Tackling Why Women Discontinue Using Contraceptives
At its launch in 2012, FP2020 set an ambitious goal of reaching 120 million women with modern family planning services by 2020. The reality is that more than one third of new users will discontinue within the first year of starting a method, and over half will stop before two years.
To change that reality, service providers must come up with innovative ways to encourage continued use; they must also offer alternative but equally effective options for women who want to switch methods. Family planning researchers also play a key role in shifting this dynamic—by conducting acceptability studies to better understand women’s needs and preferences, by evaluating reasons why women discontinue (e.g. side effects, misinformation, health clinician biases), and then by developing new or refined contraceptive technologies that address these issues, broadening the method mix accordingly.
The Population Council and FP2020 have published a new resource that sheds light on the subject of why women discontinue. The report, a comprehensive literature review, summarizes research addressing timing and reasons for discontinuation; the relationship between discontinuation, contraceptive prevalence, and method mix; factors influencing switching versus stopping; characteristics of a discontinuer; decision-making about discontinuing; and programmatic strategies to reduce discontinuation. The report concludes with a summary of suggested research topics to address holes in the evidence base. Implementation research, for example, could inform improvements in system delivery quality, reductions in provider bias, and new approaches to track users and support those wanting to switch methods. Investment in social science research to understand motivations behind discontinuing, acceptability and use of options postpartum, and why discontinuation is significantly lower in certain countries would also be illuminating.
As Dr. Anrudh Jain of the Population Council is quoted in the report’s conclusion, “The issue is not only about adding methods to the contraceptive mix in a country or improving the quality of counseling per se. Rather it is about meeting women’s reproductive health needs, their right to have a choice among contraceptive methods, their right to make informed choices, and their right to receive accurate information from service providers about the method they select and about switching methods whenever when the initial one is no longer suitable.”