Determinants of Intrauterine Contraceptive Device Discontinuation Among Women Using Family Planning, in Southwest Ethiopia: Unmatched Case–Control Study

Abstract

Background

Although the intrauterine contraceptive device is an effective, reliable, safe, and recommended contraceptive method, it is still underutilized and has a high discontinuation rate in Ethiopia. The study aims to assess determinants of the discontinuation of IUCDs among women using family planning in Ilu Aba Bor Zone.

Methods

A facility-based unmatched case–control study was conducted from September to October, 2021 among 168 (56 cases and 112 controls) IUCD-user women in public health facilities in south-west Ethiopia. Pretested, structured and interviewer administered questionnaires were used for data collection. The data were coded, cleaned and entered to Epi-data version 3.1 and exported to SPSS version 23 for advanced analysis. A binary logistic regression was used to estimate the degree of association between the outcome variable and independent variables. Finally, variables with a p-value less than 0.05 at 95% confidence interval were declared as statistically significant with outcome variable.

Results

A total of 168 (163) respondents participated in the study, with a response rate of 97%. The mean (+SD) age of the respondents was 31.36 ± 5.916. Regarding the educational status of respondents about 36 (64.3%) of cases and 90 (84.1%) of controls have formal education, and about 42 (75%) of cases’ husbands and 97 (90.65%) of controls’ husbands have formal education, respectively. Experiencing side effects (AOR = 2.36; 95% CI: 1.01, 5.55), lack of follow up (AOR = 4.069; 95% CI: l.30, 12.69), and planning for next pregnancy (AOR 4.14; 95% CI: 1.58, 10.88) were found to be the main determinants of intrauterine device discontinuation.

Conclusion

The findings of the study showed that lack of follow-up after insertion of the IUCD, experiencing side effects, and having a plan for the next pregnancy were found to be the main determinants of intrauterine device discontinuation. Hence, arranging recommended regular follow-up and treating side effects are very important to sustain intrauterine device utilization.

Keywords:

• intra uterine contraceptive device
• family planning
• determinants
• Ethiopia

Abbreviations

ANC, Antenatal care; DHS, Demographic and health survey; FP, Family planning; HC, Health center; HF, Health facility; IUCD, Intrauterine contraceptive device; NGO, Non-governmental organization; WHO, World Health Organization.

Data Sharing Statement

Data are available from corresponding author on reasonable request.

Ethical Considerations

Ethical approvals for the study were obtained from Mettu University College of Health Science, review committee. A permission letter was written from the Woreda health office. Verbal consent from each participant was obtained after explaining the purpose of the study. Written informed consent, risk, and benefit of the study were taken from individuals ready to participate in the study. To prevent the risk of back retrieval of confidential information such as names of the participants, during data collection assigned code numbers were given by the investigators, and this study was conducted in accordance with the Declaration of Helsinki.

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 there no competing interests concerning this work.

Additional information

Funding

There is no financial or non-financial was received for this work.