Correlation of Unmet Need and Discontinuation in Ethiopia: a View

2016 ◽  
Vol 51 (6) ◽  
pp. 656-668
Author(s):  
Yishak A Lailulo ◽  
A Sathiya Susuman
Keyword(s):  
Side Effects ◽  
Research Method ◽  
Quantitative Research ◽  
Contraceptive Use ◽  
Research Question ◽  
Unmet Need ◽  
Discontinuation Rate ◽  
Key Factors ◽  
Factors Affecting ◽  
Contraceptive Discontinuation

A few key factors affecting usage of all methods and contraceptive discontinuation among women whom are currently married in Ethiopia are discussed. What are the factors affecting women’s contraceptive use? The aim is to explore the two regions on the basis of high total fertility rate (TFR) regions (Oromiya (5.6) and Southern Nations, Nationalities, and People’s Region (SNNPR) (4.9)) in the Ethiopian demographic and health survey (EDHS) 2011. A descriptive and comparative study using the quantitative research method is chosen to address the above research question. The study findings show that the contraceptive discontinuation rate for users of all types of methods is 37%. The highest women’s discontinuation rate is for the pill which is 70% due to side effects.

scholarly journals A qualitative exploration of contraceptive use and discontinuation among women with an unmet need for modern contraception in Kenya

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Susan Ontiri ◽  
Lilian Mutea ◽  
Violet Naanyu ◽  
Mark Kabue ◽  
Regien Biesma ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Peer Influence ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Modern Contraception ◽  
Modern Contraceptives ◽  
Family Planning Programs ◽  
Contraceptive Discontinuation

Abstract Background Addressing the unmet need for modern contraception underpins the goal of all family planning and contraception programs. Contraceptive discontinuation among those in need of a method hinders the attainment of the fertility desires of women, which may result in unintended pregnancies. This paper presents experiences of contraceptive use, reasons for discontinuation, and future intentions to use modern contraceptives. Methods Qualitative data were collected in two rural counties in Kenya in 2019 from women with unmet need for contraception who were former modern contraceptive users. Additional data was collected from male partners of some of the women interviewed. In-depth interviews and focus group discussions explored previous experience with contraceptive use, reasons for discontinuation, and future intentionality to use. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Results Use of modern contraception to prevent pregnancy and plan for family size was a strong motivator for uptake of contraceptives. The contraceptive methods used were mainly sourced from public health facilities though adolescents got them from the private sector. Reasons for discontinued use included side effects, method failure, peer influence, gender-based violence due to covert use of contraceptives, and failure within the health system. Five reasons were provided for those not willing to use in the future: fear of side effects, cost of contraceptive services, family conflicts over the use of modern contraceptives, reduced need, and a shift to traditional methods. Conclusion This study expands the literature by examining reasons for contraceptive discontinuation and future intentionality to use among women in need of contraception. The results underscore the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help garner support for contraception, rather than focusing exclusively on women. The results of this study can inform implementation of family planning programs in Kenya and beyond to ensure they address the concerns of former modern contraception users.

Method Related Attributes and Contraceptive Discontinuation: Results from A Prospective Study from Nairobi and Homa Bay Counties in Kenya.

2021 ◽  
Author(s):  
Yohannes Dibaba Wado ◽  
Martin K. Mutua ◽  
George Odwe ◽  
Francis Obare ◽  
Kazuyo Machiyama ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Side Effects ◽  
Contraceptive Use ◽  
Longitudinal Design ◽  
Unmet Need ◽  
Health Problems ◽  
Competing Risk ◽  
Modern Contraceptive ◽  
Fertility Preferences ◽  
Contraceptive Discontinuation

