Task-shifting and family planning continuation: contraceptive trajectories of women who received their method at a community-based event in Kinshasa, DRC

Abstract

Plain Language Summary In countries with insufficient access to health facilities, such as the D. R. Congo, the provision of contraceptives through campaigns implemented in community settings is a commonly used strategy to increase the number of contraceptive users. However, the long-term trajectories of campaign clients are not often examined, and it is unclear whether these events can be an effective way to support women’s choices and preferences when it comes to using, switching or stopping a contraceptive method. Our study looks at the contraceptive trajectories of 883 women who obtained a method during a community event to see whether they were still using that a modern contraceptive method 3 and 6 months later. Almost a third of the women discontinued at some point in that period, with much higher discontinuation rates for monthly pills and injectable contraceptives. While some individual characteristics (marital status, desired number of children, experienced side-effects) influenced discontinuation risk, the most important factor was the woman’s ability to resupply her method. Implant removal was also much lower than expected and this suggested difficulties in accessing existing family planning services. Our findings indicate that campaigns are still too disconnected from existing family planning services to successfully support women’s contraceptive choices in the long run.