Factors associated with the discontinuation of modern contraceptive methods among lactating women in nine West African high-fertility countries: findings of the most recent demographic and health surveys
Abstract Introduction Contraception discontinuation is a concern, especially if it occurs in breastfeeding women, thereby exposing them to a high risk of close and unwanted pregnancies. Our study aimed to measure the prevalence and identify the individual and community-level factors associated with...
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2025-01-01
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| Series: | Archives of Public Health |
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| Online Access: | https://doi.org/10.1186/s13690-025-01506-6 |
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| author | Abou Coulibaly Adama Baguiya Denise Kpebo Augustin Zango Halima Tougri Franck Garanet Seni Kouanda |
| author_facet | Abou Coulibaly Adama Baguiya Denise Kpebo Augustin Zango Halima Tougri Franck Garanet Seni Kouanda |
| author_sort | Abou Coulibaly |
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| description | Abstract Introduction Contraception discontinuation is a concern, especially if it occurs in breastfeeding women, thereby exposing them to a high risk of close and unwanted pregnancies. Our study aimed to measure the prevalence and identify the individual and community-level factors associated with the discontinuation of modern contraceptives among breastfeeding women. Methods This was a secondary analysis of retrospective data of the most recent Demographic and Health Surveys (DHS) data from nine high-fertility rate countries, conducted mostly between 2018–2021. We reported weighted frequencies of modern contraceptives discontinuation (binary variable, coded 1 and 0). The independent variables included individual-level variables, including sociodemographic characteristics, female reproduction and family planning history, the women and their households exposure to media, and community-level ones such as place of residence (urban and rural) and country. Multilevel-modified Poisson regression was used to identify associated factors at the 5% threshold. Results The overall prevalence of modern contraceptives discontinuation was 13.1% among 5,599 lactating mothers, with wide variations between countries (prevalence ranging from 8.2% in Sierra Leone to 33.6% in Guinea). Women were more likely to discontinue contraception if they were the head of the household (adjusted prevalence ratio (aPR) = 1.71; 95% CI [1.17–2.50]; p = 0.006). In addition, compared to implant users, women using pills (aPR = 3.06; 95% CI [2.24–4.16]; p < 0.001), those using injectables (aPR = 2.80; 95% CI [2.16–3.62]; p < 0.001), and women whose partners used condoms (aPR = 2.30; 95% CI [1.47–3.59]; p < 0.001) were more likely to discontinue contraception. Moreover, women who were not sexually active (aPR = 2.11; 95% CI [1.75–2.54]; p < 0.001) and those who wanted children within two subsequent years (aPR = 1.84; 95% CI [1.36–2.48]; p < 0.001) were more likely to discontinue contraception. Finally, method discontinuation varied by country, with women in Gambia, Guinea, Mauritania, and Mali more likely to discontinue a modern contraceptive method than those living in Burkina Faso. Conclusion To improve the retention of women using contraceptive, high-fertility rate countries need to focus on contraceptive education, communication about side effects, dissemination of family planning messages through the media, and regular monitoring of women taking contraceptives. |
| format | Article |
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| institution | Kabale University |
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| spelling | doaj-art-b9e45968766c4f18aa0157a04b8418b82025-01-26T12:16:20ZengBMCArchives of Public Health2049-32582025-01-0183111510.1186/s13690-025-01506-6Factors associated with the discontinuation of modern contraceptive methods among lactating women in nine West African high-fertility countries: findings of the most recent demographic and health surveysAbou Coulibaly0Adama Baguiya1Denise Kpebo2Augustin Zango3Halima Tougri4Franck Garanet5Seni Kouanda6Département Biomédical et Santé Publique, Institut de Recherche en Sciences de La Santé (IRSS)Département Biomédical et Santé Publique, Institut de Recherche en Sciences de La Santé (IRSS)Unité de Formation Et de Recherche en Sciences Médicales d’Abidjan (DSPIM-UFR/SMA), Université Félix Houphouet BoignyInstitut Africain de Santé Publique (IASP)Département Biomédical et Santé Publique, Institut de Recherche en Sciences de La Santé (IRSS)Département Biomédical et Santé Publique, Institut