The Magnitude and Factors for Early Discontinuation of Intrauterine Contraceptive Device Use Among Clients at Marie Stopes Maternal and Child Health Center, Adama, Ethiopia: A Cross-Sectional Study

埃塞俄比亚阿达玛玛丽·斯特普斯妇幼保健中心服务对象早期停止使用宫内节育器的情况及其影响因素:一项横断面研究

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Abstract

BACKGROUND AND AIMS: Intrauterine contraceptive devices (IUCDs) are cost-effective, convenient, safe, and highly effective methods designed to be used for 10-12 years. However, early discontinuation, defined as removal before 12 months after insertion, is becoming a public health concern in Ethiopia. The practices may lead to program failures that cause significant health and economic impacts. The study aimed to assess the magnitude of early discontinuation of IUCDs and associated factors among clients who received the method at Marie Stopes Maternal and Child Center in Adama town in Ethiopia, 2024. METHODS: Institutional-based cross-sectional study was conducted among 413 clients who received the service from January 1, 2017, to March 2022. A systematic random sampling technique was used to select the study participants. Data were collected from medical records and telephone interviews. The collected data were entered into Epi Info version 7.1 and analyzed using SPSS version 25. The associations between dependent and independent variables were assessed using binary logistic regression analysis. Adjusted odds ratio with its 95% CI was used to estimate the strength of associations. p-value < 0.05 was considered to declare statistical significance. RESULTS: The magnitude of early discontinuation of IUCDs accounts for 20.6% (95% CI: 16.7-24.9). In multivariate analysis, lack of formal education [AOR = 12.5, 95% CI: 4.9, 31.5] and primary level of education [AOR = 3.5, 95% CI: 1.6, 7.9], giving birth to a male child in the last delivery [AOR = 0.32, 95% CI: 0.18, 0.55], having two and lower number of children [AOR = 3.9, 95% CI: 1.8, 8.9], not counseled on methods [AOR = 16.5, 95% CI: 5.8, 47.1], having pelvic pain [AOR = 7.4, 95% CI: 2.7, 20.3], pelvic infection [AOR = 8.7, 95% CI: 2.7, 27.7], heavy bleeding [AOR = 15.5, 95% CI: 3.3, 73.7], and history of vaginal discharge [AOR = 5.9, 95% CI: 2.1, 16.9] were associated with early discontinuation of IUCDs. CONCLUSION: The magnitude of early discontinuation of IUCDs was 20.6%. Lack of counseling was the strongest factor associated with early discontinuation of IUCDs.

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