Assessing Trends and Reasons for Unsuccessful Implant Discontinuation in Burkina Faso and Kenya Between 2016 and 2020: A Cross-Sectional Study

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Citation

Tumlinson, Katherine; Senderowicz, Leigh; Bullington, Brooke W.; Chung, Stephanie; Goland, Emilia; Zimmerman, Linnea; Gichangi, Peter; Thiongo, Mary; Guiella, Georges; & Karp, Celia (2023). Assessing Trends and Reasons for Unsuccessful Implant Discontinuation in Burkina Faso and Kenya Between 2016 and 2020: A Cross-Sectional Study. BMJ Open, 13(7), e071775. PMCID: PMC10357675

Abstract

OBJECTIVES: Contraceptive implant use has grown considerably in the last decade, particularly among women in Burkina Faso and Kenya, where implant use is among the highest globally. We aim to quantify the proportion of current implant users who have unsuccessfully attempted implant removal in Burkina Faso and Kenya and document reasons for and location of unsuccessful removal.
METHODS: We use nationally representative data collected between 2016 and 2020 from a cross-section of women of reproductive age in Burkina Faso and Kenya to estimate the prevalence of implant use, proportion of current implant users who unsuccessfully attempted removal and proportion of all removal attempts that have been unsuccessful. We describe reasons for and barriers to removal, including the type of facility where successful and unsuccessful attempts occurred.
FINDINGS: The total number of participants ranged from 3221 (2017) to 6590 (2020) in Burkina Faso and from 5864 (2017) to 9469 (2019) in Kenya. Over a 4 year period, the percentage of current implant users reporting an unsuccessful implant discontinuation declined from 9% (95% CI: 7% to 12%) to 2% (95% CI: 1% to 3%) in Kenya and from 7% (95% CI: 4% to 14%) to 3% (95% CI: 2% to 6%) in Burkina Faso. Common barriers to removal included being counselled against removal by the provider or told to return a different day.
CONCLUSION: Unsuccessful implant discontinuation has decreased in recent years. Despite progress, substantial numbers of women desire having their contraceptive implant removed but are unable to do so. Greater attention to health systems barriers preventing implant removal is imperative to protect reproductive autonomy and ensure women can achieve their reproductive goals.

URL

http://dx.doi.org/10.1136/bmjopen-2023-071775

Reference Type

Journal Article

Year Published

2023

Journal Title

BMJ Open

Author(s)

Tumlinson, Katherine
Senderowicz, Leigh
Bullington, Brooke W.
Chung, Stephanie
Goland, Emilia
Zimmerman, Linnea
Gichangi, Peter
Thiongo, Mary
Guiella, Georges
Karp, Celia

Article Type

Regular

PMCID

PMC10357675

Data Set/Study

Performance Monitoring for Action (PMA) Project

Continent/Country

Burkina Faso
Kenya

Sex/Gender

Women

ORCiD

Tumlinson - 0000-0001-8314-8219
Bullington - 0000-0002-3341-087X