Anaemic women are more at risk of injectable contraceptive discontinuation due to side-effects in Ethiopia

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Abstract Introduction This paper investigates the importance of women’s physiological condition for predicting the risk of discontinuation due to side-effects of the injectable contraceptive in Ethiopia, where side-effects account for around 20% of all discontinuations. Methods Contraceptive calendar data from the 2016 Ethiopian Demographic and Health Survey were analysed. Women aged 15-49 who had initiated the injectable contraceptive in the two years prior to interview were included in the analysis (N=1,513). After checking for reverse causality, the associations between physiological risk factors and discontinuation of the injectable contraceptive due to either side-effects (DSE) or other reasons (DOR) were estimated using multivariate Cox proportional regression analyses. Results In 2016, 10% of women had initiated the injectable in the last two years, and 1 in 4 had discontinued use by the time of the interview. Of these, 1 in 5 discontinued due to side-effects. Women with anaemia were at twice the risk of DSE compared with non-anaemic women, while anaemia status was not associated with DOR. Sociocultural factors including religion, wealth and relationship status were significant predictors for DOR, but not for DSE. Conclusion Accounting for diversity in physiological condition is key for understanding contraceptive discontinuation due to side-effects.

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