Uptake of long-acting reversible contraceptives in north central Nigeria: a five-year review
Keywords:LARC, Contraception, Uptake, Acceptors
Background: Long-acting reversible contraceptives (LARC) are methods used in the prevention of pregnancy that are long lasting. They are effective and efficacious methods of contraception and return to fertility after removal is prompt. Objectives was to determine the uptake of long-acting reversible contraception and assess the characteristics of acceptors of these methods in the area.
Methods: This was a retrospective study of clients’ who visited the family planning unit of the University of Abuja teaching hospital over a 5-year period, from 01 January 2015 to 31 December 2019. Information on socio-demographic characteristics and specific methods selected were extracted from their records and represented on simple tables, graphs, and charts.
Results: A total of one thousand eight hundred and ninety-one (1,891) clients accepted available methods of contraceptives during the five-year study period. One thousand seven hundred and twenty-four (1,724) accepted LARC (91.1%) while only one hundred and sixty-seven (167) accepted non-LARC (8.9%). Majority 946 (54.9%) of the clients that accepted LARC were aged between 30-39 years and clients less than 20 years were 22 (1.3%). Clients with parity 3 and above were 1162 (67.7%), and majority of LARC acceptors wanted more children 1145 (66.4%). Amongst the LARC acceptors, most of the clients opted for subdermal implant either Jadelle or Implanon 940(49.7%). Three hundred and ninety-eight (23.1%) discontinued a form of LARC during the study period while 1127 (65.4%) continued with one form of LARC or another.
Conclusions: The uptake of LARC in this region is very high. Teenagers and low parity rarely attended the family planning clinic.
World Population Prospects - Population Division - United Nations. Available at: https://population.un.org/wpp/. Accessed on 17 December 2020.
Oranu EO, Ojule JD. A Decade of Jadelle Subdermal Implant Contraception in a Tertiary Health Institution in Port Harcourt, Southern Nigeria. J Biosci Med. 2018;6(3):123-30.
The Federal Republic of Nigeria Nigeria Demographic and Health Survey 2018 National Population Commission Abuja, Nigeria. 2019. Available at: www.DHSprogram.com. Accessed on 17 December 2020.
Eke AC, Alabi-Isama L. Long-acting reversible contraception (LARC) use among adolescent females in secondary institutions in Nnewi, Nigeria. J Obstet Gynaecol (Lahore). 2011;31(2):164-8.
Practice Bulletin No. 186 Summary: Long-Acting Reversible Contraception: Implants and Intrauterine Devices. Obstet Gynecol. 2017;130(5):1173-5.
Id SAA, Omisakin OA, Somefun OD. Trends, patterns and determinants of long-acting reversible methods of contraception among women in sub-Saharan Africa. 2019. Available at: https://doi.org/10.1371/journal.pone.0217574. Accessed on 24 November 2020.
Mbanaso AU, Mbanuso EL, Eyinnaya OG, Okwuonu CG. Foreign body in the rectum of a Nigerian adolescent youth. Ann Biomed Sci. 2020;19(1):10-5.
Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices Committee on Adolescent Health Care Long-Acting Reversible Contraception Work Group. 2018. Available at: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/ adolescents-and-long-acting-reversible-contraception-implants-and-intrauterine-devices. Accessed on 24 November 2020.
Adedini SA, Omisakin OA, Somefun OD. Trends, patterns and determinants of long-acting reversible methods of contraception among women in sub-Saharan Africa. PLoS One. 2019;14(6).
Envall N, Groes Kofoed N, Kopp-Kallner H. Use of effective contraception 6 months after emergency contraception with a copper intrauterine device or ulipristal acetate – a prospective observational cohort study. Acta Obstet Gynecol Scand. 2016;95(8):887-93.
Ezegwui H, Onoh R, Ikeako L, Onyebuchi A, Umeorah J, Ezeonu P, et al. Investigating Maternal Mortality in a Public Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. Ann Med Health Sci Res. 2013;3(1):75.
