Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #110965

Claudia Patricia Velasquez, MPH, Georgetown University School of Medicine, Institute for Reproductive Health, 4301 Connecticut Ave, NW, Suite 310, Washington, DC 20008, 202-687-1392, cv38@georgetown.edu, Rebecka Inga Lundgren, MPH, Georgetown University Medical Center, Institute for Reproductive Health, 4301 Connecticut Ave., Suite 310, Washington, DC 20008, and Ernesto Pinto, Lcdo, Sedatos, Av. 10 de Agosto y Cuero y Caicedo, 258, Quito, Ecuador.

Family planning providers are often reluctant to offer user-dependent methods because they lack confidence in their client's ability to use them over time, or they limit it to couples they consider “ideal” candidates, with no empirical basis for this decision. Women who do not receive their preferred method are more likely to discontinue use. Contraceptive discontinuation accounts for nearly one third of unintended pregnancies in many countries. Although the effectiveness of the Standard Days Method, a fertility-awareness based method, is comparable to other methods, some providers are hesitant to offer it.

Studies in six countries tested Standard Days Method introduction in diverse settings. Life-table analysis with 1600 user interviews was used to calculate cumulative first-year continuation rates. Multivariate analysis was conducted to determine which service delivery models were most effective; and to obtain information on correct use and continuation.

Discontinuation varied significantly by type of program and user and tended to occur in the first three months of use. Users were highly satisfied. Six month continuation rates averaged at 76%. Educational level and prior family planning use had different effects by region. In India, continuation was significantly higher among women with prior use and at least six years of schooling; Central America's trends show better continuation among less educated women with no previous method use. Results will be compared to provider assumptions about who can use this method and how it must be offered. Recommendations for improving screening, counseling and follow-up to maximize correct use and continuation will be presented.

Learning Objectives: By the end of the session, participants will be able to

(
• recognize reasons why women discontinue method use; (
• identify differences in discontinuation between different countries; and (
• identify programmatic implications of method discontinuation and how to improve continuation among method users.

Keywords: Contraception, Family Violence

Related Web page: www.irh.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation