Explaining LARCs discontinuity in Ethiopia: The experience of women who access contraceptives in selected public health facilities

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Abstract Background: Unintended pregnancy remains an important public health problem among teenagers and women in developing countries. Modern family planning methods, particularly Long Acting Reversible Contraceptives (LARCs), are highly effective in addressing the problem and its undesirable outcomes in maternal mortality. But dissatisfaction with contraceptives has contributed to their early discontinuation, but the reasons in Ethiopia are not adequately explored.Objective: This study aims to explore the main reasons of discontinuation of LARCs-use within one year of adoption in selected public health facilities in Ethiopia.Methods: Institution-based, multi-center prospective-cohort study design was used to identify the reasons of discontinuation among LARCs-users in Ethiopia. The study covered four university hospitals and health centers in Addis Ababa, Gondar, Mekelle and Jimma. The main study employed survey and in-depth interviews. But this article is based on qualitative data collected through in-depth interviews. It explored the decision-making processes involved in LARCs-discontinuation based on the experiences of 29 women aged 15-49 who did within a year of insertion. Interview data were thematically organized, coded and analyzed in light of the study objectives.Results: The study found women were sufficiently aware of the various types of contraceptives, including LARCs. Many of them experimented with different types before deciding on their choice. On LARCs, most were satisfied with its benefits while they also mentioned several reasons to discontinue its use including weight gain/loss, heavy menses, tiredness, reduced libido, desire to conceive and husbands’ disapproval. Their decisions to use or not use LARCs reflected the common cultural values about childbirth and myths on contraceptive use.Conclusions: The study found women use (or discontinue use) of contraceptives depends on their knowledge about their options, personal experience with side-effects, and the support from significant others, mainly husbands. As such, any campaign to promote family planning methods has to take into account the status of women in the Ethiopian society and cultural definition of their sexuality.

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