Acceptance Of Contraceptive Methods Research Articles

Exploring maternal attitudes towards adolescent contraception: implications for use of LARC.

Introduction Maternal attitudes have been shown to impact adolescent girls' sexual decision making and attitudes towards contraception. Given the potential for maternal influence on adolescent contraceptive use, we undertook an exploratory study of mothers' perceptions of the maternal role in adolescent contraceptive decision making, and maternal perceptions of long acting reversible contraceptives (LARC) for adolescent girls. Materials and methods We utilized a mixed methods study design. Acceptability of contraceptive methods and attitudes towards adolescent contraceptive use were assessed using a paper survey of 162 mothers of girls aged 11-19 years in Cleveland, Ohio, USA. Seven survey participants completed subsequent semi-structured interviews, which were analyzed using grounded theory methodology. Results Pills, condoms and injections were most frequently selected as acceptable by 55.4%, 55.4%, and 51.6% of women, respectively. One or more LARC methods were selected by 16.6% of the women. Of those (94.4%) agreed or strongly agreed that, "It is expected of me to make sure that my daughter knows about birth control methods." Important themes that emerged during interviews were the responsibility mothers felt to help their daughters navigate contraception options, appreciation of the effectiveness of LARC methods and concerns about the use of those methods by teenagers due to the invasiveness. Conclusion Our data suggest that mothers want to be involved and support adolescent decision making about contraceptives. We also found that mothers viewed LARC as less acceptable than other forms of birth control for adolescents and have specific concerns about LARC. These results suggest directions for future work to better characterize the impact of maternal attitudes on adolescent LARC use.

Prevalence of usage of different contraceptive methods among married women of reproductive age in an urban slum area

Background: Increasing population is a worldwide problem particularly in developing countries like India. The extent of acceptance of contraceptive methods still varies within societies, different castes, and religious groups. Present study was done to find out prevalence of contraceptive use in married women of reproductive age in urban slum area. Objective: a) To know the prevalence of contraceptive use in married women of reproductive age group. b) To find out reasons for not using contraceptive methods. c) To educate married women of reproductive age group to promote for use of contraceptive methods based on study observations. Materials and Method: A community based, cross- sectional study was conducted in an urban slum area under urban health center. Participants included 350 women of reproductive age group, selected by simple random sampling. Statistical analysis: Chi-square test for association and goodness of fit. Result: Contraceptive prevalence was found to be 58.57% in urban slum area. Tubal ligation was most common method of contraception (73.65%) followed by oral pills (14.15%), intrauterine device (6.82%), and condom (4.39%). Contraceptive use was higher between age group of 30–34 years (14.57%) followed by age group 25–29 (13.71%). Contraceptive use was higher among women having 3 or more children (24.85%). Among subjects who were not using contraceptives, most common reason was desire for more children (42.76%). Conclusion: Prevalence of use of contraceptive was low in urban slum area. Younger age of women, low socio economic class, illiteracy, no living children in the family were found to be associated with low use of contraception. Motivation of couples through media and health personnel can help to achieve positive attitude for effective use of contraceptives.

Acceptance of Contraceptive Methods Among Postpartum Women in a Tertiary Care Center.

In India, a large proportion of women with an unmet need for contraception are within their first year after childbirth. Therefore, concentrating efforts to educate postpartum women on the importance of attending contraceptive clinics could have a proportionally bigger impact on increasing postpartum contraception usage. Hundred and seventy-eight (178) women were followed up to determine the proportion of postpartum women who attended the family planning clinics for contraceptive counseling. The reason for non-attendance, choice and effectiveness of contraceptive method selected was determined. Out of 178 postpartum women who were followed up, only 12 (6.8%) attended the contraceptive clinic. IUD, POPs and Inj-DMPA are the preferred contraceptive methods selected by postpartum women. Hundred percent of the postpartum women who attended contraceptive selected a contraceptive method as compared to only 44% of the postpartum women who did not attend a contraceptive clinic. Only 29.2% of these postpartum women selected highly effective contraceptive methods as compared to 83.3% by the postpartum women who attended family planning clinics. The common reasons cited for not attending contraceptive clinic was found to be time constraint (43.9%) followed by 'stay far away' (39%), followed by 'already have information' (9.7%). Family planning service that is scheduled to be delivered at the 6-week postpartum is rarely attended. The common reason cited by postpartum women for poor attendance in these family planning clinics was time constraint.

