Mohamed M Ali1, John Cleland. 1. Regional Office for the Eastern Mediterranean, World Health Organization, Cairo P.O. Box 11371, Egypt. alim@emro.who.int
Abstract
BACKGROUND: The purpose of the article was to document oral contraceptive (OC) discontinuation and switching in a large number of low- and middle-income countries, and to assess the effects of women's education and reason for use (spacing vs. limitation). An attempt was made to explain intercountry variations. STUDY DESIGN: Calendar data from 19 Demographic and Health Surveys conducted between 1999 and 2005 were used. Data were analyzed by single- and multiple-decrement life tables and by Cox proportional hazard model. RESULTS: The probability of stopping OC use within 12 months for reasons that implied dissatisfaction with the method ranged from 15% in Indonesia to over 40% in Bolivia and Peru with a median value of 28%. On average, 35% switched to a modern method within 3 months and 16% to a less effective 'traditional' method. Both education and reason for use were strongly related to the probability of switching to a modern method. Discontinuation was lower and switching higher in countries judged to have strong family planning programs. CONCLUSIONS: Both discontinuation of use and inadequate switching to alternative methods are major but neglected problems in the family planning services of many developing countries.
BACKGROUND: The purpose of the article was to document oral contraceptive (OC) discontinuation and switching in a large number of low- and middle-income countries, and to assess the effects of women's education and reason for use (spacing vs. limitation). An attempt was made to explain intercountry variations. STUDY DESIGN: Calendar data from 19 Demographic and Health Surveys conducted between 1999 and 2005 were used. Data were analyzed by single- and multiple-decrement life tables and by Cox proportional hazard model. RESULTS: The probability of stopping OC use within 12 months for reasons that implied dissatisfaction with the method ranged from 15% in Indonesia to over 40% in Bolivia and Peru with a median value of 28%. On average, 35% switched to a modern method within 3 months and 16% to a less effective 'traditional' method. Both education and reason for use were strongly related to the probability of switching to a modern method. Discontinuation was lower and switching higher in countries judged to have strong family planning programs. CONCLUSIONS: Both discontinuation of use and inadequate switching to alternative methods are major but neglected problems in the family planning services of many developing countries.
Authors: Lisa B Haddad; Carrie Cwiak; Denise J Jamieson; Caryl Feldacker; Hannock Tweya; Mina Hosseinipour; Irving Hoffman; Amy G Bryant; Gretchen S Stuart; Isaac Noah; Linly Mulundila; Bernadette Samala; Patrick Mayne; Sam Phiri Journal: Contraception Date: 2013-08-23 Impact factor: 3.375
Authors: Aisha Nz Dasgupta; Ruth Ngwalo; Keith Branson; Levie Gondwe; Frank Taulo; Bagrey Ngwira; Basia Zaba; Amelia C Crampin Journal: Bull World Health Organ Date: 2015-08-31 Impact factor: 9.408