Abstract:
Background: Despite the improvement in availability and utilization of long acting reversible
contraception, discontinuation is becoming a public health concern. Significant proportion of
women discontinue the service before its due date which poses a concern in the health system and
its consequence may lead to failure of a program. This might have also social and economic
consequences among users. Only 8% of married women in Ethiopia use implants and 2% use
intrauterine contraceptive devices. Apart from its low utilization, premature removal is common
with unknown reasons. However, there is paucity of information on discontinuation of reversible
long acting contraceptives and associated factors.
Objective: The study was aimed to assess discontinuation of reversible long acting contraceptives
and associated factors among reversible long acting contraceptive methods user women in health
facilities of Hawassa city, southern Ethiopia, from March, 01-April, 01/2019.
Methods and materials: Institution based cross sectional study design was used. Out of 16 health
facilities 9 of them were selected for this study using simple random sampling technique. Total
sample size of this study was determined to be 442. Systematic sampling method was used to select
study participants. Data were collected from study subjects using pretested semi-structured faceto-face
interview guided questionnaire. Data was analyzed using descriptive statistics and logistic
regression to identify factors associated with reversible long acting contraceptives discontinuation
and the result is presented using the Crude Odds ratio as well as Adjusted Odds Ratio with the
corresponding 95% confidence level.
Result: of the 442 study participants, the overall proportion of reversible long acting
contraceptives discontinuation was 56.6%(95% CI: 52.3%, 61.1%). Maternal educational status at
primary level (AOR =2.332; 95% CI: 1.147-4.739), lack of counseling about possible benefits of
LARCs (AOR=2.496; 95% CI: 1.008-6.181), side effects (AOR=2.092; 95% CI:1.309-3.341 and
desire to be pregnant in the near future (AOR=2.222;95CI:1.496-3.301) were the major factors
associated with discontinuation of the contraceptives.
Conclusion and Recommendation: In this study, the overall proportion of discontinuation of
reversible long acting contraceptives among women who were using reversible long acting
contraceptives was high. Health professionals could give preinsertion counseling with giving
emphasis on possible side effects and benefits of reversible long acting contraceptives to enhance
duration of utilization.