Is LARC for Everyone? A Qualitative Study of Sociocultural Perceptions of Family Planning and Contraception Among Refugees in Ethiopia.

Objective Ethiopia is home to an increasingly large refugee population. Reproductive health care is a critical issue for these groups because refugee women are at high risk for unmet family planning needs. Efforts to expand contraceptive use, particularly long acting reversible contraceptive (LARC) methods are currently underway in several Ethiopian refugee camps. Despite availability of LARC methods, few refugee women opt to use them. The purpose of this study was to explore how culture influences contraceptive attitudes and behaviors, particularly towards LARC methods, among Ethiopia's refugee populations. Methods Focus group discussions and individual interviews were conducted with Eritrean and Somali refugees living in Ethiopia. The qualitative data was analyzed to identify important themes highlighting the relationship between cultural values and contraceptive attitudes and behaviors. Results Childbearing was highly valued among participants in both study groups. Eritreans reported desire to limit family size and attributed this to constraints related to refugee status. Somalis used cultural and religious faith to deal with economic scarcity and were less likely to feel the need to adapt contraceptive behaviors to reduce family size. Participants held overall positive views of the contraceptive implant. Attitudes toward the intrauterine device (IUD) were overwhelmingly negative due to its long-acting nature. Conclusions Culture, religion and refugee status form a complex interplay with family planning attitudes and behaviors among Eritrean and Somali refugees. For these populations, the three-year implant appears to be a more acceptable contraceptive method than the longer-acting IUD because it is in line with their reproductive plans.

A Phase III, single-arm study of LNG-IUS 8, a low-dose levonorgestrel intrauterine contraceptive system (total content 13.5 mg) in postmenarcheal adolescents

ObjectiveTo assess the safety profile of the low-dose levonorgestrel intrauterine system (LNG-IUS) total content 13.5mg (average approximate release rate 8μg/24h over the first year; LNG-IUS 8; Jaydess®) in adolescents. Study designIn a Phase III study in 36 European centers, 304 healthy nulliparous or parous postmenarcheal adolescents (12–17years) received LNG-IUS 8 for 12months. The primary outcome was the incidence of treatment-emergent adverse events (TEAEs). Secondary outcomes included: serious TEAEs, adverse events of special interest, overall user satisfaction, discontinuation rate at 12months, and Pearl Index. ResultsLNG-IUS 8 placement was successful in 303/304 participants (99.7%). Overall, 82.6% of participants reported TEAEs, and serious TEAEs and serious study drug-related TEAEs were reported by 7.6% and 1.0% of participants, respectively. No cases of pelvic inflammatory disease, ectopic pregnancy, or uterine perforation were reported. No pregnancies were reported during the 12-month study. At Month 12/study end, the overall user satisfaction rate was 83.9%. Overall, 51 participants (16.8%) prematurely discontinued the study before 12months; 13.8% of participants discontinued owing to TEAEs. ConclusionsNo new or unexpected safety events were associated with the low-dose LNG-IUS 8. The safety profile of LNG-IUS 8 in adolescents was consistent with that previously reported in adults. The high overall user-satisfaction rate at study end and the low discontinuation rate over 12months demonstrate that LNG-IUS 8 is a highly acceptable contraceptive method among adolescents. ImplicationsThis study is the first to assess the low-dose levonorgestrel intrauterine system LNG-IUS 8 (average approximate release rate 8μg/24h over the first year and total content 13.5mg) specifically in females<18years of age and confirms the safety and efficacy of LNG-IUS 8 in an adolescent population.