Mohammed DA, Joel A, Bature S, Abubakar A, Mohammed C, Taingson M. Uptake and Predictors of Long-Acting Reversible Contraceptives among Women in a Tertiary Health Facility in Northern Nigeria. J Basic Clin Reprod Sci. 2017;6(2):80-4.
Egede JO, Onoh RC, Umeora OUJ, Iyoke CA, Dimejesi IBO, Lawani LO. Contraceptive prevalence and preference in a cohort of south–east Nigerian women. Patient Prefer Adherence. 2015;9:707-14.
Disney EA, Sanders JN, Turok DK, Gawron LM. Preconception Counseling, Contraceptive Counseling, and Long-Acting Reversible Contraception Use in Women with Type I Diabetes: A Retrospective Cohort Study. Women’s Heal Reports. 2020;1(1):334-40.
Ochako R, Temmerman M, Mbondo M, Askew I. Determinants of modern contraceptive use among sexually active men in Kenya. Reprod Health. 2017;14(1):1-15.
Agida, Da I, Adebayo FO. Current Trend in Method Choice among Users of Highly Effective Contraceptives in a Nigerian Tertiary Hospital. J Res Basic Clin Sci. 2019;1.
Nyasulu P, Methazia J, Ngamasana E, Ogunrombi M. Maternal anemia in HIV infected pregnant women on ART attending Themba Lethu Clinic at Helen Joseph Hospital, Johannesburg, South Africa. 2020. Available at: https://posterng.netkey.at/isid/ viewing/index.php?module=viewing_poster&task=&pi=2052. Accessed on 24 August 2020.
Fasubaa O, Sowemimo O, Ayegbusi O, Abdur-Rahim Z, Idowu B, Ayobami O, et al. Contributions of uterine fibroids to infertility at Ile-Ife, South-Western Nigeria. Trop J Obstet Gynaecol. 2018;35(3):266.
Madugu NH, Abdul MA, Bawa U, Kolawole B. Uptake of Hormonal Implants Contraceptive in Zaria, Northern Nigeria. Open J Obstet Gynecol. 2015;5(5):268-73.
Power J, Power J, French R, Cowan F. Subdermal implantable contraceptives versus other forms of reversible contraceptives or other implants as effective methods of preventing pregnancy. Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd. 2007.
Li JL, Kilembe W, Inambao M, Vwalika B, Parker R, Sharkey T, et al. Fertility intentions and long-acting reversible contraceptive use among HIV-negative single mothers in Zambia. Am J Obstet Gynecol. 2020;222(4):917.
Chigbu B, Onwere S, Aluka C. CK-NJ of, 2010 undefined. Contraceptive choices of women in rural Southeastern Nigeria. Available at: https://www.ajol.info/index.php/njcp/article/download/53507/42082. Accessed on 24 August 2020.
Ayogu M, Omonua K, Medicine MA-NJ of, 2019 undefined. A 10-year experience with copper T Intrauterine Device (IUD) in Abuja, Nigeria. Available at: https://www.ajol.info/index.php/njm/article/view/188294. Accessed on 24 August 2020.
Balogun O, Olaomo N, Adeniran A, Fawole A. Implanon sub-dermal implant: an emerging method of contraception in Ilorin, Nigeria. J Med Biomed Sci. 2014;3(1):1.
Muhammad Z, Maimuna D. Contraceptive trend in a tertiary facility in North Western Nigeria: A 10-year review. Niger J Basic Clin Sci. 2014;11(2):99.
Trend of modern contraceptive uptake and its predictors among women accessing family planning service in a tertiary hospital in Northwestern Nigeria, 2000–2014. Trop J Obstet Gynaecol. 2017;34(3):201-6.
Ohazurike E, Olamijulo JA, Olorunfemi G, Oluwole AA. Predictors of Discontinuation of Subdermal Levonorgestrel Implants (Jadelle) at the Lagos University Teaching Hospital, Lagos, Nigeria: An Analytic Cohort Study. Niger African J Reprod Health. 2020;24(2):48-63.