P-08 A Scoping Review of the Prevalence and Associated Factors of Early Discontinuation Rate of Contraceptive Implants
Author(s):
C Abrams, J Hatton, A. Hutson, E Tyrell, B Ally-Charles, D Van-Veen, K Hohenkirk, O Vanlewin, B Chester
Year of Presentation:
2024
Objective: To synthesize and analyze existing knowledge to identify reasons for early implant discontinuation, examining prevalent factors, regional disparities, and their impact on women's health and family planning and to inform evidence-based policies and healthcare practices surrounding women's contraceptive choices.
Methods: Utilizing Arksey and O’Malley’s framework (2005), a systematic approach was employed that encompasses five stages. A comprehensive review question guided the search strategy, identifying pertinent studies focusing on early intradermal implant removal. A modified PICO framework was used to determine the inclusion criteria and 10 public health databases were searched to collect articles published between January 2018 and August 2023. A meticulous screening process was conducted in two stages, resulting in the inclusion of six research papers that met the criteria. Data extracted from these studies were then organized in a chart.
Results: Findings from the selected studies highlighted similarities and variations in factors driving early contraceptive implant removal across diverse geographical regions (Thailand, Ethiopia, Uganda, and South Africa). Consistently reported side effects like headahces, weight fluctuations, and menstrual irregularities were primary reasons for early discontinuation. Inadequate counseling, lack of follow-up sessions, and dissatisfaction with services also contributed to higher removal rates. Cultural nuances were evident, with distinct focus areas such as fertility intentions in Thailand, side effects in Ethiopia and Uganda, and counseling importance in South Africa.
Conclusion: The identified factors underscore the need for targeted interventions and policy adaptations to address early implant removal rates effectively. Tailored counseling services acknowledging diverse cultural beliefs, robust post- insertion follow-ups, and improved service quality emerged as pivotal strategies. Culturally sensitive healthcare practices accommodating regional variations in family planning perspectives are crucial to enhance contraceptive continuity and women's reproductive health outcomes. Further, adolescent reproductive education was recommended for informed contraceptive use and addressing early removal concerns.