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

Figures & data

Table 1: Socio-Demographic Characteristics of Study Participants at Public Health Facilities in Southwest Ethiopia, 2021

Variables	Categories	Case N	%	Control N	%
Age in years	<20	1	1.8	1	0.9
	20–24	13	23.2	7	6.5
	25–34	25	44.6	61	57
	≥35	17	30.4	38	35.5
Religion	Orthodox	31	55.36	59	55.14
	Protestant	11	19.64	30	28.04
	Muslim	14	25	16	14.95
	Others*	0		2	1.87
Ethnicity	Oromo	47	83.91	82	76.64
	Amhara	4	7.1	23	21.49
	Others**	5	8.92	2	1.87
Marital status	Single	3	5.4	2	1.9
	Married	48	85.7	99	92.5
	Others***	5	8.9	6	5.6
Education of user	Cannot read and write	5	8.9	4	3.7
	Can read and write	15	26.8	13	12.1
	Primary	16	28.6	31	29
	Secondary	15	26.8	38	35.5
	College and above	5	8.9	21	19.6
Occupation	Housewife	26	46.4	65	60.7
	Student	2	3.6	1	0.9
	Government employee	4	7.1	15	14
	Private worker	9	16.1	14	13.1
	Daily laborer	9	16.1	8	3.71
	Others****	6	10.7	4	3.7
Education of the husband	Cannot read and write	4	7.1	1	0.9
	Can read and write	10	17.9	9	8.4
	Primary	10	17.9	25	23.4
	Secondary	20	35.7	33	30.8
	College and above	12	21.4	39	36.4
Residence	Urban	32	57.1	86	80.4
	Rural	24	42.9	21	19.6
Distance from HF	Less than one hour	40	71.4	95	88.8
	Greater than one hour	16	28.6	12	11.2

Notes: *(Wakefata, Catholic), **(Tigre, Gurage, Kafa), ***(Divorced, widowed, separated), ****(Merchant).

Abbreviation: HF, Health Facilities.

Table 2: Reproductive Characteristics of Study Participants in Southwest Ethiopian Public Health Facilities, 2021

Variables	Categories	Cases N (%)	Controls N (%)
Hx of pregnancy	Yes	48 (82.1)	101 (96.3)
	No	10 (17.9)	4 (3.7)
Number of pregnancy	1	12 (26.1)	39 (37.9)
	2–4	22 (47.8)	53 (51.5)
	≥5	12 (26.1)	11 (10.7)
History of abortion	Yes	10 (17.9)	14 (13.1)
	No	46 (82.1)	93 (86.9)
Number of abortion	1	8 (14.3)	10 (9.3)
	≥2	2 (3.6)	4 (3.7)
Parity	1	12 (26.1)	39 (37.9)
	2–4	22 (47.8)	53 (51.5)
	≥ 5	12 (26.1)	11 (10.7)
Number of alive children	No child	5 (8.9)	3 (2.8)
	1	16 (28.6)	39 (36.4)
	2–4	21 (37.5)	42 (39.3)
	≥4	14 (25)	23 (21.5)
Age of youngest child	<1 year	9 (17.6)	17 (16.3)
	1–3yrs	17 (33.3)	42 (40.4)
	3–5yrs	17 (33.3)	26 (25)
	>5yrs	8 (15.7)	19 (18.3)
Plan to have child	Yes	38 (67.9)	73 (68.2)
	No	18 (32.1)	34 (31.8)
Gaps to next pregnancy	≤2yrs	17 (44.7)	29 (38.7)
	2–5yrs	11 (28.9)	23 (30.7)
	≥5yrs	10 (26.3)	23 (30.7)
Hx of side effect	Yes	28 (50)	19 (17.8)
	No	28 (50)	88 (82.2)
Side effects (n = 28)	Excessive bleeding	7 (25)	9 (45)
	Irregular bleeding	8 (30)	7 (35)
	Cramping	12 (45)	4 (20)

Table 3: Individual Related Characteristics of Study Participants in Health Facilities in Southwest Ethiopia, 2021

