scholarly journals Discontinuation of modern contraception methods due to side effects and method failure in India: an analysis using reproductive calendar data

2021 ◽  
Vol 10 (9) ◽  
pp. 3462
Author(s):  
Mahesh R. Shete ◽  
Prakash Kumar ◽  
Enu Anand ◽  
Jayakant Singh ◽  
Manas Ranjan Pradhan
Keyword(s):  
Side Effects ◽  
Contraceptive Use ◽  
Family Health ◽  
Informed Choice ◽  
Married Women ◽  
Health Concern ◽  
Discontinuation Rate ◽  
Modern Contraception ◽  
Significant Public Health ◽  
Calendar Data

Background: Contraceptive discontinuation for reasons other than the desire to get pregnant is a significant public health concern. This study aimed to understand the elaborated role of side effects and method failure behind modern reversible contraception method discontinuation among married women aged 15-49 years in India.Methods: The analysis was based on 142992 episodes of contraceptive use contributed by 90414 married women aged 15-49 years covered in the National family health survey-4 (2015-2016). Multivariate analyses, discontinuation rates using the multiple/single decrement life table and multi-level multinomial competing risk analyses were performed.Results: Discontinuation rate due to side effects within 12 months of use was highest for injectables (14.7%) and lowest for male condoms (3%) and due to method failure, it was highest for male condoms (3%) and lowest among IUD users (1.2%). Compared to women using IUD, those using pills had 2.3 times and 1.6 times the higher hazard of discontinuation due to method failure and side effects, respectively.Conclusions: The discontinuation rate of all selected methods was higher due to side effects than method failure. The high discontinuation rate of many contraceptive methods and the frequency of contraceptive failure suggest the need for strategies to promote improved contraceptive use following method selection. Improved quality of services through proper counselling of the potential contraceptive users would enhance informed choice, thus increasing modern contraception continuation among women in India.

scholarly journals INFORMATION ABOUT METHODS RECEIVED BY CONTRACEPTIVE USERS IN INDIA

2016 ◽  
Vol 49 (6) ◽  
pp. 798-810 ◽  
Author(s):  
Anrudh K. Jain
Keyword(s):  
Side Effects ◽  
Contraceptive Use ◽  
Service Providers ◽  
Population Control ◽  
Family Health ◽  
Informed Choice ◽  
Independent Effect ◽  
Family Welfare ◽  
Modern Contraceptive ◽  
Mixed Effect

SummaryVery little is known, at national and state levels, about how much information women in India are receiving about the method of contraception they are using. The purpose of this study was to fill this gap in knowledge. A Method Information Index (MII) was calculated from the responses of women who started using a modern contraceptive method five years prior to interview, and who were still using it at the time of interview, in the third National Family Health Survey conducted in India in 2005–06. The women were asked whether at the time they initiated contraceptive use they were told about other methods they could use, the side-effects of their selected method and what to do if they experienced these side-effects. The MII values (percentages of women who responded ‘yes’ to all three questions) were calculated for each category of women’s characteristics to show the relationship between MII and each characteristic. Mixed-effect logistic regression models were used to assess the independent effect of each variable after controlling for the effects of other variables on MII. The results indicate that contraceptive users in India in 2005–06 were receiving very little information about the method they were using: only 15.6% of contraceptive users reported receiving information on all three items. This low level was prevalent across different socioeconomic strata and across all the major states. There were a few exceptions, but the level was still quite low. Clearly, there is plenty of scope to improve the content of information exchanged between service providers and clients in order to ensure the rights of women to receive services of good quality, as well as improve informed choice and continuity of contraceptive use. Such a focus on improving quality of services is likely to help the Ministry of Health and Family Welfare in making its stated transition from a ‘population control centric’ to a ‘reproductive rights based’ approach to family planning in India.

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.

