Determinants of method switching among social franchise clients who discontinued the use of intrauterine contraceptive device

Type Journal Article - International Journal of Reproductive Medicine
Title Determinants of method switching among social franchise clients who discontinued the use of intrauterine contraceptive device
Author(s)
Volume 2015
Publication (Day/Month/Year) 2015
URL https://www.hindawi.com/journals/ijrmed/2015/941708/abs/
Abstract
Introduction. Women who do not switch to alternate methods after contraceptive discontinuation, for reasons other than the desire
to get pregnant or not needing it, are at obvious risk for unplanned pregnancies or unwanted births. This paper examines the
factors that influence women to switch from Intrauterine Contraceptive Device (IUCD) to other methods instead of terminating
contraceptive usage altogether. Methods. The data used for this study comes from a larger cross-sectional survey conducted in nine
(9) randomly selected districts of Sindh and Punjab provinces of Pakistan, during January 2011. Using Stata 11.2, we analyzed data
on 333 women, who reported the removal of IUCDs due to reasons other than the desire to get pregnant. Results. We found that
39.9% of the women do not switch to another method of contraception within one month after IUCD discontinuation. Use of
contraception before IUCD insertion increases the odds for method switching by 2.26 times after removal. Similarly, postremoval
follow-up by community health worker doubles (OR = 2.0) the chances of method switching. Compared with women who received
free IUCD service (via voucher scheme), the method switching is 2.01 times higher among women who had paid for IUCD
insertion. Conclusion. To increase the likelihood of method switching among IUCD discontinuers this study emphasizes the need
for postremoval client counseling, follow-up by healthcare provider, improved choices to a wider range of contraceptives for poor
clients, and user satisfaction.

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