Abstract
BackgroundIn Rwanda, nearly a third of contraceptive users discontinue within the first year of use. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users and minimizing discontinuation is imperative for long-term family planning program success. This study explores the efforts providers and contraceptive users in Rwanda employ to prevent one of the greatest challenges to family planning programs: contraceptive discontinuation.MethodsThis was a qualitative study conducted in Rwanda between February and July 2018. It included eight focus group discussions with 88 family planning providers and 32 in-depth interviews with experienced modern contraceptive users. Data were collected in two districts with the highest (Musanze) and lowest (Nyamasheke) rates of contraceptive use. Data were analyzed using thematic content approach.ResultsFamily planning providers in this study used the following strategies to prevent discontinuation: counseling new users on the potential for side effects and switching, reminding clients about appointments for resupply, as well as supporting dissatisfied users by providing counseling, medicine for side effects, and discussing options for switching methods. Users, on the other hand, employed the following strategies to prevent discontinuation: having an understanding that experiences of side effects vary by individuals, supporting peers to sustain use, persisting with use despite experiences of side effects, and switching methods.ConclusionsThe strategies used by family planning providers and users in Rwanda to prevent discontinuation suggest the possibility of long-term sustained use of contraception in the country. Harnessing and supporting such strategies could contribute to sustaining or improving further contraceptive use in the country.
Highlights
215 million women in the world wish to avoid or delay pregnancy yet do not use family planning methods [1]
Due to contraceptive discontinuation differing by method type, discontinuation is examined among and disaggregated by many types of contraceptive methods, such as natural family planning methods (LAM, standard days, withdrawal, and rhythm), male condoms, and reversible hormonal methods
Researchers examining data from 36 developing countries estimated that approximately a third of unintended births are due to contraceptive discontinuation [2]
Summary
215 million women in the world wish to avoid or delay pregnancy yet do not use family planning methods [1]. Discontinuation of contraceptive methods, despite a desire to continue to avoid pregnancy is very common and a major challenge for family planning programs. Researchers examining data from 36 developing countries estimated that approximately a third of unintended births are due to contraceptive discontinuation [2]. Often the most common reasons for discontinuation for those who wish to continue to prevent pregnancy is method related—such as health concerns or the experience of side effects [3, 7, 9, 12, 16]. This study explores the efforts providers and contraceptive users in Rwanda employ to prevent one of the greatest challenges to family planning programs: contraceptive discontinuation
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
