Determinants of Implanon Discontinuation among Women Who Use Implanon at Bahir Dar Town Health Institutions, Northwest Ethiopia, 2019: A Case-Control Study

Abstract

Background. Implanon is a long-acting reversible contraceptive method that is 99% effective in preventing unintended pregnancy. Despite its effectiveness, the rate of Implanon discontinuation is high. In Ethiopia, there is limited information about determinants of Implanon discontinuation. Therefore, this study aimed to identify the determinants of Implanon discontinuation among women who used Implanon at Bahir Dar town health institutions. Methods. We employed an unmatched case-control study to find out the determinants of Implanon discontinuation at Bahir Dar town health institutions from March to June 2019 using the multistage stratified sampling technique to select study participants. Cases were women who had discontinued Implanon before completion of 3 years, and controls were women who had removed Implanon at the date of appointment (3 years). A pretested, structured questionnaire with face-to-face interviews was used. Binary logistic regression was performed to identify determinants of Implanon discontinuation. In the final model, variables with a p value of <0.05 were considered significant at 95% confidence interval and the strength of association was measured using odds ratio. Results. Primary education (AOR = 0.104, 95% CI (0.02-0.48)), secondary education (AOR = 0.48, 95% CI (0.24-0.952)), women who have no child (AOR = 2.04, 95% CI (1.2-3.4)), women who had no discussion with their partner (AOR = 2.2, 95% CI (1.39-3.57)), mass counseling (AOR = 3.5, 95% CI (1.75-7.01)), women who had no counseling about side effects (AOR = 1.7, 95% CI (1.07-2.07)), women who experienced side effects (AOR = 2.2, 95% CI (1.4-3.4)), and purpose of family planning use (AOR = 2.5, 95% CI (1.14-4.8)) were determinants of Implanon discontinuation. Conclusion. Implanon discontinuation is attributed by multifactorial involvement. Women's educational status, nulliparity, no counseling, not informed of side effects, and no partner discussion are significant factors. Health sector stakeholders need to tailor counseling services at individual level to bolster family planning utilization until the desired time.