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Reproductive Health
Published in: Reproductive Health 1/2021

Open Access 01-12-2021 | Contraception | Research

Association between experience of specific side-effects and contraceptive switching and discontinuation in Uganda: results from a longitudinal study

Authors: Linnea A. Zimmerman, Dana O. Sarnak, Celia Karp, Shannon N. Wood, Saifuddin Ahmed, Fredrick Makumbi, Simon P. S. Kibira

Published in: Reproductive Health | Issue 1/2021

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Abstract

Background

There is substantial evidence that contraceptive side-effects are a major deterrent to consistent use of contraception but few studies in low- or middle-income countries explore the role of specific side-effects on contraceptive use dynamics. This study used population-based, longitudinal data to explore the effect of specific side-effects on contraceptive continuation, discontinuation, and switching in Uganda.

Methods

Data for this study come from two rounds of survey data collection in Uganda: PMA2020’s sixth cross-sectional survey and a follow-up survey conducted 1 year later. The main outcomes of interest were discontinuation and switching among users of hormonal contraceptive methods (implants, injectables and oral pill) and the IUD at baseline (n = 560). Multivariable logistic regressions assessed the association of experiencing specific side-effects (more bleeding, less bleeding, irregular bleeding, increased dryness/reduced libido, and physical discomfort) with discontinuation and switching 1 year later, adjusting for socio-demographic characteristics, type of method, and length of use. We also examined the differential effects of side-effects between discontinuation and switching risks.

Results

About 23% of hormonal and IUD contraceptive users reported experiencing side-effects at baseline survey. Overall, discontinuation and switching were higher among injectables and pill users, compared to IUD and implants users. Reporting more bleeding or less bleeding increased the odds of discontinuation and switching by 2.74 (95% CI 1.00–7.51) and 1.86 (1.04–3.34), respectively. There was no significant difference in discontinuation and switching by side-effects.

Conclusions

Greater attention should be paid to understanding the unique contributions of side-effects to contraceptive behavior using population-based data. While about a quarter of women reported experiencing side effects, those who experienced bleeding specific side effects were at higher risk of contraceptive discontinuation and switching. Providing greater individualized care that includes information and counseling about common side-effects, how they may impact daily life, and how tolerable these effects may be is necessary.
Appendix
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Metadata
Title
Association between experience of specific side-effects and contraceptive switching and discontinuation in Uganda: results from a longitudinal study
Authors
Linnea A. Zimmerman
Dana O. Sarnak
Celia Karp
Shannon N. Wood
Saifuddin Ahmed
Fredrick Makumbi
Simon P. S. Kibira
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Contraception
Published in
Reproductive Health / Issue 1/2021
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-021-01287-5

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