Determinants of reversible contraceptive method discontinuation among women of reproductive age in Kano metropolis, Nigeria

Abstract

Contraceptive discontinuation contributes substantially to the total fertility rate, unwanted pregnancies and induced abortions thereby increasing the already high maternal morbidity and mortality. This study aimed to access contraceptive discontinuation among women of reproductive age in Kano metropolis. Using a cross-sectional study design with concurrent mixed method of data collection, 350 women were studied. Data was collected using a structured interviewer administered questionnaire, focus group discussion and key informant interview guides. Of the 350 participants, 168 of them had discontinued a method of contraception giving a total discontinuation rate was 48%, with method specific discontinuation rate of 35.1% for implants, 33.9% for injectables, 21.4% for pills, and IUD having the lowest rate (15.5%). The study also found side effects to be the most common reason why women discontinued contraception (67.1%), intention to get pregnant (59.5%), method failure (16.7%), method switch (12.0%), and husband’s disapproval (9.5%). Factors significantly associated with discontinuation at bivariate level were ethnicity, influence on method choice, type of facility where method was obtained, and the type of contraceptive method. These factors were found not to be significant at multivariate level. Contraceptive discontinuation is prevalent in Kano metropolis, meaning that women are at high risk of unintended, mistimed pregnancies, and unsafe abortions, increasing maternal morbidity and mortality. Efforts should be made to tackle the problem of discontinuation through effective educational strategies and counselling techniques.