Informed choice in modern contraceptive method use: pattern and predictors among young women in India

2019 ◽  
Vol 52 (6) ◽  
pp. 846-859 ◽  
Author(s):  
Manas Ranjan Pradhan ◽  
Surendra Kumar Patel ◽  
Antim Alok Saraf
Keyword(s):  
Oral Contraceptive ◽  
Side Effects ◽  
Young Women ◽  
Contraceptive Method ◽  
Reproductive Rights ◽  
Oral Contraceptive Pill ◽  
Informed Choice ◽  
Married Women ◽  
Modern Contraceptive ◽  
Modern Contraceptive Method

AbstractResearch on informed choice in modern contraceptive method acceptance by young married women is pertinent in the broader context of individual freedom and reproductive rights, especially in countries where women continue to have limited control over their reproductive and contraceptive choices. This study in India asked: (1) is young married women’s acceptance of specific modern contraceptive methods an informed choice? and (2) what are the enablers and barriers to informed choice? The study used data for currently married women aged 15–24 (N = 20,752) from the fourth round of the National Family Health Survey (NFHS-4) conducted in 2015–16. A Method Information Index (MII) was calculated as a measure of informed choice from the percentage of users who responded ‘yes’ to all three questions on: whether they were informed about methods other than the one they received, told about the method-specific side-effects, and advised what to do if they experienced side-effects. Binary logistic regression analysis was carried out to examine the adjusted effect of factors associated with the MII separately for female sterilization, the intrauterine device and the oral contraceptive pill, and a combined MII including all three methods plus injectables. One-fifth of the study women used any modern contraceptive method at the time of survey, of which only 36% had fully informed choice. The likelihood of being informed about the methods was significantly higher among those using the oral contraceptive pill (OR: 1.75, CI 1.58–1.94), IUD (OR: 2.23, CI 1.97–2.52) and injectables (OR: 1.37, CI 0.97–1.94) compared with those who were sterilized. Informed choice varied by region and the socioeconomic profile of the users. Inadequately informed choice violates the reproductive rights of young women and might result in higher post-use health problems, discontinuation of and unmet need for contraceptives, unintended pregnancies, induced abortions and regret, adversely affecting women’s health. Training of health/family planning workers in India about the importance of reproductive rights is urgently required to enhance informed contraceptive choice and improve the health of young married women.

scholarly journals Contraceptive Practice of Married Women: Experience from a Rural Community of Bangladesh

2014 ◽  
Vol 5 (1) ◽  
pp. 14-18
Author(s):  
Md Atiqur Rahman ◽  
Md Mahfuzar Rahman ◽  
Sazia Huq ◽  
Sardar Mahmud Hossain
Keyword(s):  
Side Effects ◽  
Life Expectancy ◽  
Contraceptive Use ◽  
Oral Contraceptive Pill ◽  
Married Women ◽  
Fertility Rate ◽  
Reproductive Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
High Level

Bangladesh is a country having high density of population in the world. Its fertility rate ranges from 4.1 to 5.49 and life expectancy is 66years while the total fertility rate of Asia is 2.2 and life expectancy 70 years. This descriptive type of cross sectional survey was carried out among 240 married women of reproductive age from July to December, 2012 in some villages of Keranigonj, Upazila, Dhaka. 73(31%) were practicing some methods of contraception, while 167 (69%) were not using it. OCP (Oral Contraceptive Pill) was the commonest method of contraception followed by Condoms 12(5%), Injectable 12(5%), Implant 12(5%) & Tubectomy 6(3%). None was found using IUCD and Traditional method ( withdrawal, rhythm method ) and emergency contraceptive method. The use of contraceptive was more common in grand multipara (p<0.01), >35 years old ladies (p<0.05). Non users of contraceptives in this study were 167 (69%) and the major reason for the non use was intention to have more children 53(31.46%) followed by pressure from the husband 21(12.35%), prohibition by the religion 18 (10.9%) and desire for son 17 (10.11%). Among the 73 contraceptive users 38 (52%) experienced side effects with the use of contraceptives. The commonest side effects were menstrual irregularities 17(23.8%) followed by change in body weight 8(11.19%). Frequency of contraceptive use was found comparatively low among rural married women despite high level of awareness. Desire for larger family, religious concerns and fear of side effects were the main factors responsible for non users. Religious scholars must play their role in clarifying many aspects regarding contraceptives. DOI: http://dx.doi.org/10.3329/akmmcj.v5i1.18767 Anwer Khan Modern Medical College Journal Vol. 5, No. 1: January 2014, Pages 14-18

