Discontinuation and switching of postpartum contraceptive methods over twelve months in Burkina Faso and the Democratic Republic of the Congo: a secondary analysis of the Yam Daabo trial
Tóm tắt
Women who use contraceptive methods sometimes stop early, use methods intermittently, or switched contraceptive methods. All these events (discontinuations and switching) contribute to the occurrence of unwanted and close pregnancies. This study aimed to explore contraceptive discontinuation and switching during the Yam-Daabo project to measure the effect of interventions on the continuation of contraceptive methods use. We conducted a secondary analysis of the Yam-Daabo trial data. We choose the discontinuation and switching of a modern contraceptive method as outcome measures. We performed a survival analysis using the Stata software package to estimate the effect of the interventions on contraceptive discontinuation. We also studied the main reasons for discontinuation and switching. In total, 637 out of the 1120 women used at least one contraceptive method (of any type), with 267 women in the control and 370 in the intervention group. One hundred seventy-nine women of the control group used modern methods compared to 279 women of the intervention group with 24 and 32 who discontinued, respectively. We observed no statistically significant association between interventions and modern methods discontinuation and switching. However, modern methods’ discontinuation was higher in pills and injectables users than implants and IUDs users. The pooled data comparison showed that, in reference to the women who had not switched while using a modern method, the likelihood of switching to a less or equal effectiveness method among the women of the control group was 3.8(95% CI: 1.8–8.0) times the likelihood of switching to a less or equal effectiveness method among the women of the intervention group. And this excess was statistically significant (p < 0.001). The main reason for discontinuation and switching was method-related (141 over 199), followed by partner opposition with 20 women. The results of this study show no statistically significant association between interventions and modern methods discontinuation. Discontinuation is more related to the methods themselves than to any other factor. It is also essential to set up specific actions targeting women’s partners and influential people in the community to counter inhibiting beliefs. Pan African Clinical Trials Registry (PACTR201609001784334,
https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=1784
).
Tài liệu tham khảo
Commission économique pour l’Afrique, Union Africaine, BAD: Banque africaine de développement. Evaluation des progrès réalisés en Afrique pour atteindre les objectifs du millénaire pour le développement: rapport OMD 2015. Addis-Abeba: Commission économique pour l’Afrique; 2015 [cited 2020 Oct 1]. Available from: https://www.afdb.org/fileadmin/uploads/afdb/Documents/Publications/MDG_Report_2015_FRE-draft14Sept.pdf.
Tran NT, Gaffield ME, Seuc A, Landoulsi S, Yamaego WME, Cuzin-Kihl A, et al. Effectiveness of a package of postpartum family planning interventions on the uptake of contraceptive methods until twelve months postpartum in Burkina Faso and the Democratic Republic of Congo: the YAM DAABO study protocol. BMC Health Serv Res. 2018;18:439.
Tran NT, Yameogo WME, Langwana F, Gaffield ME, Seuc A, Cuzin-Kihl A, et al. Participatory action research to identify a package of interventions to promote postpartum family planning in Burkina Faso and the Democratic Republic of Congo. BMC Womens Health. 2018;18:122.
Tran NT, Seuc A, Tshikaya B, Mutuale M, Landoulsi S, Kini B, et al. Effectiveness of postpartum family planning interventions on contraceptive use and method mix at 1 year after childbirth in Kinshasa, DR Congo (yam Daabo): a single-blind, cluster-randomised controlled trial. Lancet Glob Health. 2020;8:e399–410.
Tran NT, Seuc A, Coulibaly A, Landoulsi S, Millogo T, Sissoko F, et al. Postpartum family planning in Burkina Faso (yam Daabo): a two group, multi-intervention, single-blinded, cluster-randomised controlled trial. Lancet Glob Health. 2019;7:e1109–17.
Barden-O'Fallon J, Speizer IS, Calhoun LM, Corroon M. Women's contraceptive discontinuation and switching behavior in urban Senegal, 2010–2015. BMC Womens Health. 2018 [cited 2019 Jun 20];18. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800088/.
