Implanon removal experiences of women in Butajira, Ethiopia

Abstract

Abstract
Introduction: Over the last decade, a lot of advocacy work has been done to increase long acting and permanent contraceptive methods (LAPMs) use in Ethiopia. However, LAPMs uptake is very low compared to short acting ones where eventual disinterest and subsequent removal of the method is observed.
Objective: This study was carried out to explore reasons behind implanon removal within unreasonably short time after insertion.
Methods: An exploratory qualitative study was employed to apply class room qualitative research method training organized by the School of Public Health, Addis Ababa University. Research participants were purposively selected women in Bido and Diram kebeles of rural Butajira, which is a research site of the School of Public Health, Addis Ababa University's. Nine women who had recently removed implanon and two health extension workers (one from each kebele) were interviewed. Data analysis was facilitated using ATLAS.ti qualitative software and presented using content analysis.
Results: Study participants were aware of the different types of family planning (FP) services available at the health facilities. However, women did not get two sided information which explains the benefits and side effects of implanon. Women in this study reported that the main reasons for early implanon removal were perceived side effects, desire to get pregnant, partner pressure and at times, religious leaders delay the burial of a woman who had implanon. After implanon removal, some reported to have shifted back to short acting FP methods while others reported to have faced unintended pregnancy. Though implanon insertion is conducted at a community level, removal was possible only at health centers or Hospitals and this has created discomfort and anxiety among women.
Conclusion and recommendation: Women's agency to decide on their reproductive health, cultural influences, and inadequate information was the main causes for the untimely removal of implanon. Working with community leaders, access to implanon removal services at a community level and strengthening the pre-insertion counseling process to assure informed choice would help to avoid unnecessary removal of implanon and increase uptake.. [Ethiop. J. Health Dev. 2015;29(3):176-182]
Key word: Implanon, Maternal health, Rural setting, Ethiopia