Suchergebnisse

Collecting contraceptive‐use data by means of calendar methods has become standard practice in large‐scale population surveys, yet the reliability of these methods for capturing accurate contraceptive histories over time remains largely unknown. Using data from overlapping contraceptive calendars included in a longitudinal study of 3,080 rural Bangladeshi women, we assessed the consistency of reports from the baseline interview month in 2006 with reports from the same month in a follow‐up survey three years later, and examined predictors of reliable reporting. More than one‐third of women were discordant in their reports for the reference month in the two surveys. Among women reporting use of any contraceptive method for the reference month in both surveys, 25 percent reported different methods at the two time points. Women using condoms or traditional methods and those with more complex reproductive histories, including more births and more episodes of contraceptive use, were least likely to report reliably.

AbstractFew longitudinal studies have measured contraceptive continuation past one year in sub‐Saharan Africa. We surveyed 674 women who had been randomized to receive the three‐month intramuscular contraceptive injectable (DMPA‐IM), levonorgestrel (LNG) implant, or copper intrauterine device (IUD) during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) trial in South Africa and Zambia and were subsequently followed for two additional years to explore method continuation, reasons for discontinuation, and access to implant and IUD removal services. We also conducted in‐depth qualitative interviews with 39 participants. We estimated cumulative discontinuation probabilities using Kaplan–Meier estimates and assessed factors associated with discontinuation using Cox‐proportional hazards models. The LNG implant continuation rate over the maximum 44‐month study period was 60 percent, while rates for the copper IUD and DMPA‐IM were 52 percent and 44 percent, respectively. Reasons for method discontinuation included side effects, particularly menstrual changes, and method stock‐outs. Most implant and IUD users who sought removal were able to access services; however, room for improvement exists. In this cohort originally randomized to receive a contraceptive method and attend regular study visits, implants and IUDs continued to be highly acceptable over an additional two years, but facilities should continue to ensure that insertions and removals are available as requested.