Abstract Background: Rates of contraceptive discontinuation are high in many low and middle countries contributing to unmet need for contraception and other adverse reproductive health outcomes. Few studies have investigated how method specific beliefs and strength of fertility preferences affect discontinuation rates. This study examines this question using primary data collected in Nairobi and Homa Bay counties in Kenya.Methods: We used data from two rounds of a longitudinal study of married women ages 15-39 years (2812 and 2424 women from Nairobi and Homa Bay respectively at round 1) from two communities in Kenya. Information on fertility preferences, past and current contraceptive behavior, and method-related beliefs about six modern contraceptive methods were collected, along with a monthly calendar of contraceptive use between the two interviews. The analysis focused on discontinuation of the two most commonly used methods in both sites, injectable and implants. We carry out competing risk survival analysis to identify which method related beliefs predict discontinuation among women using at the first round. Results: The percentages of episodes discontinued in the 12 months between the two rounds was 36%, with a higher rate of discontinuation in Homa Bay (43%) than in the Nairobi slums (32%) and higher for injectables than implants. Method related concerns and beliefs were the major self-reported reasons for discontinuation in both sites. The competing risk survival analysis showed that the probability of method related discontinuation of implants and injectables was significantly lower among respondents who believed that the methods do not cause serious health problems (SHR=0.78, 95% CI 0.62-0.98), do not interfere with regular menses (SHR=0.76, 95% CI 0.61 - 0.95) and do not cause unpleasant side effects (SHR=0.72, 95% CI 0.56-0.89). By contrast, there were no net effects of three method related beliefs that are commonly cited as obstacles to contraceptive use in African societies: safety for long-term use, ability to have children after stopping the method, and the approval of the husband.Conclusion: This study is unique in its examination of the effect of method specific beliefs on subsequent discontinuation for a method-related reason, using a longitudinal design. The single most important result is that concerns about serious health problems, which are largely unjustified and only moderately associated with beliefs about side effects, are a significant influence on discontinuation. The negative results for other beliefs show that the determinants of discontinuation differ from the determinants of method adoption and method choice.

scholarly journals Patterns and determinants of modern contraceptive discontinuation among women of reproductive age: Analysis of Kenya Demographic Health Surveys, 2003–2014

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241605
Author(s):  
Susan Ontiri ◽  
Vincent Were ◽  
Mark Kabue ◽  
Regien Biesma-Blanco ◽  
Jelle Stekelenburg
Keyword(s):  
Side Effects ◽  
Health Surveys ◽  
Contraceptive Use ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Discontinuation Rate ◽  
Women Of Reproductive Age ◽  
Short Term ◽  
Younger Women ◽  
Contraceptive Discontinuation

Objectives This study aimed to examine patterns and determinants of modern contraceptive discontinuation among women in Kenya. Methods Secondary analysis was conducted using national representative Kenya Demographic and Health Surveys of 2003, 2008/9, and 2014. These household cross-sectional surveys targeted women of reproductive age from 15 to 49 years who had experienced an episode of modern contraceptive use within five years preceding the surveys from 2003 (n = 2686), 2008/9 (n = 2992), and 2014 (5919). The contraceptive discontinuation rate was defined as the number of episodes discontinued divided by the total number of episodes. Weighted descriptive statistics, multivariable logistic regression analysis, and Cox proportional hazards analysis were used to examine the determinants of contraceptive discontinuation. Results The 12-month contraceptive discontinuation rate for all methods declined from 37.5% in 2003 and 36.7% in 2008/9 to 30.5% in 2014. Consistently across the three surveys, intrauterine devices had the lowest 12-month discontinuation rate (6.4% in 2014) followed by implants (8.0%, in 2014). In 2014, higher rates were seen for pills (44.9%) and male condoms (42.9%). The determinants of contraceptive discontinuation among women of reproductive age in the 2003 survey included users of short-term contraception methods, specifically for those who used male condoms (hazard ratio [HR] = 3.30, 95% confidence interval [CI] = 2.13–5.11) and pills (HR = 2.68; 95CI = 1.79–4.00); and younger women aged 15–19 year (HR = 2.07; 95% CI = 1.49–2.87) and 20–24 years (HR = 1.94; 95% CI = 1.61–2.35). The trends in the most common reasons for discontinuation from 2003 to 2014 revealed an increase among those reporting side effects (p = 0.0002) and those wanting a more effective method (p<0.0001). A decrease was noted among those indicating method failure (p<0.0001) and husband disapproval (p<0.0001). Conclusions Family planning programs should focus on improving service quality to strengthen the continuation of contraceptive use among those in need. Women should be informed about potential side effects and reassured on health concerns, including being provided options for method switching. The health system should avail a wider range of contraceptive methods and ensure a constant supply of commodities for women to choose from. Short-term contraceptive method users and younger women may need greater support for continued use.

