DETERMINANTS  OF  IMPLANON  DISCONTINUATION  AMONG  WOMEN  WHO  EVER  USED  IMPLANON  IN  DUGUNA  FANGO  WOREDA,  WOLAYTA  ZONE,  SOUTHERN ETHIOPIA
Creators: name: AMANUEL TADESSE
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2017

description: Introduction:  There  is  paucity  of  information  on  the  determinants  of  implanon 
discontinuation  in  low  income  countries  like  Ethiopia.  Encouraging  contraceptive 
continuation has been less of a priority than encouraging new adopters in  the country.  Inspite 
of  significant  scale  up  of  implanon  program  in  health  facilities  including  health  posts  at 
community,  significant  numbers  of  women  make  implanon  as  their  first  choice  of 
contraception and then discontinue their implanon before it’s expire date at all health facilities 
of the study Woreda.  Objectives:  The  objective of this study was to identify the determinants 
of  implanon  discontinuation  among  women  who  ever  used  implanon  in  Duguna  Fango 
Woreda,  Wolayta  Zone,  Southern  Ethiopia.  Methods:  A  community  based  unmatched  case 
control study design was used from March 20 to April 20, 2017. Sampling frame was obtained
from implanon registration book of the selected kebele Health centers and Hospital. A total of 
340  (85 cases and  255 controls) were  randomly  selected. Cases were implanon discontinuers 
before  3  years  and  controls  were  those  used  implanon  for  3  years.  Data  were  collected  by
using  a pretested structured questionnaire through face  to face interview by diploma nurses. 
Backward  stepwise  likelihood  ratio  method  was  used  in  multivariable  analysis  to  identify 
determinants of implanon discontinuation. The  strength of the association was assessed using 
adjusted odds ratio along with 95% CI. Level of statistical significance was declared at p-value 
less  than  0.05.  Result:  Of  the  total  of  340  eligible  women  (85  cases  and  255  controls) 
requested  for  interview,  all  were  participated  yielding  the  response  rate  of  100%  for  both 
cases  and  controls.  Provision  of  pre-insertion  counseling  and  follow-up  appointment  were 
major  determinants  of  implanon  discontinuation,  AOR=0.36(0.20-0.64)  and  0.35(0.20-0.62) 
respectively.  The  other  factors  to  be  found  significant  association  with  implanon 
discontinuation were age at insertion  less than 20  years (AOR= (95%CI) =  3(1.16-7.80),  lack 
of maternal  formal education (AOR (95%CI) = 2.8(1.31-6.11),  having less than or equal to 4 
living  children  (AOR  (95%CI)  =  1.8(1.01-3.21)  and  previous  history  of  abortion  AOR 
(95%CI = 2.3(1.10-4.63).  Conclusion:  Pre-insertion counseling, follow-up appointment, age 
at insertion,  lack of maternal  formal education,  having less than or equal to  4 living children, 
and  previous  history  of  abortion  were  found  to  be  the  major  determinants  of  implanon 
discontinuation.  Thus,  health  professionals  and  health  extension  workers  must  take  in  to 
consideration  on  determinants  of  implanon  discontinuation  of  these  factors  for  future 
intervention  in an attempt to improve the up-take of implanon  including informed  choice for 
all clients after implanon insertion.