Study on Perspectives and Practice of Contraception in Women

ABSTRACT Purpose of the study This study is undertaken to determine the knowledge, preferences, practice, experiences and perspectives of women toward contraception and also to note down the various factors influencing the acceptance and usage of contraception among women. Methodology Five hundred women of age group 15 to 49 years who were currently married were studied. Sexually active unmarried women were excluded from the study. The study data were obtained using a questionnaire. The questionnaire was divided under four broad headings: personal details, knowledge, usage and expectations. The data collected was analyzed. Changing trends, knowledge, usage and expectations of the women toward various contraceptive methods were noted. Results The most common method used was female sterilization (41.4%), followed by intrauterine contraceptive device (IUCD) (14.8%) and condom (9%). Among the sociodemographic patterns, women belonging to lower socioeconomic status, with rural background, younger women, Christians and illiterate women the prevalence of contraceptive use was lower compared to their counterparts. Spacing methods was most commonly used by women residing in urban and women with higher education background. Couple protection rate in this study was 77%. The unmet need was 9.8%. Knowledge of female sterilization was most common in 93% followed by oral contraceptives (OCP) 73.2%. The knowledge was higher among upper socioeconomic status and urban women. 78.8% had discussion with spouse. More than 70% had preference for male child. Conclusion This study stresses upon the fact that contraception services should be affordable delivered by informed choice and sensitive to individual's needs. The unmet need of contraception can be reduced by improving female literacy, contraceptive counseling, male involvement and availability of contraceptive services. These measures will indeed reduce unwanted pregnancies, improve self-esteem of women as they will have control over their fertility and in future reduce population explosion to some extent by limiting the family. Capsule Fertility control is an important medical discipline, it is essential for the welfare of the individual, family and the nation. The usage of contraceptive method depends on knowledge, preference, acceptance and experience. Objectives of the study • To determine the awareness, perception and acceptance of contraceptive methods • To study the contraception usage by the women. How to cite this article Shetty VH, Nagarathnamma R. Study on Perspectives and Practice of Contraception in Women. J South Asian Feder Obst Gynae 2016;8(1):16-20.

Racial and ethnic differences in women's preferences for features of contraceptive methods

ObjectivesTo understand women's preferences for specific features of contraceptive methods, the extent to which features of existing methods match women's preferences and whether this match differs by racial and ethnic subgroups. Study designUsing data from 1783 women in family planning and abortion clinics across the United States, we performed analyses of racial and ethnic differences in contraceptive features reported to be “extremely important” by participants. We explored how preferences vary for more and less effective contraceptive methods. ResultsIn multivariate analysis, non-Hispanic Black, Latinas and Asian Pacific Islander women were more likely to report the following features as extremely important compared to non-Hispanic Whites (p<0.05): being able to stop using the method at any time, using a method only with intercourse and the method not changing her menstrual periods. Non-Hispanic Black and Latina women were statistically more likely to report that protection against sexually transmitted diseases, having control over when and whether to use the method and being able to become pregnant after stopping use were extremely important. The contraceptive feature preferences of racial and ethnic minority women in our study had a relatively lower match with high efficacy methods and higher match for low efficacy methods compared to White women (p<0.05). ConclusionsHigh rates of unintended pregnancy among minority women may be due in part to differences in contraceptive features preferences and discrepancy between their preferences and the features of currently available highly effective methods. ImplicationsIn the context of disparities in rates of unintended pregnancy by racial and ethnic group, this variation in preferences for contraceptive features by race/ethnicity may explain differences in contraceptive use and can inform the development of more acceptable methods of contraception.

Intrauterine devices placed at oocyte retrieval are an acceptable method of contraception in women with cancer

Intrauterine devices placed at oocyte retrieval are an acceptable method of contraception in women with cancer

English

BACKGROUND: Both spacing and permanent birth control methods are the need of the hour. The popularity of male sterilization i.e. vasectomy is low compared to female sterilization (tubectomy). However, being safe, effective, cheap, and having less surgical complications no scalpel vasectomy (NSV) is emerging as good option. AIMS: To study the various demographic and behavioural factors of NSV acceptors. SETTING & DESIGN: This is institution based retrospective study conducted in Department of Obstetrics and Gynaecology, Medical College, Kolkata during the time period of 1st April ‘2009 to 31st March’ 2015. METHODS AND MATERIAL: The patients who accepted NSV for family planning were analysed with respect to their age, residence, occupation, literacy, number of issues and complications. STATISTICAL ANALYSIS: Data were represented as simple proportions or percentages and graphs by using micro soft excel. RESULTS: Out of 13, 048 sterilization operations, there were 3737(28.64%) vasectomies and 9311(71.36%) tubectomies. 67.08% of the couples selected sterilization for contraception. Tubectomies accounted for 2.5 times the vasectomies. The number of NSVs as a percentage of total sterilizations were 28.78% in 2009, rising to 36.96% in 2011 and gradually falling to 21.36% in 2015. Most of the clients (84%) were ≥30 years of age. In 2009-10, only educated (71%, primary education) accepted NSV. However, 74% were illiterate acceptors in 2014-15 and 83% were labourers. In last 2 years the trend is NSV after the 3rd child. CONCLUSION: NSV is emerging as a socially and culturally acceptable method of contraception in our society.