scholarly journals Contraceptive Use Dropout-adjusted Unmet Need for Family Planning

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 780
Author(s):  
Budi Utomo ◽  
Hariyanti Hariyanti ◽  
Sabarinah Prasetyo ◽  
Robert Magnani ◽  
Sukma Rahayu
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unwanted Pregnancy ◽  
Unmet Need ◽  
Discontinuation Rate ◽  
Study Results ◽  
Unwanted Pregnancies ◽  
Contraceptive Discontinuation ◽  
History Of ◽  
Calendar Data

Background: In the last two decades, unmet need for family planning in Indonesia remains stagnant, and contraceptive discontinuation has increased. These two indicators describe the risk of unwanted pregnancy in a population. Therefore, this study aims to develop an accurate calculation of the unmet need for family planning in Indonesia.  Method: The study uses 2017 IDHS data to compare unmet need at survey-time and five years preceding the survey, measured by contraceptive calendar data that measured history of contraceptive use within five years preceding the survey. Unmet need at five years preceding the survey is measured by calculating the proportion of months not using contraceptive to the duration of months exposed to pregnancy in a period of 69 months. The study population is married women in Indonesia, with a sample size of 35,681.   Results: Unmet need with contraceptive calendar calculation is higher than unmet need at survey-time. A difference of 3% concerns an additional of nearly 1.6 million unwanted pregnancies. This study proves that the high number of contraceptive discontinuations is directly proportional to higher unmet need with contraceptive calendar calculation.  Conclusion: In Indonesia, with a relatively high contraceptive discontinuation rate, the calculation of unmet need using the calendar method is more precise than at survey-time method. The study results suggest the use of unmet need calendar for countries with high contraceptive discontinuation rate and provision of primary health care that is responsive to a potential unwanted pregnancy.

scholarly journals Predictors of modern contraceptive use among women and men in Uganda: a population-level analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034675 ◽  
Author(s):  
Amrita Namasivayam ◽  
Sarah Lovell ◽  
Sarah Namutamba ◽  
Philip J Schluter
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Secondary Data ◽  
Population Level ◽  
Modern Contraceptive ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Logistic Regression Models ◽  
Modern Contraceptive Use

Objective(s)Despite substantial and rapid improvements in contraceptive uptake in Uganda, many women continue to have unmet need for contraception. As factors affecting contraceptive use are dynamic and complex, this study seeks to identify current predictors and provide effect size estimates of contraceptive use among women and men in Uganda.Study designA nationally representative cross-sectional population survey, using secondary data from Uganda’s 2016 Demographic and Health Survey. Stratified by sex, weighted bivariable and multivariable logistic regression models were derived from a suite of potential predictor variables. Predictive abilities were assessed via 10-fold cross-validated area under the receiver operating characteristic curves (AUCs).SettingUganda.ParticipantsAll women aged 15–49 years who were permanent residents of the selected households or stayed in the household the night before the survey were eligible to participate. In one-third of the sampled households, all men aged 15–54 years who met the same residence criteria were also eligible.Primary outcome measuresModern contraceptive use.ResultsOverall, 4914 (26.6%) women and 1897 (35.6%) men reported using a modern contraceptive method. For women and men, both demographic and proximate variables were significantly associated with contraceptive use, although notable differences in effect sizes existed between sexes—especially for age, level of education and parity. Predictively, the multivariable model was acceptable for women with AUC=0.714 (95% CI 0.704 to 0.720) but less so for men with AUC=0.654 (95% CI 0.636 to 0.666).Conclusion(s)Contemporary significant predictors of contraceptive use among women and men were reported, thereby enabling key Ugandan subpopulations who would benefit from more targeted family planning initiatives to be identified. However, the acceptable AUC for women and modest AUC for men suggest that other important unmeasured predictors may exist. Nonetheless, these evidence-based findings remain important for informing future programmatic and policy directions for family planning in Uganda.

scholarly journals Financial and Non-financial Factors Affecting Board Size of the Listed Firms in Vietnam

