Abstract
Background Implanon discontinuation is unacceptably high in developing countries, including Ethiopia. Furthermore, there is an observed problem of high unintended pregnancy after method discontinuation that strides to program failure. Therefore, the purpose of this study was to assess the level and determinants of Implanon discontinuation among women who used Implanon in Andabet district, public health facilities, North-West Ethiopia, 2017. Methods Facility-based cross-sectional study design was employed among 537 women from Feb. 03 to April 28, 2017. Study participants were selected using a systematic random sampling technique. A face-to-face interview was employed to collect data. Epi-Info version 7 was used for data entry and SPSS version 20 for analysis. Both descriptive and analytical statistical analysis was computed. On multivariable binary logistic regression, a p value of less than 0.05 was used to declare statistical significance. Results About 37% of Implanon users have discontinued the method before the intended time. About 86% of them discontinued Implanon before two years of insertion. Women who had no live child (AOR = 2.17, 95% CI: 1.25-3.77), women who did not receive preinsertion counseling (AOR = 1.85, 95% CI: 1.15-2.97), women who developed Implanon-related side effect (AOR = 5.17, 95% CI: 3.18-8.40), and women who did not satisfy by the service provided (AOR = 5.40, 95% CI: 3.04-9.57) had higher odds of Implanon discontinuation. On the other hand, women who received appointment follow-up (AOR = 0.23, 95% CI: 0.13-0.41) had lower odds of Implanon discontinuation. Conclusions The level of Implanon discontinuation before its intended time was high in the district. Hence, strengthening preinsertion counseling and appointment follow-up as well as improving the clients' level of service satisfaction could increase Implanon's continuation.
Highlights
Implanon is a second-generation single-rod progestogenonly contraceptive implant with a length of 40 mm and a diameter of 2 mm containing 68 mg of etonogestrel dispersed in a membrane of ethylene-vinyl acetate
It delivers ENG at a dose sufficient to suppress ovulation in every cycle throughout the 3 years of use [1,2,3]. This single-rod progestogen subdermal is developed as a need to reduce some of the problems associated with the six implant systems, Norplant by 2008, and it is prequalified by the World Health Organization (WHO) in 2010 [2, 4]
In multivariable binary logistic regression analysis, there were a higher odds of Implanon discontinuation among women who had no live child (AOR = 2:17, 95% confidence interval (CI): 1.25-3.77), had
Summary
Implanon is a second-generation single-rod progestogenonly contraceptive implant with a length of 40 mm and a diameter of 2 mm containing 68 mg of etonogestrel dispersed in a membrane of ethylene-vinyl acetate. It delivers ENG at a dose sufficient to suppress ovulation in every cycle throughout the 3 years of use [1,2,3]. Significant numbers of women discontinue the method before its intended period [7]. The purpose of this study was to assess the level and determinants of Implanon discontinuation among women who used Implanon in Andabet district, public health facilities, North-West Ethiopia, 2017. Strengthening preinsertion counseling and appointment follow-up as well as improving the clients’ level of service satisfaction could increase Implanon’s continuation
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