Knowledge and attitude of medical undergraduate, interns and postgraduate students in India towards emergency contraception

Background:Although India was the first country in the world to have national family planning policy, the acceptance of contraceptive methods has been unsatisfactory. Many women in their peak reproductive years, who wish to control their fertility, are not aware about the different methods of contraceptives available. Unregulated fertility results in unplanned pregnancies. Emergency contraceptive pills can avoid many such unplanned pregnancies.Aim:The study was to assess the knowledge and attitude about emergency contraception (EC) among the undergraduate, interns and postgraduate medical science university students.Materials and Methods:A cross-sectional study was carried out among 180 medical students which include undergraduate (final year MBBS), interns, and postgraduate students (60 from each group) studying at Rural Medical College and Pravara Rural Hospital of Pravara Institute of Medical Sciences University of central India by a convenient sample method over a period of February 2009 to May 2009. Data were collected by pre-designed, pre-tested, self-administered questionnaire. Data was analyzed in the form of percentage and proportions and Chi-square test was applied.Results:In this study, a total of 180 respondents, of which 110 (61.2%) were male and 70 (38.8%) were female. The knowledge about EC was highest (47.6%) among postgraduates in comparison to interns (43.3%) and undergraduate students (41.6%). Overall positive attitude toward EC was observed among 73.8% of the respondents.Conclusions:Considering the role of a medical graduate as counselor and health-care provider, the technical knowledge about different aspects of EC among the study population was inadequate.

Pattern of discontinuation of Intrauterine Copper T 380a at The University College Hospital, Ibadan: A Ten-Year review

Intrauterine contraceptive device is a highly acceptable method of contraception, however despite it sacceptability many users still discontinue its use for various reasons, this study was embarked upon to determine the rate of its discontinuation and the factors associated with its discontinuation. It was a retrospective study of 10 years duration starting from January 1997 to December 2006 at the University College Hospital, Ibadan. A total of 6,515 had insertion of IUCD (Copper T380 A) over the study period and 1,295(19.9%) discontinued within the period with the highest discontinuation rate being the first year while the least discontinuation rate was the 9th year. The commonest reason for discontinuation was the desire for pregnancy which accounted for 665(51.4%) of removal followed by menopause in 225(17.4%), no reason was found in 204(15.7%), side effects accounted for 101(7.8%) of removal, husbands wish 53(4.1%) and changing to another method accounted for 47(3.6%) of removal. The reasons for discontinuation were significantly associated with the clients age, side effects, number of living children and their educational status. The rate of discontinuation is still high especially because of the desire to get pregnant while some even discontinued for no reason. It therefore becomes imperative for providers of family planning to further enlighten the populace on the benefit of limiting their family size and to also encourage the prolonged use of the device in those who discontinue for no reason by improving on our counseling methods.

Do women and men consider abortion as an alternative to contraception in the United States? An exploratory study

The USA, a country with widespread access to the full range of modern methods of contraception, continues to have one of the highest abortion rates among developed countries. Forty-nine per cent of women reported ever experiencing an unintended pregnancy in 2001; 48% of these conceptions occurred during a month that contraception was used. We explored the extent to which people use contraception and abortion interchangeably to achieve their fertility goals via focus groups (n=4) and semi-structured in-depth interviews (IDIs) (n=18) with men and women between the ages of 18 and 35 in New York City in 2006. While there was a consensus that abortion cannot replace contraceptive use, poor couple communication, lack of planning, lack of acceptable contraceptive methods and the pleasures that people associate with having unprotected sex result in the perception that some individuals rely on abortion over contraception to prevent unintended births. Men and women both identified women as solely in charge of avoiding an unwanted pregnancy and resolving it should one occur. No one supported repeat abortions for themselves or others, and many respondents perceived multiple abortions to lead to infertility, which strengthens their position that substituting abortion for contraception is unacceptable.

Male hormonal contraception: potential risks and benefits.