2020 ◽  
Vol 11 (2) ◽  
pp. 187
Author(s):  
Nguyen Vinh Khuong ◽  
Phung Anh Thu ◽  
Do Thi Thu Lieu ◽  
Tran Thi Phuong Anh ◽  
Nguyen Thi My Giau ◽  
...  
Keyword(s):  
Empirical Evidence ◽  
Research Method ◽  
Quantitative Research ◽  
Board Independence ◽  
Corporate Management ◽  
Factors Affecting ◽  
Listed Firms ◽  
Financial Factors ◽  
Board Of Director ◽  
Management Policies

The study contributes by providing empirical evidence on the extent to which financial and non-financial factors affect the size of the board of director of listed firms in Vietnam. Based on the data from 80 listed firms on the Vietnam’s stock market in 11 years from 2007-2017, using quantitative research method. We concluded that financial and non-financial factors affect board independence of listed firms in Vietnam. From the research results, it is recommended that listed companies have reasonable and effective corporate management policies, consistent with accounting policies at enterprises.

scholarly journals Family planning providers and contraceptive users in Rwanda employ strategies to prevent discontinuation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hilary Schwandt ◽  
Angel Boulware ◽  
Julia Corey ◽  
Ana Herrera ◽  
Ethan Hudler ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Contraceptive Use ◽  
First Year ◽  
Modern Contraceptive ◽  
Group Discussions ◽  
Program Success ◽  
Family Planning Programs ◽  
Contraceptive Discontinuation

Abstract Background In 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. Methods This 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. Results Family 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. Conclusions The 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.

scholarly journals Trends in contraceptive demands and unmet need for family planning in migrant population of Uttarakhand

2018 ◽  
Vol 5 (2) ◽  
pp. 590 ◽  
Author(s):  
Sadhna Singh ◽  
Neha Priya ◽  
Debabrata Roy ◽  
Anurag Srivastava ◽  
Surekha Kishore
Keyword(s):  
Side Effects ◽  
Failure Rate ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Reproductive Age ◽  
Modern Contraceptive ◽  
Migrant Population ◽  
High Failure Rate ◽  
Cross Sectional Survey ◽  
Traditional Methods

Background: The knowledge of contraceptive use and unmet need is important to know the constraints for unmet need based on user perspective. The aim of the study was to find the prevalence of Contraceptive use, Contraceptive preferred and the Un-met demand for contraceptives. Methods: Married, non-pregnant women of reproductive age group (15-49 years) from the migrant population were interviewed by Census method using pre-designed and pre-tested instrument by cross-sectional survey. Operational definitions for unmet need for spacing, limiting and unfelt need used in the study were as per NFHS -4 findings and traditional methods of contraception like abstinence, withdrawal were included in Un-met need for contraceptive due to its very high failure rate. Results: 58.44% study subjects had ‘Ever Used FP’ and 56.78% are currently using FP methods. The CPR is 56.7% by ‘Any Method’ and 43.0% by ‘Modern method’. The method which is most popular is ‘Sterlisation 29% and 20.96% and ‘Others’ i.e. highly unreliable methods like coitus interruptus, calendar method etc. found high number of users. The reasons for non use were apprehension of complication/side effects in 39%) and inconvenience or the difficulties with modern contraceptive methods or lack of knowledge by 7.67% and 6.95% respectively, 16% were relied on traditional methods, such as periodic abstinence, withdrawal and herbal mixtures from traditional healers as well as LAM 8% for a FP method, all of which have high failure rate. Only 24.8% Women were decision maker regarding the time and type of contraceptive to be used. The unmet need was 29.7% out of which the unmet needs for spacing and limiting were 9.6 per cent and 20.1 per cent, respectivelyConclusions: The unmet need is high and can be addressed by removing the constraints such as poor accessibility to the knowledge thus removing apprehension for side effects, improve accessibility to resources and low decision-making autonomy. 

scholarly journals Discontinuation of Different Contraceptive Methods in Thai Women During a One-year Period: A Cohort Study

