Early contraceptive implants removal and its associated factors among women using implants at Kawempe National Referral Hospital, Kampala Uganda.

Abstract

Introduction. Early discontinuation of implant contraceptive methods and reasons for discontinuation remains a major concern for family planning programs and is generally higher in developing countries. This is closely related to higher rates of the overall fertility rate, unwanted pregnancies leading to possibly induced abortion and has been associated with high morbidity and mortality among young women in Uganda. Objective: To determine the magnitude and factors associated with early implants removals among women receiving implants services in the study area. Methods: A facility-based cross-sectional study was conducted from 2nd January to 3rd March 2020 through a face-to-face interview. A total of 207 Implant user women were selected by systematic random sampling technique with kth value 2. SPSS version 20 was used for both data entry and analysis. Factors associated with early Implant discontinuation were analyzed using a binary and multivariable logistic regression model. Variables with a p-value of <0.05 and a 95% confidence interval were considered as statistically significant. Results: The proportion of early implant discontinuation was 42%. Factors associated with early implant discontinuation included; clients who experienced side effects were more likely to have early implant removal than those who did not experience side effects (AOR= 2.629; 95%CI: 1.095-6.314; P= 0.031), Clients who did not receive pre-insertion counselling on benefits and side effects of contraceptive implants were more likely to remove implants early than those who had (AOR= 2.565; 95%CI: 1.190-5.532; P= 0.016) and those staying in rural areas were more likely to remove the implants early than those in urban areas (AOR= 2.390; 95%CI: 1.229-4.648; P= 0.010). Conclusion: The proportion of early discontinuation was considerably high at 42 percent. Factors associated with early implant removal were the experience of side effects, lack of effective counselling about the benefits and possible side effects a prior insertion, and staying in rural areas. Recommendation: Health workers could give counseling before insertion of the implant with emphasis on possible side effects with their immediate management, and also involving their spouses would improve retention of implants. Health workers could also screen for pregnancy before insertion of the implant.