Patterns and determinants of modern contraceptive discontinuation among women of reproductive age: Analysis of Kenya Demographic Health Surveys, 2003-2014

• Published in: PloS one 2020-11, Vol.15 (11), p.e0241605-e0241605
• Main Authors: Ontiri, Susan, Were, Vincent, Kabue, Mark, Biesma-Blanco, Regien, Stekelenburg, Jelle
• Format: Article
• Language: English
• Subjects: Adult; Age; Biology and Life Sciences; Birth control; Calendars; Condoms; Confidence intervals; Contraception; Contraception Behavior - psychology; Contraception Behavior - statistics & numerical data; Contraceptive Agents, Female - therapeutic use; Contraceptive Devices, Female - statistics & numerical data; Contraceptives; Demographics; Dosage and administration; Drug Utilization - trends; Engineering and Technology; Family planning; Female; Fertility; Health Knowledge, Attitudes, Practice; Health sciences; Health Surveys; Humans; Intrauterine devices; IUD; Kenya; Maternal mortality; Medicine and Health Sciences; Methods; Middle Aged; People and Places; Physical Sciences; Polls & surveys; Pregnancy; Questionnaires; Regression analysis; Research and Analysis Methods; Secondary analysis; Side effects; Sociodemographics; Statistical analysis; Statistics; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241605

This study aimed to examine patterns and determinants of modern contraceptive discontinuation among women in Kenya. Secondary analysis was conducted using national representative Kenya Demographic and Health Surveys of 2003, 2008/9, and 2014. These household cross-sectional surveys targeted women of reproductive age from 15 to 49 years who had experienced an episode of modern contraceptive use within five years preceding the surveys from 2003 (n = 2686), 2008/9 (n = 2992), and 2014 (5919). The contraceptive discontinuation rate was defined as the number of episodes discontinued divided by the total number of episodes. Weighted descriptive statistics, multivariable logistic regression analysis, and Cox proportional hazards analysis were used to examine the determinants of contraceptive discontinuation. The 12-month contraceptive discontinuation rate for all methods declined from 37.5% in 2003 and 36.7% in 2008/9 to 30.5% in 2014. Consistently across the three surveys, intrauterine devices had the lowest 12-month discontinuation rate (6.4% in 2014) followed by implants (8.0%, in 2014). In 2014, higher rates were seen for pills (44.9%) and male condoms (42.9%). The determinants of contraceptive discontinuation among women of reproductive age in the 2003 survey included users of short-term contraception methods, specifically for those who used male condoms (hazard ratio [HR] = 3.30, 95% confidence interval [CI] = 2.13-5.11) and pills (HR = 2.68; 95CI = 1.79-4.00); and younger women aged 15-19 year (HR = 2.07; 95% CI = 1.49-2.87) and 20-24 years (HR = 1.94; 95% CI = 1.61-2.35). The trends in the most common reasons for discontinuation from 2003 to 2014 revealed an increase among those reporting side effects (p = 0.0002) and those wanting a more effective method (p