2020 ◽  
Author(s):  
Unnop Jaisamrarn ◽  
Monchai Santipap ◽  
Somsook Santibenchakul
Keyword(s):  
Side Effects ◽  
Incidence Density ◽  
Discontinuation Rate ◽  
Contraceptive Methods ◽  
Thai Women ◽  
Contraceptive Discontinuation ◽  
Contraceptive Implant ◽  
History Of ◽  
One Year ◽  
Copper Iud

Abstract BackgroundEven though almost 80% of sexually active Thai women use modern contraceptives, yet unintended pregnancy remains a significant reproductive health issue. One possible explanation is that the women do not use contraceptives or stopped using contraceptives at some point in their lifetime. At present, there is scant information available about contraceptive discontinuation among Thai women. We assessed the discontinuation rate and the reason for discontinuation of the four most common contraceptives used by reproductive aged Thai women: combined oral contraceptive pills (COCs), depot medroxyprogesterone acetate (DMPA), copper IUD, and contraceptive implant(s).MethodsThere were 1,880 women aged 18-45 years recruited from the Family Planning Clinic of the Chulalongkorn Hospital in Bangkok. The participants were followed at months 3, 6 and 12 either by attending the clinic or being interviewed via a phone call. Incidence density and cumulative incidence based on the Kaplan-Meier approach were used to assess contraceptive discontinuation. Cox proportional hazards model was used to determine significant personal risks of discontinuing contraceptive.ResultsAmong all, 839 (44.6%) women initiated COCs; 494 (26.3%) initiated DMPA; 280 (14.9%) initiated copper IUD and 267 (14.2%) initiated contraceptive implant(s). The incidence density for discontinuation of COCs, DMPA, copper IUD, and contraceptive implant(s) were 21.33, 9.21, 4.36, and 2.26 / 100 person-year, respectively. Most of the women (185/222) discontinued their contraceptives because of the side effects. Compared to the contraceptive implant(s) users, adjusted HR (95% CI) of discontinuing COCs, DMPA, and copper IUD were 9.92 (4.38-22.46), 4.25 (1.81-9.98), 2.16 (0.81-5.76), respectively. Lower-income, higher parity numbers, history of miscarriage, and history of abortion were independent predictors of contraceptive discontinuation in a multivariable model.ConclusionsThe discontinuation rate of COCs, the most popular contraceptive method for Thai women, was the highest during the one-year period of the study. The primary reason for discontinuing the use of the various contraceptive methods was the side effects.

FACTORS AFFECTING EVER-MARRIED MEN’S CONTRACEPTIVE KNOWLEDGE AND USE IN NIGERIA

2002 ◽  
Vol 34 (4) ◽  
pp. 497-510 ◽  
Author(s):  
KOLAWOLE A. OYEDIRAN ◽  
GBENGA P. ISHOLA ◽  
BAMIKALE J. FEYISETAN
Keyword(s):  
Family Planning ◽  
Contraceptive Use ◽  
Key Factors ◽  
Factors Affecting ◽  
Contraceptive Knowledge ◽  
The Past ◽  
Size Limitation ◽  
Married Men ◽  
Living Children ◽  
Men’S Involvement

African men play important roles in the decisions about family life, including fertility and family planning. However, fertility and family planning research and programmes have ignored their roles in the past, focusing only on women’s behaviours. Since the 1994 International Conference on Population and Development (ICPD), interest in men’s involvement in reproductive health has increased. Unfortunately, data on their knowledge and use of contraception are generally scanty. This paper examines knowledge and use of contraception among ever-married men in Nigeria. A total of 1451 ever-married men aged 18–55 were interviewed in Imo and Ondo States, Nigeria. The findings reveal that men’s level of contraceptive knowledge is high in the study areas. About 90% knew at least one method of family planning. Furthermore, the level of contraceptive use among married men is such that men could participate in family planning activities if there were adequate programmes to involve them. Men in the sample areas were found not only to support their spouses’ use of contraceptives, but were actually using condoms to delay or prevent pregnancy. Age, education, place of residence, number of living children and being counselled for family planning were identified as key factors determining contraceptive knowledge and use among married men in the study areas. To ensure increased participation of men in family planning, programmes must be designed to educate them on the need for family size limitation and involve them in service delivery, even if only to their male counterparts.

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