Discontinuation of long acting reversible contraceptive use and its determinants among women in Ethiopia: Systematic review and meta-analysis.

Autor:	Gebeyehu NA; Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia., Tegegne KD; Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia., Biset G; Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia., Sewuyew DA; Department of Midwifery, College of Medicine and Health Science, Debretabore University, Debre Tabor, Ethiopia., Alemu BW; Department of Midwifery, College of Medicine and Health Science, Injbara University, Injbara, Ethiopia., Yitayew AM; School of Medicine, College of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia.
Jazyk:	angličtina
Zdroj:	Frontiers in public health [Front Public Health] 2022 Dec 06; Vol. 10, pp. 979231. Date of Electronic Publication: 2022 Dec 06 (Print Publication: 2022).
DOI:	10.3389/fpubh.2022.979231
Abstrakt:	Introduction: Contraception discontinuation is a major public health issue that leads to unwanted pregnancies and unsafe abortions. Therefore, this systematic review and meta-analysis aimed to estimate discontinuation of contraceptives and its determinants in Ethiopia. Methods: PubMed, Google Scholar, Scopus, Science Direct, and Addis Ababa University online library were searched. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Publication bias was checked by forest plot, Begg's rank test, and Egger's regression test. To look for heterogeneity, I 2 was computed, and an overall estimated analysis was carried out. Subgroup analysis was done by region, study setting, and publication. The pooled odds ratio for associated factors was also computed. Results: Out of 654 studies assessed, 20 met our criteria and were included in the study. The total number of study participants was 8,780. The pooled prevalence of discontinuation of long acting reversible contraceptive use was 36.94% (95% CI: 28.547-45.326). According to sub-group analysis, Amhara region (45%) and institution-based studies (47.9%) had the highest prevalence. The most common reason for contraceptive discontinuation was negative side effect (42.3%).Women experienced side effects (AOR = 2.833:95% CI:2.005-4.003), didn't receive counseling on side effects (AOR = 2.417; 95% CI: 1.591-3.672), didn't appoint follow up (AOR = 2.820; 95% CI: 2.048-3.881), dissatisfied with the given service (AOR = 5.156; 95% CI: 3.644-7.296), and a desire to be pregnant (AOR = 2.366; 95% CI: 1.760-3.182) were predictors of discontinuation of contraceptives. Conclusion: In Ethiopia, the pooled prevalence of long acting contraceptive discontinuation was high. Side effects, not being informed about side effects, dissatisfaction with the provided service, no insertion follow-up, and a desire to become pregnant were all associated factors. Healthcare professionals should focus on the client's reproductive goals, proper management of side effects, counseling, and post-insertion visits. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022347860, identifier CRD42022347860. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Gebeyehu, Tegegne, Biset, Sewuyew, Alemu and Yitayew.)
Databáze:	MEDLINE
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