Prevalence and factors associated with early discontinuation of long-acting reversible contraceptives among women using long - acting reversible contraceptives at Kawempe National Referral Hospital.

Abstract

Background: Level of unmet need, fertility rate and unwanted pregnancies is high especially in developing countries despite government’s efforts to improve the vital statistics. Long acting reversible methods offer effective and satisfying contraception but high rates discontinuation rates hinder their efficacy. Prevalence of LARC use has remained low despite improvement in their uptake, discontinuation is thought to be the reason. The objective of this study was to determine the prevalence and factors associated with early discontinuation of LARC among women using long acting reversible contraceptives at Kawempe National Referral hospital. Methods: A facility-based cross-sectional study was conducted from February 2020 to June 2021. We consecutively recruited 354 participants who discontinued a LARC (IUD and sub-dermal implant) during study period after informed written consent. Data on duration of use of LARC and factors associated was collected using an interviewer administered questionnaire. Early LARC discontinuation was defined as termination of the contraception within the first 12 months of use. Questionnaire were entered using Statistical Package for Social Services (SPSS) version 14/0. Data cleaned, coded, and analyzed in STATA. Prevalence was expressed as a proportion while logistic regression was used to assess for the association of factors with Early LARC discontinuation. Variables with a p-value of <0.05 and a 95% confidence interval were considered statistically significant. Results: The proportion of early discontinuation of LARC was 29%. Factors associated with early discontinuation included; Age less than 25 years (OR=5.07; 95% CI: 1.1-24.8 p=0.045) and Desired family size < 4 children (OR=3.188; 95%CI: 1.2-8.7; p=0.023). Conclusion: Prevalence of early discontinuation of LARC is high and needs urgent interventions in order to maximize the cost effectiveness of these methods; Women less than 25 years need more support when choosing and for the period they are on the LARC method. Lastly women desiring small families should be actively supported while on LARC.