scholarly journals A qualitative study on determinants of choice of contraceptives in a rural

2017 ◽  
Vol 4 (6) ◽  
pp. 1943
Author(s):  
Hamsa T. Swamy ◽  
Bhanu M. ◽  
Nanda Kumar B. S. ◽  
Shivaraj N. S.
Keyword(s):  
Side Effects ◽  
Focus Group ◽  
Irrational Beliefs ◽  
Contraceptive Use ◽  
Family Health ◽  
Modern Contraceptive ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Entire Family ◽  
Lack Of Knowledge

Background: Family planning is a fundamental right of every human being. According to National Family Health Survey-4 Karnataka factsheet the rate of female sterilization is 48.6%, as compared to 57.4% in the NFHS-3 survey.1 Further as per NFHS-4 the rate of male sterilization is 0.1%, IUD/PPIUCD is 0.8%, pill use is 0.4%, and condom use is 1.3%. This study aims to determine factors influencing contraceptive non-use among women aged 15 - 49 years in rural area, Karnataka.Methods: Three focus group discussions were conducted in Ardesahalli Primary Health Center area to assess the knowledge and attitude of the women with regards to use and determinants for choices of contraceptives. Conceptual framework was used to develop the leading questions for the focus group discussions which included macro and micro level factors determining use or non-use of contraceptives.Results: Mother-in-law’s lack of knowledge about contraceptive use and fear of side effects regarding contraceptive had an influence on daughter and daughter-in-law’s for using/not using any method.Conclusions: Similar qualitative studies revealed that there were personal, cultural, and health system barriers to modern contraceptive use. In our study also Mother-in-law’s lack of knowledge and fear of side effects regarding contraceptive had an influence on daughter-in-law’s. It is imperative that the entire family is involved during the counseling sessions so that the misconceptions and irrational beliefs are addressed comprehensively. 

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.

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.

Side effects and discontinuation of oral contraceptive use in southern Brazil

1986 ◽  
Vol 18 (3) ◽  
pp. 261-271 ◽  
Author(s):  
Barbara Janowitz ◽  
Thomas T. Kane ◽  
Jose Maria Arruda ◽  
Deborah L. Covington ◽  
Leo Morris
Keyword(s):  
Oral Contraceptive ◽  
Side Effects ◽  
Oral Contraceptives ◽  
Contraceptive Use ◽  
Married Women ◽  
Medical Attention ◽  
Southern Brazil ◽  
Oral Contraceptive Use ◽  
Contraceptive Prevalence

SummaryThe subsequent contraceptive behaviour following reported side effects in users of oral contraceptives in the southern region of Brazil is examined in relation to discontinuation of pill use, changing to other methods, termination of contraceptive use, the role of the physician in influencing a woman's decision to discontinue pill use, and discontinuation according to the type of problem experienced.In 2904 currently married women, aged 15–44, almost 75% reported that they had used the pill at some time, and of these 45.6% were still doing so. Women who reported problems with the pill were less likely to be current users (25%) than the women who did not (65%). However, overall contraceptive prevalence was about the same in both groups. Women who stop using oral contraceptives are more likely to be using traditional methods than women in the general population, especially if they want more children. Termination of pill use varies little according to the type of problem reported. Women with problems who sought medical attention were more likely to stop using the pill and so were women advised to stop by their physician, but the major factor affecting discontinuation was the reported experience of a problem.

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.

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