Oral contraceptive discontinuation and its aftermath in 19 developing countries

Area of Science:

• Reproductive Health
• Global Health
• Family Planning

Background:

• Oral contraceptive (OC) discontinuation and switching patterns are critical in low- and middle-income countries.
• Understanding factors influencing these patterns, such as education and reason for use, is essential for effective family planning programs.

Purpose of the Study:

• To document oral contraceptive discontinuation and switching in numerous low- and middle-income countries.
• To assess the impact of women's education and intended use (spacing vs. limitation) on OC use.
• To explain intercountry variations in OC discontinuation and switching.

Main Methods:

• Analysis of calendar data from 19 Demographic and Health Surveys (1999-2005).
• Utilized single- and multiple-decrement life tables.
• Employed Cox proportional hazard models for data analysis.

Main Results:

• Median 12-month discontinuation probability due to dissatisfaction was 28%, ranging from 15% to over 40%.
• Within 3 months, 35% switched to modern methods, while 16% switched to traditional methods.
• Higher education, use for limitation, and strong family planning programs correlated with lower discontinuation and higher switching to modern methods.

Conclusions:

• High rates of oral contraceptive discontinuation and suboptimal switching to alternative methods represent significant challenges in developing countries.
• Family planning services require enhancement to address these issues and improve contraceptive continuation and appropriate method switching.