Modern contraceptives discontinuation, method switching and associated factors among clients at the family planning clinic of a tertiary hospital in Port-Harcourt, Nigeria

Abstract

Background: Contraceptive discontinuation and switching to less effective methods, often leads to unintended pregnancies and reduces the impact of family planning programs. To understand what drives contraceptive use behavior, it is important to identify factors that influence discontinuation and switching. This study sought to determine the discontinuation rates, reasons for discontinuation or switching, and assess associated factors among women in Port Harcourt.Methods: A retrospective descriptive study, of women 15-48 years who accepted a modern method, over a five-year period from 1st January 2014 to 31st December 2018 was carried out. Information on age, parity, education, contraceptive use intention, method and duration of use, reason for discontinuation, and method switching, were extracted from their hospital records. Coded data were entered into Excel spreadsheet and exported to SPSS version 20 for statistical analysis at significance level of P<0.05.Results: There were 349 women with complete data. Their mean age was 32±56 years and median parity was 3. The all-method discontinuation rate was 29.0% at 12 months and 31.5% by 24 months. Method specific discontinuation at 12 months were injectables 53.3%, IUCD 38.2% and implants 23.8%, the difference was significant P=0.018. Reasons for discontinuation were reduced need-64.5%, method problems-26.8% and expiration-7.2%. Majority 79.7% abandoned further use, 6.5% renewed their method and 13.8% switched to other methods.Conclusions: The discontinuation rate was high, with associated poor switching behaviour. Proper counseling on contraceptive options and reinforcing switching are critical to reduce unwanted pregnancies that might result from poor method use and discontinuation.