de Recherche en Sciences de La Santé (IRSS)Département Biomédical et Santé Publique, Institut de Recherche en Sciences de La Santé (IRSS)Abstract Introduction Contraception discontinuation is a concern, especially if it occurs in breastfeeding women, thereby exposing them to a high risk of close and unwanted pregnancies. Our study aimed to measure the prevalence and identify the individual and community-level factors associated with the discontinuation of modern contraceptives among breastfeeding women. Methods This was a secondary analysis of retrospective data of the most recent Demographic and Health Surveys (DHS) data from nine high-fertility rate countries, conducted mostly between 2018–2021. We reported weighted frequencies of modern contraceptives discontinuation (binary variable, coded 1 and 0). The independent variables included individual-level variables, including sociodemographic characteristics, female reproduction and family planning history, the women and their households exposure to media, and community-level ones such as place of residence (urban and rural) and country. Multilevel-modified Poisson regression was used to identify associated factors at the 5% threshold. Results The overall prevalence of modern contraceptives discontinuation was 13.1% among 5,599 lactating mothers, with wide variations between countries (prevalence ranging from 8.2% in Sierra Leone to 33.6% in Guinea). Women were more likely to discontinue contraception if they were the head of the household (adjusted prevalence ratio (aPR) = 1.71; 95% CI [1.17–2.50]; p = 0.006). In addition, compared to implant users, women using pills (aPR = 3.06; 95% CI [2.24–4.16]; p < 0.001), those using injectables (aPR = 2.80; 95% CI [2.16–3.62]; p < 0.001), and women whose partners used condoms (aPR = 2.30; 95% CI [1.47–3.59]; p < 0.001) were more likely to discontinue contraception. Moreover, women who were not sexually active (aPR = 2.11; 95% CI [1.75–2.54]; p < 0.001) and those who wanted children within two subsequent years (aPR = 1.84; 95% CI [1.36–2.48]; p < 0.001) were more likely to discontinue contraception. Finally, method discontinuation varied by country, with women in Gambia, Guinea, Mauritania, and Mali more likely to discontinue a modern contraceptive method than those living in Burkina Faso. Conclusion To improve the retention of women using contraceptive, high-fertility rate countries need to focus on contraceptive education, communication about side effects, dissemination of family planning messages through the media, and regular monitoring of women taking contraceptives.https://doi.org/10.1186/s13690-025-01506-6PrevalenceModern contraceptionDiscontinuationBreastfeeding womenAssociated factorsWest Africa |
| spellingShingle | Abou Coulibaly Adama Baguiya Denise Kpebo Augustin Zango Halima Tougri Franck Garanet Seni Kouanda Factors associated with the discontinuation of modern contraceptive methods among lactating women in nine West African high-fertility countries: findings of the most recent demographic and health surveys Archives of Public Health Prevalence Modern contraception Discontinuation Breastfeeding women Associated factors West Africa |
| title | Factors associated with the discontinuation of modern contraceptive methods among lactating women in nine West African high-fertility countries: findings of the most recent demographic and health surveys |
| title_full | Factors associated with the discontinuation of modern contraceptive methods among lactating women in nine West African high-fertility countries: findings of the most recent demographic and health surveys |
| title_fullStr | Factors associated with the discontinuation of modern contraceptive methods among lactating women in nine West African high-fertility countries: findings of the most recent demographic and health surveys |
| title_full_unstemmed | Factors associated with the discontinuation of modern contraceptive methods among lactating women in nine West African high-fertility countries: findings of the most recent demographic and health surveys |
| title_short | Factors associated with the discontinuation of modern contraceptive methods among lactating women in nine West African high-fertility countries: findings of the most recent demographic and health surveys |
| title_sort | factors associated with the discontinuation of modern contraceptive methods among lactating women in nine west african high fertility countries findings of the most recent demographic and health surveys |
| topic | Prevalence Modern contraception Discontinuation Breastfeeding women Associated factors West Africa |
| url | https://doi.org/10.1186/s13690-025-01506-6 |
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