Norplant contraceptive acceptability among women in five Asian countries

Abstract

An analysis of 1,882 Asian acceptors of Norplant implants indicates that method acceptability remained high among the 882 women who used the method for five years. Women who discontinued early from the study were, on average, younger than those who completed five years of use. Also, they had fewer live births and were more likely to desire additional children. Overall, about 70% of the women in these countries found the Norplant implant method to be very favorable. The majority (> 40%) of the women found the ease and duration of use of the method to be most attractive, while menstrual disturbances were the least-liked aspect of the method. Although it was apparent that there are still some potential obstacles to Norplant implant acceptance, most noticeably concerns about menstrual irregularities, interest in continuing the method after five years of use is high. Further research of issues related to Norplant implant acceptability may improve continuation rates and overall client satisfaction.

PIP: Norplant method acceptability was assessed in women who completed 5 years of use, and their sociodemographic profile was compared with that of those who discontinued early. The population consisted of 1882 women, 882 of whom completed the study. The subjects were from 3 sites in Bangladesh, 2 each in the Philippines, Nepal and Sri Lanka, and 1 in Singapore. Women in the group who discontinued early (noncompleters) were significantly younger (p 0.05) than women who completed 5 years of use (completers): the mean difference in age ranged from 1.4 years in the Philippines to 4.5 years in Singapore. For all subjects the mean educational level varied from 2.1 years in Nepal to 10.0 years in the Philippines. The mean number of live births varied significantly, ranging from 2.1 in Singapore and Sri Lanka to 3.4 in Bangladesh. In all countries, noncompleters had a significantly lower mean number of live births and were more likely to desire additional children. A user satisfaction questionnaire was administered at 5 years postinsertion to completers. In Sri Lanka, almost 90% of the completers indicated very favorable experience, as did more than 70% of the completers in Bangladesh and Singapore. The most liked feature of the implants for completers in Bangladesh, Nepal, and Sri Lanka was its duration for 5 years. Low risk of pregnancy was the most liked feature of the implants in fewer than 25% of the subjects in each country, and as few as 1.6% in Nepal. The least liked feature of the implants for both completers and noncompleters at 6 months was menstrual disturbance. Most completers in all 5 countries (ranging from 87.4% in Sri Lanka to 99.4% in the Philippines) would recommend Norplant implants to a friend. 73.9% of women in Sri Lanka and 91.4% in Singapore planned to continue using contraception after Norplant removal; and Norplant was the most popular choice in Sri Lanka (41.5%), Nepal (49.1%), and Singapore (69.8%).