195492 Reasons for contraceptive discontinuation: Data from 8 developing countries

Monday, November 9, 2009: 10:30 AM

Sarah E.K. Bradley, MHS , Demographic and Health Surveys, Macro International, Calverton, MD
Hilary M. Schwandt, MHS , Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Shane Khan, MPH , Measure DHS, Macro International, Calverton, MD
Many family planning programs have been successful in increasing adoption of contraception in developing countries. Programs have been less successful, however, in sustaining contraceptive use. To understand why this problem continues, we examine levels and trends of contraceptive discontinuation, focusing on women who stop using contraceptives while still wishing to avoid pregnancy.

Data come from the two most recent Demographic and Health Surveys in Armenia, Bangladesh, Colombia, the Dominican Republic, Egypt, Indonesia, Kenya, and Zimbabwe. We examine the most common reasons for stopping contraceptive use, and provide discontinuation rates by method and by reason for discontinuation.

On average across countries, one out of every three women who begin using a reversible method will discontinue within the first year of use, despite a desire to avoid pregnancy. Discontinuation rates for those in need of contraception have decreased over time in every country studied other than Kenya and Egypt. Discontinuations while in need during the first year of use are generally lowest for contraceptive pills (8-36% across countries), and much higher for injectables (13-57%) and condoms (19-57%). Over half of injectable users discontinue for reasons other than wanting to become pregnant during the first year of use in most countries studied, mainly due to health concerns and side effects. Most condom and traditional method users discontinue because of failure or inconvenience of the method.

These results can help us understand why women stop using contraception while still in need of contraception, and can be translated directly into programmatic changes that will help women and families meet their reproductive needs.

Learning Objectives:
Explain what contraceceptive discontinuation rates represent. Define the term "abandonment in need." Explain why some contraceptive methods have higher rates of in-need discontinuation than others.

Keywords: Family Planning, Developing Countries

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Extensive experience working on family planning programs in developing countries; designed and conducted analysis and wrote paper.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.