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The recent increase in contraceptive discontinuation in Egypt
Mona Khalifa1, Wafaa Abdelaziz1, Soha Metwally1
1Department of Biostatistics and Demography, Institute of Statistical Studies and Research (ISSR), Cairo University, Giza, Egypt.
Journal of Biosocial Science
|May 21, 2019
Summary
Recent shifts in contraceptive use in Egypt, particularly moving from IUDs to less effective hormonal methods, have increased discontinuation rates. This contributes to higher fertility and unintended pregnancies, highlighting unmet contraceptive needs.
Area of Science:
- Reproductive Health
- Demography
- Public Health
Background:
- Contraceptive prevalence in Egypt has seen a slight fall.
- Overall fertility has unexpectedly increased in Egypt.
- Changes in contraceptive discontinuation and switching patterns are under investigation.
Purpose of the Study:
- To determine if changes in contraceptive discontinuation and switching are causing increased fertility and decreased contraceptive prevalence in Egypt.
- To analyze reasons for discontinuation of Intrauterine Devices (IUDs), pills, and injectables.
- To examine trends in contraceptive method switching and their effectiveness.
Main Methods:
- Analysis of calendar data from the 2008 and 2014 Egyptian Demographic and Health Surveys (DHS).
- Construction of single/multiple decrement life tables to calculate discontinuation rates.
- Examination of discontinuation reasons and switching behavior by contraceptive method type.
Main Results:
- The overall contraceptive discontinuation rate increased between 2008-2014, driven by a shift from IUDs to hormonal methods with higher discontinuation rates.
- Method/service-related reasons, including contraceptive failure and side effects, were primary causes for discontinuation.
- 'Desire to get pregnant' emerged as a significant reason for discontinuation, coinciding with an increased ideal family size.
- Approximately half of discontinuations led to switching to another method, but many switched to less effective options.
- Switching behavior improved for IUDs, but a high percentage of switchers opted for less effective methods.
Conclusions:
- Shifts in contraceptive method choice and higher discontinuation rates, particularly with hormonal methods, contribute to increased fertility and unintended pregnancies in Egypt.
- There is an unmet need for effective contraception, necessitating improvements in family planning services.
- Interventions should focus on enhancing counseling for IUDs and reducing failure rates for hormonal contraceptives to improve contraceptive effectiveness and reduce unintended pregnancies.
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