Pattern of Implanon uptake in a tertiary hospital in Niger Delta, Nigeria.

Osegi Nkencho1, Makinde Olakunle I1*, Ozori Ebiogbo S1, Biakolo Akpobome1
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
*Correspondence: Dr. Olakunle I. Makinde; +234 803 213 6315; olakunleife@gmail.com

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Abstract

Background: Implants are the most effective of the contraceptive options currently available with 99.95% effectiveness. Implanon is a subdermal implant, which consists of single 4cm x 2mm ethylene-vinyl acetate (EVA) rod embedded with 68mg of etonogestrel. Experience with Implanon at the Federal Medical Centre, Yenagoa has not been documented since its introduction.
Objective: To determine Implanon uptake, socio-demographic characteristics of Implanon users, Implanon discontinuation rate, reasons for discontinuation, and the effectiveness of Implanon.
Method: A retrospective descriptive study of clients that used Implanon at the Federal Medical Centre, Yenagoa from January 2014 to December 2018. A Proforma was used to obtain data from client cards and record books at the contraception and family planning clinic. Statistical analysis was done using IBM SPSS Statistics version 22.
Results: Of the 2,701 women who used a modern contraceptive within the study period, 253 women had Implanon insertion, giving an Implanon uptake of 9.4%. Majority of Implanon users (38.1%) were aged 30-34 years. The mean age was 32.3 ± 5.4 years. Most (81.5%) had secondary education, were Christians (97.4%) and multiparous (70.5%). Most (69.5%) of them used Implanon for child spacing, and 63.1% had never used any modern contraceptive previously. Injectable contraceptives were the most common (31.9%) among previous users. Implanon discontinuation rate was 14.6%. Majority (45.5%) discontinued after two years of use, 36.4% within two years of use, 35.7% discontinued to have another child, and 32.1% because of abnormal menstrual bleeding patterns. Implanon failure rate was 0.2% per 100 women years.
Conclusion: Implanon is effective as a long-acting reversible contraceptive but its uptake is low.  Cost of insertion services, level of education of the women and prevalence of family planning myths are possible factors limiting uptake of Implanon. Out-of-pocket cost reduction, awareness programmes and counselling in local dialects are recommended.

Keywords: Modern contraceptive, Implanon, Implanon uptake, Implanon discontinuation rate, Implanon failure rate.

Cite this article: Osegi N, Makinde OI, Ozori ES, Biakolo A. Pattern of Implanon uptake in a tertiary hospital in Niger Delta, Nigeria. Yen Med J. 2020;2(1):119-129.

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