Sato R, Elewonibi B, Msuya S, Manongi R, Canning D, Shah I. Why do women discontinue contraception and what are the post-discontinuation outcomes? Evidence from the Arusha Region, Tanzania. Sex Reprod Health Matters. 2020;28:1723321.
Weldemariam KT, Gezae KE, Abebe HT. Reasons and multilevel factors associated with unscheduled contraceptive use discontinuation in Ethiopia: evidence from Ethiopian demographic and health survey 2016. BMC Public Health. 2019;19:1745.
Casey SE, Cannon A, Mushagalusa Balikubirhi B, Muyisa J-B, Amsalu R, Tsolka M. Twelve-month contraceptive continuation among women initiating short- and long-acting reversible contraceptives in north Kivu, Democratic Republic of the Congo. PloS One. 2017;12:e0182744.
Peterson J, Brunie A, Ndeye S, Diatta E, Stanback J, Chin-Quee D. To be continued: family planning continuation among the urban poor in Senegal, a prospective, longitudinal descriptive study. Gates Open Res. 2018;2:65.
Barden-O'Fallon J, Speizer IS, Calhoun LM, Corroon M. Women's contraceptive discontinuation and switching behavior in urban Senegal, 2010–2015. BMC Womens Health. 2018;18:35.
do Nascimento Chofakian CB, Moreau C, Borges ALV, dos Santos OA. Contraceptive discontinuation: frequency and associated factors among undergraduate women in Brazil. Reprod Health. 2019;16:131.
Yideta ZS, Mekonen L, Seifu W, Shine S. Contraceptive discontinuation, method switching and associated factors among reproductive age women in Jimma town, Southwest Ethiopia, 2013. Fam Med Med Sci Res. 2017;6:1–6.
Halpern V, Lopez LM, Grimes DA, Gallo MF. Strategies to improve adherence and acceptability of hormonal methods of contraception. Cochrane Database Syst Rev. 2011;CD004317.
Mack N, Crawford TJ, Guise J-M, Chen M, Grey TW, Feldblum PJ, et al. Strategies to improve adherence and continuation of shorter-term hormonal methods of contraception. Cochrane Database Syst Rev. 2019;4:CD004317.
Cavallaro FL, Benova L, Owolabi OO, Ali M. A systematic review of the effectiveness of counselling strategies for modern contraceptive methods: what works and what doesn't? BMJ Sex Reprod Health. 2019;0:bmjsrh-2019-200377.
Trussell J. Contraceptive failure in the United States. Contraception. 2011;83:397–404.
Diedrich JT, Madden T, Zhao Q, Peipert JF. Long-term utilization and continuation of intrauterine devices. Am J Obstet Gynecol. 2015;213:822 e1–822.e6.
Tran NT, Yameogo WME, Gaffield ME, Langwana F, Kiarie J, Mashinda Kulimba DM, et al. Postpartum family-planning barriers and catalysts in Burkina Faso and the Democratic Republic of Congo: a multiperspective study. Open Access J Contracept. 2018;9:63–74.
Blackstone SR, Nwaozuru U, Iwelunmor J. Factors influencing contraceptive use in sub-Saharan Africa: a systematic review. Int Q Community Health Educ. 2017;37:79–91.
Koffi TB, Weidert K, Ouro Bitasse E, Mensah MAE, Emina J, Mensah S, et al. Engaging men in family planning: perspectives from married men in Lomé, Togo. Glob Health Sci Pract. 2018;6:316–27.
Coomson JI, Manu A. Determinants of modern contraceptive use among postpartum women in two health facilities in urban Ghana: a cross-sectional study. Contracept Reprod Med. 2019;4:17.
Apanga PA, Adam MA. Factors influencing the uptake of family planning services in the Talensi District, Ghana. Pan Afr Med J. 2015;20:10.