An effective, safe, reversible, and acceptable method of contraception is an important component of reproductive health and provides the opportunity of shared responsibility for family planning for both partners. Female hormonal contraceptives have been proven to be safe, reversible, available and widely acceptable by different populations. In contrast, male hormonal contraception, despite significant progress showing contraceptive efficacy comparable to female hormonal methods during last three decades, has not yet led to an approved product. Safety of a pharmaceutical product is an appropriate concern but the majority of male hormonal contraceptive clinical trials have not reported significant short term safety concerns. While the absence of serious adverse effects is encouraging, the studies have been designed for efficacy endpoints not long term safety. In this review we summarize potential risks and benefits of putative male hormonal contraceptives on reproductive and non-reproductive organs. While the review covers what we believe will be the likely class of drugs used for male hormonal contraception a true assessment of long term risks and benefits cannot be achieved without an available product.

One-year experience with implanon sub-dermal implants in Jos, Nigeria

To determine Implanon acceptance, the group of women accepting it, complications, indications for discontinuation; and report an initial experiencewith themethod. Thiswas a retrospective observational study of Implanon®, a single rod, long acting, reversible subdermal contraceptive implant system, containing the progestin etonogestrel, which was introduced in Jos, Nigeria, inMay 2006. Implanon capsules were accepted by 404 clients constituting 13.4% of acceptors of all contraceptive methods. The average age, parity and number of living children to the acceptors were 32.1 years, 3.6 and 3.3 respectively.About three-quarters (76.0%) of the women had secondary and tertiary education. Seventy-three (18.1%) of the women were taking a modern contraceptive method for the first time. There were 7 removals giving a high continuation rate of 98.3% in the first year. Menstrual disturbance was the commonest (57.1%) indication for removal. Implanon is an acceptablemethod of contraception among ourwomen population. Keywords: Implant, Implanon, sub-dermal, Jos,Nigeria.

Sex Preference and Contraceptive Norms among Regions in Bangladesh

Using data derived from the 2004 Bangladesh Demographic and Health Survey (BDHS, 2004) the present study examines the effect of sex preference on contraceptive use among different regions in Bangladesh. The study also investigates the impact of some selected socio-economic and demographic variables on the use of contraceptive methods. The result shows that sex preference has a significant effect on the use of contraceptive methods. The families who have one child of each sex are most satisfied with their current family composition. The result reveals a huge unmet need for contraception in the eastern part of Bangladesh. The study confirms that sex preference may be a constraint in the acceptance of contraceptive methods in Bangladesh. The demand for large families and sex preference can be reduced through affirmative social and economic policies. It was also observed that female education has a positive effect on contraceptive use among almost all regions.

The subdermal etonogestrel implant is a safe and acceptable post-abortal method of long-term contraception

To evaluate use and continuation rates of subdermal etonogestrel implants following abortion.

Cycle control, tolerability, efficacy and acceptability of the vaginal contraceptive ring, NuvaRing®: Results of clinical experience in Germany

Objectives To investigate the real-life clinical experience of NuvaRing® users in Germany.Methods An open-label, prospective, uncontrolled, non-randomized, multicentre post-marketing surveillance study was conducted by 1204 gynaecologists amongst 5823 women requesting contraception. The women underwent routine examinations and contraceptive counselling, and were assessed after three and six cycles of NuvaRing® use.Results: Good cycle control was observed and there was a reduction in cycle irregularity and inter-menstrual bleeding, bleeding duration and intensity, and dysmenorrhoea. NuvaRing® was well tolerated, and had no significant effect on body weight or blood pressure. Nine women became pregnant unintentionally (two had conceived before they started to use NuvaRing®, three due to non-compliance, one because of repeated ring expulsion/loss and three during treatment in spite of having applied this latter as instructed). Most women expressed their satisfaction with NuvaRing®; 82% were ‘very satisfied/satisfied’, 72% planned to continue using it and 82% would recommend it to others. More than 90% of women found NuvaRing®‘without problems/easy’ to insert and to remove, and more than 80% of the women and their partners were not disturbed by its presence during intercourse.Conclusion: NuvaRing® is a highly effective and acceptable method of once-monthly contraception that is safe and well tolerated.

