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Title: Magnitude and factors for method discontinuation and switching among long acting reversible contraceptive users in health facilities of Southern Ethiopia. Author: Bereku T, Habtu Y, Abreham B, Ayele M, Eliso M. Journal: Reprod Health; 2022 Feb 19; 19(1):47. PubMed ID: 35183214. Abstract: BACKGROUND: Long Acting Reversible Contraceptives (LARCs) are contraceptives that prevent unplanned pregnancy in a more safer and effective way than other modern short acting methods. However, method discontinuation and switching are still challenges for utilization of LARCs in resource limited countries for several reasons. Thus, the aim of this study was to determine magnitude and factors for method discontinuation and switching among LARCs users in health facilities of Southern Ethiopia. METHODS: A Facility based record review was used to collect data from May to June 2019. Three hospitals were randomly selected from five hospitals found in southern Ethiopia. A total of 1050 records were included in the study from long acting family planning registers between 2018 and 2019. Data were entered to Epi-info 3.5.4 and exported to SPSS for windows version 20 for analysis. A descriptive statistics was performed to describe factors and reasons for LARCs discontinuation and switching off. Logistic regression technique with a 95% confidence level was used to determine the association between factors and magnitude of method discontinuation and switching. RESULTS: Of the 1050, 69.8% of women discontinued long acting reversible family planning method before the recommended duration of use and 30.2% of them switched from long acting family planning methods to any other modern contraceptive methods. Women who shifted from any LARCs to short-acting family planning methods accounted for 38.8% of those who shifted to any other modern methods. Desire to get pregnant and method specific side effect were most common reasons for both method discontinuation and switching. Women with only one child were 1.61 times more likely to discontinue than women who had greater than five number of children. CONCLUSION: Discontinuation and switching of long acting reversible family planning method was high. Primiparous women were more likely to discontinue use of long acting reversible family planning methods. Re-evaluating family planning services focusing on effective counseling about side effects of LARCs methods is required. Training should also be given for family planning providers including community healthcare workers. Ethiopia has a substantially greater percentage of unintended pregnancy than other developing and developed countries. Long-acting reversible contraception (LARC) has a potential to address a huge and growing unmet need in resource limited countries like Ethiopia, such as reducing unwanted births and abortion rates.As part of this global approach to fertility management, Ethiopia has been implementing various strategies like an on-going task shifting and task sharing with the implanon scale up program, and IUD revitalization program starting from the community health services to higher level healthcare systems to increase access and utilization of long acting reversible family planning methods. However, discontinuing LARCs before the recommended duration use and switching to short-acting contraceptives have proven difficulty in Ethiopia. This may have led to low utilization rate of LARCs in Ethiopian contexts including the study area, when compared to the national target. Very low coverage of use of LARC among unmet need has shown by many studies in various corners of the country. Thus, determining the magnitude and factors of LARC discontinuing and switching is still a pressing need to establish additional strategies used to improve consistent use of LARC for the recommended duration and expand access to LARC for better planning of births.In this study we assessed magnitude and factors of LARC discontinuation and switching from a relatively huge number of records extracted from systematically selected health facilities in Southern Ethiopia. Extracted data from registers of long acting reversible family planning methods were analysed using descriptive statistics and logistic regression. Accordingly, we found significant proportion women discontinued long acting reversible family planning methods before the recommended duration of use as well as switched from long acting reversible family planning methods to other modern short-acting methods due to various reasons. Only a number of children women had is associated with discontinuation and no single factor was associated with method switching in Southern Ethiopia. Family planning services should be re-evaluated with a focus on effective counseling on the side effects of LARCs approaches, and training for family planning providers, particularly community healthcare workers, should be provided.[Abstract] [Full Text] [Related] [New Search]