الفهرس 
coverOnly 14 pages are availabe for public view
 |  | from | 155 |  |  |
| | | from | 155 | | |
Abstract
Background Contraceptive use in Egypt doubled during the 11-year period between 1980 and 1991, from 24 percent to 48 percent. The use rate continued to rise over the next 12 years although at slower pace, reaching a level of 60 percent in 2003, where it has remained virtually unchanged, Contraceptive discontinuation is an important determinant of contraceptive prevalence. Objectives: the present study was to determine contraceptive discontinuation percentage and contraceptive prevalence rate in Beni Suef and to determine some factors affecting contraceptive discontinuation and non using methods in Beni Suef. Methodology: Data used in this study is from the survey that is conducted by the Population and Family Planning sector, Ministry of Health and Population as ongoing monitoring system. The survey provided data related to women contraceptive use, which allows the study to assess determinants of contraceptive discontinuation at the household and individual level and causes of non using methods. This survey is a comprehensive population based door-to- door survey conducted in rural Upper Egypt governorates (nine governorates) targeting 881 villages which are the poorest villages in the country. Beni Suef was selected purposively because it is one of the most deprived regions according to the Egypt human development report 2010. The study population is married women aged 15–49 years who are residents in the targeted villages in Beni Suef. All available data concerning the poorest 130 villages. Results : The study revealed that, Contraceptive prevalence rate (CPR) is 53.5% in studied female, Women who discontinue their contraceptive use (ex –users ) stands at 17.3% of studied women ( married women of reproductive age),. The most commonly used method among all studied women in the present study was the IUD (27%) followed by injectables (15%), oral pills (10%), Implants (1%) and. Barrier methods was the least in use constituting 0.06%. Employment status is associated with current use of family planning methods, that working women employed in a job were more likely to be currently using family planning methods than not working women (60% and 53%, respectively), On the other side, the present study shows that employment status does not play a significant role in contraceptive discontinuation. Age is associated with current family planning practice, use of any contraceptive method generally rises with age, Intermediate education & highly educated women are using contraception more than illiterate &less than intermediate education women. Also, the risk of discontinuing contraception methods will decrease by increasing the woman’s education level. In the present research highly educated women showed the least percent of discontinuation. Wide variation in contraceptive use between districts, the highest contraceptive prevalence rate (CPR) is in Bani suef districts (61%) and the lowest CPR is in Somosta district (43.7%), and the highest contraceptive discontinuation percentage is in Somosta district (22.4%) and the lowest contraceptive discontinuation percentage in Pepa district is (14.7%). The most common method used before discontinuation is intrauterine device (IUD) by 38.7%, the second method is injectables by 34.2%, the third is oral pills by 25.6%. The type of contraceptive method used is associated with the source. The source of injectables used before discontinuation mainly is primary Healthcare Units (PHC) by 83.4 %, and the main source of IUD which used before discontinuation is also PHC unit (57.5%) and the second source of IUD is mobile clinic (26%), The majority of IUD users rely on public sector sources for the method. Reliance on public sector sources for the IUD is most frequent in rural areas; while the main source of oral pills is pharmacy (57.7%), The most common causes of discontinuation are desire to get pregnant (34.3%), health concerns (19.6%), absence of husband (17.5%), method failure (11.8%),
The desire to pregnancy as a main cause of discontinuation decreases significantly when age increase, The study finding presents that, desire to get pregnant was most often cited reason for discontinuations among IUD users (44 %) , pill users (32 %) and injectables ( 26 %). Health concerns as a prominent cause of discontinuation increases significantly when age increases, The present study shows that, health concerns represent 31% of all discontinuation of injectables, and they were the second most common cause of discontinuation among implants and IUD users, (25.4% and 14.3% respectively) and health concerns represent 12.5% of all causes of discontinuation among oral pills users. Health concerns decreases significantly when education level increases,. The lowest percent of the cause method failure is in the age group from (45-49 years) by percent 0.8%, this reflects that women in the age group from 45 – 49 are so keen & have experience to correct use of contraception.
Method failure represents 7.5% among injectables users, and represents 14.8% among oral pills, and 13.7% among IUD users to reach 21.7% in condom as the last method used before discontinuation. Husband’s disapproval was also rarely cited as a main factor affecting the decision to discontinue use.
The most common cause of never use of contraception is desire to get pregnant (41.1%), the second cause is, health concerns & fear of methods represent (18.2%), while lack of awareness of FP methods represent 0.03% and religious causes represent small percent 0.3%. and family opposition represent 4.6%. Health concerns increases significantly with increasing age, it represent 15% in younger women (less than 30 years ) and represent 26% in older women (30 years & older) and desire to pregnancy decreases significantly with increasing age, it represent 50% of all causes of discontinuation in women less than 30 years, and represent 20% in older women (30years &older). Family opposition represents 5.3% in illiterate & less than intermediate education and 2.9% in intermediate education &higher education. So the study recommend that there is a need to improve counseling between the service providers and the clients on the side effects that may experience and appropriate response if side effects occur, providers should encourage women to return for regular follow-up care and for assistance if they have problems with the method that they adopt and also increasing women’s autonomy would help them to increase their ability to conduct discussions with their husband, and in turn will increase the frequency of that discussion with the husband was found to be one of the predictors of contraceptive discontinuation.
Text in English, abstracts in Arabic and English.