背景:尽管在按需创建方面已经做了大量工作,能力建设和确保Iplanon的后勤;埃塞俄比亚的停药率仍然很高;据报道,Shashemene区的患病率为31%。然而,在我们的研究环境中,导致Iplanon早期停药的高患病率的因素尚不清楚.
目的:这项研究旨在确定在Shashemene区曾经使用过Implanon的女性中,植入中断的决定因素,埃塞俄比亚南部。
方法:在Shashemene区随机选择的264名妇女(88例和176例对照)中进行了一项基于社区的无匹配病例对照研究,埃塞俄比亚南部,2021年4月12日至5月18日。采用系统随机抽样技术选择受访者。病例为在3年之前停用Implanon的女性,对照组为使用植入物3年的女性。一个预先测试,采用采访者管理的结构化问卷收集数据.进行了双变量和多变量二元逻辑回归分析,以确定Implanon停药的决定因素。使用具有95%置信区间(CI)的优势比(OR)来估计关联的强度,并且在P值小于0.05时宣布显著性。
结果:受访者的平均年龄为28.23(±5.46)岁:病例为27.27(±5.38)岁,对照组为28.70(±5.5)岁。未受过正规教育的妇女[AOR=3.09,95%CI:(1.20,8.00)],少于四个孩子[AOR=2.47,95%CI:(1.20,5.08)],无流产史[AOR=2.84,95%CI:(1.25,6.46)],作为新的受体[AOR=2.14,95%CI:(1.02,4。49)],被告知少于15分钟[AOR=2.47,95%CI:(1.29,4.70)],未与伴侣讨论[AOR=2.88,95%CI:(1.42,5.84)]和出现副作用[AOR=0.35,95%CI:(0.17,0.71)]与植入中断显著相关.
结论:未受过正规教育的妇女,有不到四个孩子,流产史,新的受体,咨询的持续时间,与合作伙伴讨论,副作用是女性Iplanon停药的决定因素。需要确保充分的植入前咨询和适当的副作用管理。此外,干预措施应针对新的接受者和那些没有正规教育的人。
BACKGROUND: Despite tremendous work has been done on demand creation, capacity building and ensuring the logistics of Implanon; its discontinuation rate remained high in Ethiopia; the prevalence is reported to be 31% in Shashemene District. However, the factors contributing to the high prevalence of early Implanon discontinuation were not well understood in our study setting.
OBJECTIVE: This study aimed to identify the determinants of implanon discontinuation among women who had ever used Implanon in Shashemene District, Southern Ethiopia.
METHODS: A community-based unmatched case-control study was conducted among randomly selected 264 women (88 cases and 176 controls) in Shashemene District, Southern Ethiopia, from April 12 to May 18, 2021. A systematic random sampling technique was used to select the respondents. Cases were women who discontinued Implanon before 3 years and controls were those who used implanon for 3 full years. A pre-tested, interviewer-administered structured questionnaire was used to collect data. Bivariable and multivariable binary logistic regression analyses were performed to identify determinants of Implanon discontinuation. An odds ratio (OR) with a 95% confidence interval (CI) was used to estimate the strength of the association, and significance was declared at a P value of less than 0.05.
RESULTS: The mean age of the respondents was 28.23 (± 5.46) years: 27.27 (± 5.38) years for cases and 28.70 (± 5.5) years for controls. Women with no formal education [AOR = 3.09, 95% CI: (1.20, 8.00)], fewer than four children [AOR = 2.47, 95% CI: (1.20, 5.08)], no history of abortion [AOR = 2.84, 95% CI: (1.25, 6.46)], being new acceptors [AOR = 2.14, 95% CI: (1.02, 4. 49)], being counseled for less than fifteen minutes [AOR = 2.47, 95% CI: (1.29, 4.70)], not discussing it with a partner [AOR = 2.88, 95% CI: (1.42, 5.84)] and experiencing side effects [AOR = 0.35, 95% CI: (0.17, 0.71)] were significantly associated with discontinuation of implanon.
CONCLUSIONS: Women with no formal education, having less than four children, history of abortion, new acceptors, duration of counseling, discussion with partner, and side effects were determinants of Implanon discontinuation among women. There is a need to ensure adequate pre-implantation counseling and appropriate management of side effects. Furthermore, interventions should target new acceptors and those without formal education.