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Citation Information

Type Working Paper
Title IUD use and discontinuation in Bangladesh.
Author(s)
Publication (Day/Month/Year) 2007
URL http://www.popline.org/node/201093
Abstract
The ACQUIRE Project is a five-year cooperative agreement awarded by the U.S. Agency for International Development (USAID). Building on an earlier project focusing on long-term and permanent methods of family planning (LAPMs), ACQUIRE has undertaken a number of interventions in collaboration with the Directorate General of Family Planning (DGFP) since 2001 to support the Bangladesh Government's National Population Policy. One aspect of the ACQUIRE Project has been to rebuild capacity for LAPM service delivery within the public sector. Awareness of the intrauterine device (IUD) as a long-term contraceptive method is fairly high among married women (89.6%) and married men (69.5%) in Bangladesh. The current use of IUDs, however, remains low (0.6%) compared with the use of other modern methods. According to the recent Bangladesh Demographic and Health Survey (BDHS), contraceptive discontinuation rates are very high for all methods in Bangladesh: About half of Bangladeshi couples discontinue their family planning method within one year, a rate much higher than in other countries in the Asian region. Worldwide, discontinuation rates for the IUD are generally lower than for other modern methods, yet the 12-month IUD discontinuation rate in Bangladesh was reported to be 35.4% in 2004, not much lower than that of oral contraceptives (46.5%) and injectables (48.7%). The majority of Bangladeshi IUD users (63.7%) state that side effects and health concerns are the major reasons behind method-specific IUD discontinuation (NIPORT, Mitra and Associates, and ORC Macro, 2005). The study's overall objectives were to quantify the outcomes of IUD use 12 months after insertion and to examine factors associated with IUD discontinuation in six districts of Bangladesh. Specific objectives were to examine: the sociodemographic characteristics of IUD acceptors and discontinuers; the outcome of IUD use among IUD acceptors within the first 12 months and the reasons given for discontinuation; common side effects, how they were experienced by both continuers and discontinuers, and factors associated with experience with and tolerance of those side effects; key determinants of discontinuation; and preinsertion and postinsertion health-sector support for IUD clients.

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