Abstract:
A retrospective survey among women 15-49 years of age who accepted oral, injectable and IUD contraceptives for the first time during the period October 1991 through September 1993 at Family Planning Service Delivery Points (SDPS) in Hai District, was conducted between December 1993 and March 1994. The aim of the study was to determine incidence and factors associated with contraceptive discontinuation, method switching and quality of care at the SDPs.
/ A total of 1055 subjects from 15 SDPs selected by a multi-stage sampling method were investigated following house to house interview using a questionnaire. The data
was analyzed by SPSS and STATXACT software.
Results showed that 37.8% of the study population discontinued contraception with monthly incidence rates of 1 to 333 per 1,000 person-months exposure at risk of
discontinuation; with the high rates occurring during the first three to six months of method use. Risk factors influencing contraceptive discontinuation
significantly included: age group 40-49, early marriage, low parity, having no or low number of living children, low education status for women and/or husband, desire for
additional children, Roman Catholic and not gainfully employed. Others were: spacing contraception, informal inter-personal communication prior contraception, lack of informed method choice, method switching, clinic-drop out and dissatisfaction with quality of care at SDPs. Reasons reported for discontinuation included: Side- effects of method (48.8%), insufficient quality of care at SDPs (13.1%), planned pregnancies (12.8%), unplanned pregnancies (6.8%), and rumors (6.8%). A woman dissatisfied with contraceptive method and
services may either change to another technique and source
of supplies if sufficiently motivated or drop out of the
family planning program participation if motivation is
weaker.
Improving quality of care at SDPs according to clients
characteristics and needs especially for newly recruited
clients with risk factors that influence contraception
discontinuation will motivate and satisfy clients and
minimize discontinuation.