Variable	Categories	Case N (Percent)	Control N (Percent)
Training related to FP	Yes	8 (14.3%)	6 (5.6%)
	No	48 (85.7%)	101 (94.4%)
Currently using IUCD	Yes	0	107 (96%)
	No	56 (100%)	5 (4%)
Source of information	Friend	12 (21.4%)	14 (13.7%)
	Health worker	32 (57.1%)	83 (77.6%)
	Husband	4 (7.1%)	4 (3.7%)
	Media	5 (8.9%)	6 (5.6%)
	Others*	3 (5.4%)	0
Reason to choose	Safety	13 (23.2%)	27 (25.2%)
	Long protection	18 (32%)	51 (47.7%)
	Can be removed any time	12 (21.4%)	16 (15%)
	Chosen by provider	8 (14.3%)	6 (5.6%)
	Other**	5 (8.9%)	7 (6.7%)
Counseling received	Yes	42 (75%)	95 (88.8%)
	No	14 (25%)	12 (11.2%)
How counseling seemed	Well understood	10 (17.9%)	56 (52.3%)
	Naturally understood	36 (64.3%)	41 (38.3%)
	Not happy with counseling	10 (17.3%)	10 (9.3%)
Benefit and effect told	Yes	37 (66.1%)	73 (68.2%)
	No	19 (33.9%)	34 (31.8%)
Routine follow-up	Yes	9 (16.1%)	59 (55.1%)
	No	47 (83.9%)	48 (44.9%)
Hx of discontinuation Reasons to discontinuation	Yes	56 (100%)	107 (96%)
	Plan to conceive	14 (25%)	–
	Automatic expulsion	12 (21.43%)
	Excessive bleeding	12 (21.43%)
	Irregular bleeding	10 (17.86%)
	Cramping	8 (14.28%)

Notes: *(Newspaper, internet), **(Fewer side effects, feasible for all).

Table 4 Bivariable and Multi-Variable Analysis Showing Factors Associated with IUCD Discontinuation Among IUCD User Women in Southwest Ethiopia, Public Health Facilities, 2021

Variables	Category	Case (N = 56)	Controls (N = 107)	COR	AOR (95% CI)	P value
Residence	Rural	25 (44.6%)	20 (18.7%)	3.508 (1.71, 7.18)	1.360 (0.392, 4.718)	0.628
	Urban	31 (55.4%)	87 (81.3%)	1.00
Side effect	No	28 (50%)	19 (17.8%)	1.00
	Yes	28 (50%)	88 (82.2%)	4.63 (2.25, 9.52)	2.364 (1.01, 5.55)	0.048*
Educational status	Informal	21 (37.5%)	16 (15%)	3.41 (1.59, 7.28)	1.405 (0.449, 4.39)	0.559
	Formal	35 (62.5%)	91 (85%)	1.00
Distance	> 1hr	17 (30.4%)	11 (10.3%)	3.8 (1.63, 8.85)	1.499 (0.35, 6.37)	0.583
	< 1hrs	39 (69.6%)	96 (89.7%)	1.00
Follow up	No	47 (83.9%)	48 (44.9%)	6.41 (2.86, 14.1)	4.069 (1.30, 12.69)	0.016*
	Yes	9 (16.1%)	59 (55.1%)	1.00
Counseling	No	14 (25%)	12 (11.2%)	2.64 (1.12, 6.18)	1.279 (0.45, 3.63)	0.643
	Yes	42 (75%)	95 (88.8%)	1.00
Training	Yes	8 (14.3%)	6 (5.6%)	2.81 (0.92, 8.54)	0.249 (0.059, 1.05)	0.059
	no	48 (85.7%)	101 (94.4%)	1.00
Plan to have next child	Yes	47 (83.9%)	62 (57.9%)	3.79 (1.68, 8.52)	4.139 (1.58, 10.88)	0.004*
	no	9 (16.1%)	45 (42.1%)	1.00
Way of counseling	Well understood	10 (17.9%)	56 (52.3%)	1.00
	Naturally understand	36 (64.3%)	41 (38.3%)	4.92 (2.19, 11.13)	2.119 (0.679, 6.61)	0.196
	Not good	10 (17.9%)	10 (9.3%)	5.60 (1.85, 16.90)	1.23 (0.272, 5.522)	0.791

Notes: *Statistically significant at P value <0.05, 1.00: reference.