Continuation rates and reasons for discontinuation of intra-uterine device in three provinces of Pakistan: results of a 24-month prospective client follow-up

Health Research Policy and Systems
Waqas HameedHasan Bin Hamza

Abstract

Long-acting reversible contraceptives, such as the intrauterine device (IUD), remain underutilised in Pakistan with high discontinuation rates. Based on a 24-month prospective client follow-up (nested within a larger quasi-experimental study), this paper presents the comparison of two intervention models, one using private mid-level providers branded as "Suraj" and the other using community midwives (CMWs) of Maternal Newborn and Child Health Programme, for method continuation among IUD users. Moreover, determinants of IUD continuation and the reasons for discontinuation, and switching behaviour were studied within each arm. A total of 1,163 IUD users, 824 from Suraj and 339 from the CMW model, were enrolled in this 24-month prospective client follow-up. Participants were followed-up by female community mobilisers physically every second month to ascertain continued IUD usage and to collect information on associated factors, switching behaviour, reasons for discontinuation, and pregnancy occurrence. The probabilities of IUD continuation and the risk factors for discontinuation were estimated by life table analysis and Cox proportional-hazard techniques, respectively. The cumulative probabilities of IUD continuation at 24 months...Continue Reading

References

Oct 8, 2004·European Journal of Epidemiology·Vicki KristmanPierre Côté
Apr 22, 2011·Obstetrics and Gynecology·Jeffrey F PeipertGina Secura
May 25, 2012·The New England Journal of Medicine·Brooke WinnerGina M Secura

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Citations

Nov 20, 2016·Studies in Family Planning·Ben BellowsAshish Bajracharya
Jul 7, 2020·Archives of public health = Archives belges de santé publique·Gedefaw Abeje FekaduAlemayehu Worku Yalew

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Software Mentioned

Visual FoxPro
Statistical Package for Social Sciences

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