The Discontinuation, Switching, and Contraceptive Failure Patterns of Long-Acting Reversible Contraceptive Users in Kenya (2017-2022)

Midanna de Almada, London School of Economics and Political Science (LSE)

The number of IUD and implant (LARC) users in sub-Saharan Africa is increasing yearly. Little is known about user’s experiences and their discontinuation, switching, and failure rates. Understanding user’s experiences and if these methods meet their needs can facilitate user-centered contraceptive programming and informed decision-making. This study applies event history analysis and life tables to Kenyan contraceptive calendar data to understand LARC users’ behaviors and patterns compared to short-acting users. Results show that LARC typical-use failure is much higher than reported in clinical trials and other studies measuring typical-use failure. LARC users are less likely to switch and discontinue than other users, which may signal user satisfaction or barriers to removal as reported in other countries. LARC early discontinuation due to a desire to become pregnant increases over time which may indicate a lack of knowledge related to the method’s long-acting nature and a need for improved contraceptive counseling.