Factors associated with incidence of contraceptive discontinuation among women 15-49 years of age in Hai district, Tanzania 1991-1993

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.