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. 2023 Jul 18;13(7):e071775.
doi: 10.1136/bmjopen-2023-071775.

Assessing trends and reasons for unsuccessful implant discontinuation in Burkina Faso and Kenya between 2016 and 2020: a cross-sectional study

Katherine Tumlinson  1   2 , Leigh Senderowicz  3   4 , Brooke W Bullington  5   6 , Stephanie Chung  1 , Emilia Goland  1 , Linnea Zimmerman  7 , Peter Gichangi  8 , Mary Thiongo  8 , Georges Guiella  9 ; PMA Principal Investigators Group; Celia Karp  7
Collaborators, Affiliations

Assessing trends and reasons for unsuccessful implant discontinuation in Burkina Faso and Kenya between 2016 and 2020: a cross-sectional study

Katherine Tumlinson et al. BMJ Open. .

Abstract

Objectives: Contraceptive implant use has grown considerably in the last decade, particularly among women in Burkina Faso and Kenya, where implant use is among the highest globally. We aim to quantify the proportion of current implant users who have unsuccessfully attempted implant removal in Burkina Faso and Kenya and document reasons for and location of unsuccessful removal.

Methods: We use nationally representative data collected between 2016 and 2020 from a cross-section of women of reproductive age in Burkina Faso and Kenya to estimate the prevalence of implant use, proportion of current implant users who unsuccessfully attempted removal and proportion of all removal attempts that have been unsuccessful. We describe reasons for and barriers to removal, including the type of facility where successful and unsuccessful attempts occurred.

Findings: The total number of participants ranged from 3221 (2017) to 6590 (2020) in Burkina Faso and from 5864 (2017) to 9469 (2019) in Kenya. Over a 4 year period, the percentage of current implant users reporting an unsuccessful implant discontinuation declined from 9% (95% CI: 7% to 12%) to 2% (95% CI: 1% to 3%) in Kenya and from 7% (95% CI: 4% to 14%) to 3% (95% CI: 2% to 6%) in Burkina Faso. Common barriers to removal included being counselled against removal by the provider or told to return a different day.

Conclusion: Unsuccessful implant discontinuation has decreased in recent years. Despite progress, substantial numbers of women desire having their contraceptive implant removed but are unable to do so. Greater attention to health systems barriers preventing implant removal is imperative to protect reproductive autonomy and ensure women can achieve their reproductive goals.

Keywords: EPIDEMIOLOGY; PUBLIC HEALTH; Quality in health care; REPRODUCTIVE MEDICINE.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Implants and injectables as a percent of the total modern contraceptive method mix: (A) Burkina Faso and (B) Kenya.
Figure 2
Figure 2
(A) Percent of current implant users reporting unsuccessful discontinuation attempt. (B) Percent of all discontinuation attempts that were unsuccessful.
Figure 3
Figure 3
Reasons for implant discontinuation: (A) Burkina Faso and (B) Kenya.
Figure 4
Figure 4
Location of implant discontinuation and discontinuation attempt in Burkina Faso and Kenya, 2017–2019.
Figure 5
Figure 5
Barriers to implant discontinuation: (A) Burkina Faso and (B) Kenya.
See this image and copyright information in PMC

References

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