Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-30T00:31:56.099Z Has data issue: false hasContentIssue false
  • English
  • Français

The recent increase in contraceptive discontinuation in Egypt

Published online by Cambridge University Press:  20 May 2019

Mona Khalifa ,
Wafaa Abdelaziz ,
Soha Metwally  and
Ehab Sakr
Mona Khalifa
Affiliation:
Department of Biostatistics and Demography, Institute of Statistical Studies and Research (ISSR), Cairo University, Giza, Egypt
Wafaa Abdelaziz
Affiliation:
Department of Biostatistics and Demography, Institute of Statistical Studies and Research (ISSR), Cairo University, Giza, Egypt
Soha Metwally*
Affiliation:
Department of Biostatistics and Demography, Institute of Statistical Studies and Research (ISSR), Cairo University, Giza, Egypt
Ehab Sakr
Affiliation:
Department of Biostatistics and Demography, Institute of Statistical Studies and Research (ISSR), Cairo University, Giza, Egypt
*
*Corresponding author. Email: monakhalifa2010@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

This study sought to establish whether recent changes in discontinuation of contractive use and switching in Egypt can be considered an important cause of the unexpected increase in overall fertility and slight fall in contraceptive prevalence in the country. The analysis was based on calendar data from the 2008 and 2014 Egyptian DHS. Single/multiple decrement life tables were built to calculate contraceptive discontinuation rates and examine these by reasons for discontinuation focusing on three methods: IUDs, pills and injectables. The unit of the analysis was ‘segment of use’, defined as a continuous period of use/non-use of a contraceptive method (in months). It was found that over the period 2008–2014 the rise in the ‘all method’ discontinuation rate was mainly due to the shift away from IUDs to hormonal methods, which have higher discontinuation rates. Segments of use were more likely to be discontinued for ‘method/service-related’ reasons than for ‘reduced need’ reasons. This was due to an increase in contraceptive failure and side-effect/health concerns. Also, ‘the desire to get pregnant’ increased to become the second highest reason-specific discontinuation rate. This has coincided with a recent increase in ideal family size in Egypt. About half of the women who reported discontinuing for reasons related to method/services switched to another method, while the rest became subject to the risk of an unintended pregnancy. The rate of switching, rather than stopping use, increased for IUDs, remained the same for pills and increased slightly for injectables, indicating an improvement in switching behaviour. However, a marked high percentage of switchers moved to less-effective methods. If these issues are not addressed, many women in Egypt have an unmet need for contraception, leading to an increase in unintended pregnancies. Specific interventions that would greatly benefit the family planning programme in Egypt include improvement in counselling at the time of IUD insertion and removal and the reduction in failure rates for hormonal methods.

Keywords

DiscontinuationFamily planningEgypt
Type
Short Report
Information
Journal of Biosocial Science , Volume 52 , Issue 1 , January 2020 , pp. 154 - 157
Copyright
© Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ali, M, Cleland, J and Shah, I (2012) Causes and Consequences of Contraceptive Discontinuation: Evidence from 60 Demographic and Health Surveys. World Health Organization, Geneva.Google Scholar
Ali, M, Sadler, R, Cleland, J, Ngo Thoai, D and Shah, I (2011) Long-term Contraceptive Protection, Discontinuation and Switching Behavior: Intrauterine Device (IUD) Uses Dynamics in 14 Developing Countries. World Health Organization and Marie Stopes International, London.Google Scholar
Jain Anrudh, K, Obare, F, RamaRao, S and Askew, I (2013) Reducing unmet need by supporting women with met need. International Perspectives on Sexual and Reproductive Health 39(3), 133–141.CrossRefGoogle Scholar
Ministry of Health and Population [Egypt], El-Zanaty and Associates [Egypt] and ICF International (2015a) Egypt Demographic and Health Survey 2014. Cairo, Egypt and Rockville, MD, USA.Google Scholar
Ministry of Health and Population [Egypt], El-Zanaty and Associates [Egypt] and ICF International (2015b) Egypt Health Issues Survey 2015. Cairo, Egypt and Rockville, MD, USA.Google Scholar
National Population Council (2015) National Strategic Population Plan 2015–2030. National Population Council, Cairo.Google Scholar