Attitudes towards long-acting reversible methods of contraception in general practice in the UK

Introduction Recently published national guidance in England recommended that increased use of long-acting reversible methods of contraception could reduce unintended pregnancy rates. Usage rates of long-acting reversible methods of contraception in the UK are currently low. Since these methods require medical intervention, attitudes of professionals are important determinants of prevalence of use. Study Design A questionnaire survey was conducted of 321 health professionals working in general practice which sought practitioner views on safety, efficacy and acceptability of contraceptive methods, and on the feasibility and desirability of prescribing long-acting methods. Results A high proportion of practitioners (80.2%) endorsed the role of LARC in preventing teenage pregnancy, but fewer than half (47.1%) saw them as returning to favor. The combined oral contraceptive pill is still the mainstay of prescriptions. Lack of skill in providing was seen by 60.6% as a barrier to provision of long-acting methods of contraception. Half of respondents (50.3%) thought that irregular bleeding deterred women from using LARC and 20.6% were concerned about high discontinuation rates. Misconceptions about side effects of contraceptive methods were common. Conclusion Investment in professional education and training is needed for health professionals in general practice if the goal of increased provision of long-acting contraceptive methods is to be realized.

Contraception with Levonorgestrel Subdermal Implants ($Norplant^R$) in Benin-City, Nigeria: A 12-year Review

The case notes of 377 clients who accepted Norplant out of 11961 acceptors of family planning methods in the Department of Obstetrics and Gynaecology University of Benin Teaching Hospital, between January 1985 and December 1996 were retrieved and analysed at the end of 2004, for socio-demographic characteristics of the clients, side effects and complications reported and reasons for discontinuation in relation to duration of use. The daily register of the acceptors were analysed for new acceptors of other methods during the same period and confirmed with their case notes. The acceptance incidence of Norplant was 3.2%. The mean age and parity of the acceptors were 32.2 +/- 4.5 years and 3.9 +/- 1.8 respectively. The duration of use ranged between 6 months and 13 years. 65% of the acceptors reported menstrual abnormalities. 48% of them reported reduced bleeding pattern, while 7.5% (25) discontinued method under 4 years of use because of increased bleeding episodes. Other side effects reported were headache 6%, weight gain 3%, mastalgia 1.8%, decreased libido 1.8%, abdominal pain 1.5% and hypertension 1.2%. 20.4% (68) discontinued the use under 4 years because of desire to have another baby. 38.6% (129) had implants removed at 5 years, while 20.1% (67) continued the use for 6-13 years before removal and replacement with another set. Husband's request for removal constituted 7.2% (24). The effectiveness was 100% as no pregnancy was reported during the study period. The continuation rate at 5 years was 58.7%. 43 clients were however lost to follow up. Norplant was found to be an effective and acceptable method of long-term reversible contraception with minimal side effects. The low incidence was attributed to the fact that the implants were donor driven and not included in the country contraceptive logistic system. Norplant acceptors who continued the use after 5 years did so, because they enjoyed it and did not want to part with them without replacement of new sets.

Contraception with levonorgestrel subdermal implants (Norplant) in Benin-City, Nigeria: a 12-year review.

The case notes of 377 clients who accepted Norplant out of 11961 acceptors of family planning methods in the Department of Obstetrics and Gynaecology University of Benin Teaching Hospital, between January 1985 and December 1996 were retrieved and analysed at the end of 2004, for socio-demographic characteristics of the clients, side effects and complications reported and reasons for discontinuation in relation to duration of use. The daily register of the acceptors were analysed for new acceptors of other methods during the same period and confirmed with their case notes. The acceptance incidence of Norplant was 3.2%. The mean age and parity of the acceptors were 32.2 +/- 4.5 years and 3.9 +/- 1.8 respectively. The duration of use ranged between 6 months and 13 years. 65% of the acceptors reported menstrual abnormalities. 48% of them reported reduced bleeding pattern, while 7.5% (25) discontinued method under 4 years of use because of increased bleeding episodes. Other side effects reported were headache 6%, weight gain 3%, mastalgia 1.8%, decreased libido 1.8%, abdominal pain 1.5% and hypertension 1.2%. 20.4% (68) discontinued the use under 4 years because of desire to have another baby. 38.6% (129) had implants removed at 5 years, while 20.1% (67) continued the use for 6-13 years before removal and replacement with another set. Husband's request for removal constituted 7.2% (24). The effectiveness was 100% as no pregnancy was reported during the study period. The continuation rate at 5 years was 58.7%. 43 clients were however lost to follow up. Norplant was found to be an effective and acceptable method of long-term reversible contraception with minimal side effects. The low incidence was attributed to the fact that the implants were donor driven and not included in the country contraceptive logistic system. Norplant acceptors who continued the use after 5 years did so, because they enjoyed it and did not want to part with them without replacement of new sets.