Methods

          A community- based cross- sectional study was conducted in Humera town among 321 married women of reproductive age (15–49 yrs.) who had a history of modern contraceptive use. Systematic sampling technique was employed to select study participants and data was collected by BSc health extension workers using interviewer -administered questionnaire. EPI-INFO (V-7) and SPSS (V-23) software were used for entry and analysis respectively. Descriptive statistics and logistic regression analysis were used to present results accordingly. P- Value < 0.05 was used as a cut point for statistical significance.

          Results

          The magnitude of modern contraceptive discontinuation was 27.1%. Number of desired children (AOR = 2.83 95% CI = 1.16, 6.89), experience of side effects (AOR = 3 95% CI = 1.2, 7.58), discussion with female friend (AOR = 3.26 95% CI = 1.27, 8.36), counseled on side effects (AOR = 6.55 95% CI = 2.21, 19.39), number of male children (AOR = 2.51 95% CI = 1.06, 5.96), absence of husband support (AOR = 12.99 95% CI = 4.59, 36.78) and presence of community prohibition (AOR = 6.88 95% CI = 3.05, 15.51) were identified as predicting factors for modern contraceptive discontinuation.

          Conclusion

          Magnitude of modern contraceptive discontinuation among reproductive age group women in Humera was relatively high. Increasing community awareness, involving partners and pre dispensation counseling might help to reduce discontinuation and its consequences. Various targeted messages are also needed to dispel misconception at community level.

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          Most cited references5

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          The reliability of calendar data for reporting contraceptive use: evidence from rural Bangladesh.

          Collecting contraceptive-use data by means of calendar methods has become standard practice in large-scale population surveys, yet the reliability of these methods for capturing accurate contraceptive histories over time remains largely unknown. Using data from overlapping contraceptive calendars included in a longitudinal study of 3,080 rural Bangladeshi women, we assessed the consistency of reports from the baseline interview month in 2006 with reports from the same month in a follow-up survey three years later, and examined predictors of reliable reporting. More than one-third of women were discordant in their reports for the reference month in the two surveys. Among women reporting use of any contraceptive method for the reference month in both surveys, 25 percent reported different methods at the two time points. Women using condoms or traditional methods and those with more complex reproductive histories, including more births and more episodes of contraceptive use, were least likely to report reliably. (STUDIES IN FAMILY PLANNING
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            Assessing regional differences in contraceptive discontinuation, failure and switching in Brazil

            Background Contraceptive prevalence is relatively high in Brazil (55% among women of reproductive age). However, reversible methods account for less than half of the method mix and widespread differences persist across regions and social groups. This draws attention to the need for monitoring family planning service-related outcomes that might be linked with quality of care. The present study examines the factors associated with method discontinuation, failure and switching among current contraceptive users, with a focus on sub-national assessment. Methods Data for the analysis are drawn from the Brazil Demographic and Health Survey, notably the calendar module of reproductive events. Multilevel discrete-time competing risks hazard models are used to estimate the random- and fixed-effects on the probability of a woman making a specific transition after a given duration of contraceptive use. Results Contraceptive continuation was found to be highest for the contraceptive pill, the most popular reversible method. Probabilities of abandonment while in need of family planning and of switching to another method were highest for injections. Failure, abandonment and switching were each higher among users in the Northeast region compared to the more prosperous Southeast and South. Conclusion Findings point to seemingly important disparities in the availability and quality of family planning and reproductive health care services across regions of the country. Expanding access to a range of contraceptive methods, improving knowledge among health agents of contraceptive technologies and increasing medical supervision of contraceptive practice may be considered key to expanding quality reproductive health care services for all.
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              Factors associated with oral contraceptive discontinuation in rural Bangladesh.

              M. Khan (2003)
              Oral contraceptives (OCs) account for half of all modern contraceptive methods used in Bangladesh, however, discontinuation remains fairly high in OC use. This paper identifies factors associated with discontinuation of OC use, where discontinuation refers to cessation of OC use in the 6 months prior to the survey. The data for this study were drawn from a survey on OC compliance in rural Bangladesh. A total of 1600 OC users, current or past, aged 15 to 49 years were interviewed; of these, 36% discontinued OC use. Of the women who discontinued, 47% reported the experience of side-effects as the main reason for OC discontinuation. Multivariate analysis identified lack of fieldworker's visit as the strongest predictor of OC discontinuation; women who were not visited by fieldworkers had a four-fold risk of discontinuing OC use. Discontinuation of OC use decreased with increased duration of use and number of living children. OC discontinuation was associated with side-effect experiences, lack of husband's support in OC use and failure to purchase OCs. Of great concern is that about 70% of the women who were at risk of unintended pregnancy were not using any method of contraception following OC discontinuation. Husband's education was positively associated with the substitution of OCs with another contraceptive method. Effective OC use should be advocated through adequate counselling about how to take it correctly, the possibility of side-effects and their proper management and, more importantly, the possible alternative contraceptive method should OCs prove unsatisfactory or unsuitable. Better provider-client interactions along with improved access to the newly established community clinics could be instrumental in the continued and effective use of OCs.
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                Author and article information

                Contributors
                nigistibelete0@gmail.com
                ayuzem21@yahoo.com
                twoh2129@gmail.com
                abe2004g@gmail.com
                Journal
                BMC Womens Health
                BMC Womens Health
                BMC Women's Health
                BioMed Central (London )
                1472-6874
                22 November 2018
                22 November 2018
                2018
                : 18
                : 190
                Affiliations
                [1 ]Department of Midwifery, Axum University College of Health Science, Axum, Ethiopia
                [2 ]St. Paul Millennium Medical College, Addis Ababa, Ethiopia
                [3 ]ISNI 0000 0001 1539 8988, GRID grid.30820.39, Department of Midwifery, , Mekelle University College of health Sciences, ; Mekelle, Ethiopia
                Article
                663
                10.1186/s12905-018-0663-4
                6249880
                30466419
                4fcfb779-ae95-478d-a536-5c8a82a41950
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 February 2018
                : 10 October 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100009402, Mekelle University;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Obstetrics & Gynecology
                humera,modern contraceptive,discontinuation,reproductive age women
                Obstetrics & Gynecology
                humera, modern contraceptive, discontinuation, reproductive age women

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