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Reasons for Premature Removal of Implanon among Users in Arsi Zone, Oromia Region, Ethiopia, 2013

Abay Burusie

Abstract

Background: Ethiopian government is dedicated to expansion of implanon insertion service to meet the huge unmet need in family planning since the beginning of 2010. Nevertheless, opting for premature removal of implanon by the users is very rampant at this early stage of the initiative.

Objective: To identify reasons for premature removal of implanon among users

Method: Descriptive cross-sectional study was conducted from February 2012 to June 30, 2013 in Arsi Zone, Southeast Ethiopia. A total sample size of 103 was decided for data collection. Data were entered through Epi info version 3.5.3 and imported to SPSS version 16 software for cleaning and analysis. Numerical summary measures and probabilities were computed as found important. Kaplan Meier survival analysis and error bar were also employed for comparison of reasons for premature removal.

Result: With 97% response rate, the main reasons for premature removal of implanon among users were heavy/ prolonged menstrual bleeding, plan to conceive in the near future, about to leave for abroad and pain on insertion arm representing 36%, 24%, 15% and 13% of the reasons, respectively. The median duration the study subjects used implanon was 19.5 months. Median duration of premature removal was significantly earlier in those who reasoned heavy/prolonged menstrual bleeding compared with those presented with plan to conceive in the near future as their reason for premature removal.

Conclusion and recommendation: Heavy/prolonged menstrual bleeding, plan to conceive in the near future, about to leave for abroad and pain on insertion arm were the main reasons for premature removal of implanon and the duration of implanon use was not long enough to be cost effective. Hence, thorough pre-insertion counseling on implanon side effects and discussing future fertility desire and revising effective management of side effects are indispensible to increase the duration implanon is being used.