Determinants of early implanon removal among reproductive-age women in Ofla woreda, Tigray region, northern Ethiopia: A case-control study

Abstract

Background

Implanon is a single-rod, long-acting reversible contraceptive (LARC) that provides effective pregnancy prevention for up to three years after insertion. Despite its efficacy and convenience, early removal of implanon remains to receive little attention universally.

Objectives

To determine the associated factors of early Implanon removal among reproductive age women (15- 49) in Ofla Woreda , Tigray region, Ethiopia.

Methods

This study employed an unmatched case-control design. Women who discontinued Implanon use early were recruited as cases (n=139) whereas those  women who continued using Implanon for more than two years were considered as controls (276). A  1:2 ratio for cases and controls were used, respectively. A systematic sampling technique was used to select study participants within a sample population. Individual consent was obtained from each participant. Finally, multiple variable logistic regression analyses was used to identify factors associated with early Implanon removal with 95% CI. SPSS version 20 was used to analyzed the data.

Result:

After controlling for the effect of other factors, menstrual irregularities, prolonged vaginal bleeding, weight gain, acne, amenorrhea, headache, hair loss, and lack of knowledge about Implanon were significantly associated with early removal of Implanon. women with menstrual irregularities were 4.5 more odds to remove Implanon early than those without (AOR=4.5, 95% CI:2.4, 8.6).

Conclusion

This study identified the critical role of comprehensive pre-Implanon insertion counseling, especially regarding common side effects, in preventing early implant removal. To enhance patient satisfaction and adherence, it is imperative to implement community-based awareness campaigns about potential side effects and provide targeted training programs for family planning providers on effective counseling techniques.