Prevalence of Early Removal of Long-Acting Contraceptive Methods and Its Associated Factors in Sidama Regional State, Ethiopia

Abstract

Background

Long-acting reversible contraceptive methods, IUD and sub-dermal implant, offer women the most effective method to control fertility. Yet, reports on high early removal rates were emerged, prompting concern among service providers and highlighting the need to review removal rates and its reasons. Therefore, this study was conducted to assess the prevalence of early removal rates of LARCs and its associated factors in Sidama Regional State, Southern Ethiopia.

Methods

 Community-based cross-sectional study was conducted in Sidama Regional State, Ethiopia from June 1 to June 30, 2019. A multistage sampling technique was used to select 21 administrative units in the first stage. Then, systematic sampling was used to select 475 women who have ever used implants or IUD 3 years preceding the data collection period. Data were entered into Epi Info version 3.4.3 and exported to SPSS version 20 for analysis. Descriptive statistics, bivariate, and multivariate logistic regression were computed. P-value <0.05 was used to declare a significant association.

Results

The mean (±SD) of the participant’s age was 29.81 (±5.69) years. The prevalence of early removal rate of LARCs was 10.3%, ie, 43 (10.8%) among Implanon/jadelle users and 6 (7.8%) among IUD users. Eleven (22.4%) discontinued within the first six months and 38 (77.6%) utilized for more than six months and discontinued before the 12th month. Women who were not advised about advantage [OR= 2.81 (95% CI: 1.23–6.40)] and effectiveness of contraceptive [OR= 2.70 (95% CI: 1.30–5.60)] and those who were satisfied with the family planning service [OR= 2.24 (95% CI: 1.10–4.57)] were identified as factors.

Conclusions

The prevalence of early removal rate was considerably high among the study subjects. Providing appropriate counseling about the advantage and effectiveness of family planning and improving client satisfaction need to be considered to reduce the early removal rate.

Keywords:

• IUD
• Implanon
• jadelle

Abbreviations

CSA, Central Statics Agency; FGA, Family Guidance Association; FP, family planning; HEW, health extension worker; IUDs, intrauterine devices; LARC, long-acting reversible contraceptive; MCH, maternal and child health; REC, Research and Ethical Committee; SRS, Sidama Regional State; SPSS, Statistical Package for Social Science.

Data Sharing Statement

Data supporting the findings of this study are presented in the manuscript.

Ethics Approval and Consent to Participate

Ethical clearance was obtained from the Ethical review committee of the Hawassa University College of Medicine and Health Science & permission was obtained from each participant.

Acknowledgments

We would like to express our gratitude to the study participants for their willingness in providing the necessary information. We would like to acknowledge health Extension workers of the selected kebeles for easing the data collection process. Our gratitude also goes to EzedineMolla, Seife Kibru, AmezenechAyele, Mohammed Ayalew, Fikru Tadesse, BediluDeribe, Sihne Tadesse, Kurabachew Mengistu, Tadesse Yohannes, Sileshi Demelash&Abraham Abate for their unreserved support though out the paper preparation.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis, and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors declare that they have no conflicts of interest for this work.

Additional information

Funding

There is no funding to report.