The case for vigorous promotion of long acting reversible contraceptives (LARC) is particularly strong in sub-Saharan Africa where contraceptive usage remains low but future increases are projected. The objective was to respectively determine the number of users of copper T intrauterine device and Jadelle levonorgestrel implants who discontinued usage within two years, and factors associated with early discontinuation.METHODS:
A cohort study of women accepting Cu T IUD and Jadelle levonorgestrel implant in a single family planning clinic under the Women's Health Project in southeastern Nigeria from 1 January 2008 to 31 December 2009. The period of use in this study was the interval between date of insertion and date of removal rounded up to the nearest whole number.RESULTS:
Average age of the women was 34 years (range 20–50) while average parity was 5. Out of a total of 250 participants (155 acceptors of Jadelle and 95 acceptors of IUD) analyzed, 239 (95.6%) were using their method at 2 years. Discontinuation rates at 6 months, 12 months and 24 months were 1.1%, 1.1%, 2.1% for the IUD and 0.6%, 3.2%, 5.2% for the implant. Women of low socioeconomic status were more likely to discontinue compared with those of high status P<.05. The commonest reason given for discontinuation was desire for another pregnancy among users of both contraceptives and frequent vaginal bleeding among implant users.CONCLUSION:
Managers of family planning programs in Africa need to formulate appropriate strategies for ensuring that clients sustain longer term use of LARC.