Uptake and reason for discontinuation of long-acting reversible contraception in a tertiary hospital: A 5 years retrospective review

Abstract

Long-acting reversible contraception (LARC) methods, including intrauterine contraceptives and subdermal implants, are some of the most effective contraceptive methods available. They are known to be convenience, cost effective and suitable for many women. The study aims to determine the trends and uptake of long acting reversible contraception in University of Maiduguri Teaching Hospital, Maiduguri, assess the characteristics of the acceptors and identify the reason for discontinuation of the methods. A 5 years retrospective study was conducted at the family planning clinic of University of Maiduguri Teaching Hospital from 1st January 2015 to 31st December 2019. Case notes for all acceptors of LARC were retrieved. Data extracted include socio demographic characteristics of acceptors, previous contraceptive use and reason for discontinuation after one year of use; statistical significance was tested using chi-square. The results showed that 4064 new clients accepted the available family planning methods in University of Maiduguri Teaching Hospital, during the study period. Out of this, 43.1% accepted sub dermal implant, and only 9.0% uses intra uterine contraceptive device (IUCD). Findings further revealed that there is a significant relationship (P<0.05) between uptake of LARCs and related socio demographic characteristics in this study. This means that adolescent are less likely to use LARC so also those of low parity. Reason for discontinuation include desire for more children, irregular menses, and contraceptive faire; husband refusal, weigh gain, infection and missing string of IUCD. The rising uptake of subdermal implant in this study is encouraging, however there is a low uptake of IUCD and adolescent are less likely to use LARC. Some clients discontinue the methods within one year of use. Therefore appropriate counseling, follow up care and management of side effects and clients inconveniences, involving men in reproductive health are important in reducing the rate of discontinuation and improved the uptake of LARC. Key words: Long-acting reversible contraception (LARC), reason for discontinuation, Nigeria.