Early Contraceptive Implants Removal and its Associated Factors Among Women Using Implants at a National Referral Hospital, Kampala Uganda

Abstract

Background: Early discontinuation of implant contraceptive methods and reasons for discontinuation remains a major concern for family planning programs and is generally higher in developing countries. Discontinuation is closely related to higher rates of the overall fertility rate and unwanted pregnancies, leading to a possibly induced abortion. The proportion and factors associated with early contraceptive implant removal are not well known in Uganda. The study's objective was to determine the magnitude of early implant discontinuation among women receiving implant services in the study area and its associated factors. Methods: A facility-based cross-sectional study was conducted from 2nd January to 3rd March 2020 through a face-to-face interview. A total of 207 Implant user women were selected by systematic random sampling technique. SPSS version 20 was used for both data entry and analysis. Factors associated with early Implant discontinuation were analyzed using a binary and multivariable logistic regression model. Variables with a p-value of <0.05 and a 95% confidence interval were considered as statistically significant. Results: The proportion of early implant discontinuation was 42%. Factors associated with early implant discontinuation included; experience of side effects (OR=2.629; 95%CI:1.095-6.314; P=0.031), not having received pre-insertion counseling about the benefits and side effects of contraceptive implants (OR=2.565; 95%CI: 1.190-5.532; P= 0.016) and staying in rural areas (OR= 2.390; 95%CI: 1.229-4.648; P= 0.010). 1 Conclusion: Nearly one in every two mothers have early discontinuation of contraceptive implants. Factors associated with early implant removal were side effects, lack of effective counseling before insertion, and staying in rural areas. Hence, health workers should provide adequate counseling services before inserting the Implant, emphasising possible side effects and their immediate management. Spouses, where possible, should be involved during the counselling to increase implant retention. Also, proper screening of women for pregnancy before insertion of an implant should be routine.