Determinants of Intrauterine Contraceptive Device Discontinuation Among Women Using Family Planning, in Southwest Ethiopia: Unmatched Case–Control Study

Abstract

Background: Although the intrauterine contraceptive device is an effective, reliable, safe, and recommended contraceptive method, it is still underutilized and has a high discontinuation rate in Ethiopia. The study aims to assess determinants of the discontinuation of IUCDs among women using family planning in Ilu Aba Bor Zone. Methods: A facility-based unmatched case-control study was conducted from September to October, 2021 among 168 (56 cases and 112 controls) IUCD-user women in public health facilities in south-west Ethiopia. Pretested, structured and interviewer administered questionnaires were used for data collection. The data were coded, cleaned and entered to Epi-data version 3.1 and exported to SPSS version 23 for advanced analysis. A binary logistic regression was used to estimate the degree of association between the outcome variable and independent variables. Finally, variables with a p-value less than 0.05 at 95\% confidence interval were declared as statistically significant with outcome variable. Results: A total of 168 (163) respondents participated in the study, with a response rate of 97\%. The mean (+SD) age of the respondents was 31.36 +/- 5.916. Regarding the educational status of respondents about 36 (64.3\%) of cases and 90 (84.1\%) of controls have formal education, and about 42 (75\%) of cases' husbands and 97 (90.65\%) of controls' husbands have formal education, respectively. Experiencing side effects (AOR = 2.36; 95\% CI: 1.01, 5.55), lack of follow up (AOR = 4.069; 95\% CI: l.30, 12.69), and planning for next pregnancy (AOR 4.14; 95\% CI: 1.58, 10.88) were found to be the main determinants of intrauterine device discontinuation. Conclusion: The findings of the study showed that lack of follow-up after insertion of the IUCD, experiencing side effects, and having a plan for the next pregnancy were found to be the main determinants of intrauterine device discontinuation. Hence, arranging recommended and side effects are to sustain intrauterine device utilization.