Prevalence of contraceptive implant discontinuation among women who used implant in Ethiopia: Systemic review and meta-analysis

Abstract

The likelihood of contraceptive implant discontinuation is very common and varies worldwide. This high prevalence of discontinuation may also indicate problems with implementation of family planning programmes. Consequently, a significant number of women are exposed to conception after discontinuation. Although studies have been conducted in Ethiopia, there are inconsistencies across studies. Therefore, this meta-analysis aimed to estimate the pooled prevalence of contraceptive implant discontinuation among women in Ethiopia. Published articles from various electronic databases such as PubMed/MEDLINE, Google Scholar, Science Direct, AJOL and Cochrane library were systematically searched. All cross-sectional studies conducted on prevalence of contraceptive implant discontinuation and published up to 30 January 2022 were included in this review. To estimate the pooled prevalence, random effect model was used and a subgroup analysis was performed to identify the possible source of heterogeneity. Begg’s and Egger’s tests were used to identify possible publication bias. A total of 13 cross-sectional studies with 5012 participants were included. Significant heterogeneity was observed across studies (I2 = 98.2%). However, there was no evidence of publication bias (p = 0.066). The estimated pooled prevalence of contraceptive implant discontinuation in Ethiopia was found to be 36.95% (95% confidence interval = 27.6–46.3). A subgroup analysis by time of discontinuation indicated that 21.5%, 42.2% and 33.5% of contraceptive implant user discontinue within 12 months, 2.5 years and 3 years, respectively. This meta-analysis indicated that the prevalence of discontinuation of contraceptive implant was found to be high in Ethiopia. Therefore, strengthening the appropriate counselling prior to insertion and proper follow-up, independent choice will improve the proportion of implants retention.