Abstract:
Background: Happening of pregnancy while a woman is using a contraceptive is termed as
Contraceptive failure. It is a major source of unintended pregnancy, in most cases associated
with typical inconsistent and/or incorrect use of methods. In 2012,30% of unintended pregnancy
was resulted from contraceptive failure. In Harari Region, majority of users constitute methods
with intermediate and higher failure rates (Injectable 12.6 % & pills 5%) respectively. As a
result, significant contraceptive failure rate & associated factors to be addressed were the key
concerns.
Objective: to assess level of contraceptive failure and associated factors among pregnant
women in Harari Region, 2018.
Method: Institution based cross sectional study design was used. A Sample of 1250 study
participants were selected from pregnant women who were using contraceptives prior to their
current pregnancy and visited health facilities. Data was collected using structured
questionnaire. It was entered into EPI Data version 3 and was exported to SPSS version 20 for
analysis. Descriptive statistics was performed to assess the frequency and percentage of the
variables. Bivariate and multivariable logistic regression model was used to assess the
association between the outcome and independent variables.
Result: The level of contraceptive failure was 10.3%. There was a strong association between
contraceptive failure and behavior while on use. Inconsistent use of contraceptive showed very
strong association with contraceptive failure that women with such behavior were 4 times in
higher risk of getting it (AOR = 3.73, (95% CI 2.00 - 6.94). Similarly, duration of use of
participants who were using contraceptives 1 to 3 years showed 2 times higher risk of facing
contraceptive failure (AOR = 2.16, (95% CI 1.14 - 4.07).
Conclusion and recommendation: The level of contraceptive failure in Harari region is
significant and high. Inconsistent and incorrect use and duration of use were found to have the
strongest association. Harari regional health bureau should give due attention on action to reduce
the burden of contraceptive level at least to the national level. Health facilities should capacitate
family planning service providers including those who work in private pharmacies and drug
vendors on the place of user focused quality counselling on behavior of users to reduce failure
of contraceptives most importantly on user dependent methods.