Contraceptive choice and discontinuation in selected countries in sub-Saharan Africa

Sarah Harbison, U.S. Agency for International Development (USAID)
Jacob A. Adetunji, U.S. Agency for International Development (USAID)

Getting a clearer understanding of the determinants of contraceptive choice and discontinuation is a priority issue for family planning and reproductive health programs in sub-Saharan Africa. In this paper, Demographic and Health Survey data for Ethiopia, Malawi and Zimbabwe are analyzed to investigate the reasons for the rising prevalence of injectables as well as the continued dominance of pills in Zimbabwe. Patterns and reasons for method switching and discontinuation are also investigated. The results show that convenience and secrecy are major reasons for the popularity of injectables, particularly among rural women. For example, 27% of Malawian men whose spouses reported current use of injectables reported them as not using any method of contraception. We found that discontinuation and switching were higher for the pill than for injectables. A higher proportion of pill users switch to injectables than vice versa. The program implications of these results are discussed.